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LOS ANGELES (AP) — California health officials are pleading with people to get vaccinated for COVID-19 as infections and hospitalizations continue a worrying rise.

The state on Thursday reported nearly 5,600 new cases and the average positive-test rate over seven days was 4.9% — a nearly five-fold increase over last week. Most cases are among the unvaccinated and fueled by the highly transmissible delta variant.

On Thursday, health officers in Contra Costa, Santa Clara and San Francisco counties in the Bay Area urged employers to require vaccinations for workers and masks for those who weren’t fully vaccinated.

In San Diego this week, county health officials urged residents to voluntarily get their shots.

“The best protection we have against COVID-19 is getting vaccinated,” said Dr. Wilma Wooten, county public health officer. “The vaccines are extremely effective at preventing serious illness from COVID-19. If you have not gotten immunized, do it now.”

In the past seven days, 3,465 COVID-19 cases were reported in San Diego County. That’s 1,566 or 82% more cases than the previous seven-day period.

Hospitalizations due to COVID-19 are also trending up. The daily total rose above 100 on July 6 and has remained above that threshold since. Hospitalizations are likely to increase, a county spokesman said, since they typically do after increases in cases.

There has also been a very slight increase in post-vaccination infections, meaning people got infected with COVID-19 even though they were fully vaccinated.

Wooten said that was expected and that breakthrough cases typically have mild symptoms.

“This does not mean the vaccine is not working. Quite the opposite, the vaccine is doing what it’s supposed to do: keep most people from being hospitalized, or worse, dying,” she said.