More than a year and a half into the pandemic, COVID-19 case numbers in Pennsylvania are still in the thousands.Dr. Michael Ripchinski, with Penn Medicine Lancaster General Health, has been tracking the statistics since the onset of the pandemic.The number of cases isn't going in the right direction."We're seeing in Lancaster County, 12% positivity rates. That's two and half times where we want to be at this time. We're seeing cases go very high," he said.Ripchinski doesn't mind sounding like a broken record when it comes to the vaccine."It's incredibly important if you haven't gotten your vaccine yet – get your first vaccine. Get your second vaccine to follow, and hopefully get it boosted in six months," he said.He's concerned when he sees daily state caseloads in the 6,000s.WGAL asked him: Who are the thousands of people getting sick?"We're certainly seeing contributions from those that are unvaccinated, those that are shopping more, getting ready for the holidays. We're certainly seeing masks in the schools are now reduced, and as a result, we're going to see spread," he said.Ripchinski acknowledges that more than 12% are breakthrough cases, but the rest are unvaccinated."The vaccine is absolutely making a difference. Even if you've had COVID-19 and you're worried about whether or not you should get vaccinated, definitely consider getting a vaccine at this point," he said.From Jan. 1 to Nov. 10, the state says 88% of COVID-19 cases were unvaccinated or not fully vaccinated. Ninety percent of people in a hospital with COVID-19 were unvaccinated or not fully vaccinated.