Tokyo adopted tougher measures against the coronavirus Monday as it struggles to curb the rapid spread of a more contagious variant ahead of the Olympics in a country where less than 1% of people have been vaccinated.

Japan started its vaccination drive with medical workers and expanded Monday to older residents, with the first shots being given in about 120 selected places around the country.

The tougher COVID-19 rules, just three weeks after a state of emergency ended in the capital, allow Tokyo’s governor to mandate shorter opening hours for bars and restaurants, punish violators and compensate those who comply. The measures remain through May 11.

The status was also raised for Kyoto in western Japan and the southern island prefecture of Okinawa, where cases have surged in recent weeks. The near-emergency status there is to continue through May 5, the end of Japan’s “Golden Week” holidays, to discourage traveling.

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Tokyo Gov. Yuriko Koike has asked residents to avoid nonessential trips and practice social distancing. She asked bars and restaurants in many areas of the prefecture to close at 8 p.m.

An elder care home in downtown Tokyo was among the locations where vaccines were being administered Monday.

But Koike urged residents to buckle up and be cautious while vaccinations are in an early stage.

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“We are still unarmed as we fight against the resurgence of the infections,” Koike said. “Please follow the guidelines.”

Health officials also will patrol bars and restaurants to ensure safety measures are observed, and testing will be increased at elderly care facilities.

The alert status had been raised a week ago for pats of western prefectures of Osaka and Hyogo, as well as Miyagi in the north. Fifteen cities in the six prefectures, including downtown Tokyo, are now under elevated virus measures.

The non-binding emergency ended in the Tokyo area on March 21. Tokyo’s return to the alert status Monday underscores the difficulty of balancing anti-virus measures and the economy. Suga’s government has been criticized for being too slow in enacting anti-virus measures out of a reluctance to further damage the pandemic-hit economy.

Japan has managed the pandemic better than the United States and many countries in Europe, but not so well compared to other Asian countries and vaccinations have largely lagged behind due to limited supplies of the Pfizer vaccine, which is the only one approved in Japan which so far entirely relies on imports.

In Hachioji city in western Japan, a first group of elderly residents had their first shots Monday. But officials are expecting a slow start due to limited shipment at the beginning. It will be the end of June when Japan will have enough vaccine to cover the elderly population of 36 million, officials said.

Just over 1 million people in Japan have received the first of two vaccine doses, and the surge in cases may cause further cancellations of Olympic-related events.

Inoculations started in mid-February for medical workers, and the campaign will focus on older people through late June. The rest of the population is likely to have to wait until about July, making it almost impossible for Japan to reach so-called herd immunity before the Tokyo Olympics begin on July 23.