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New COVID-19 vaccine boosters are now widely available in the Twin Cities this week, amid low but persistent pandemic numbers in Minnesota and an uncertain fall and winter.

Pandemic trends in Thursday's weekly state report showed little change — with publicly reported coronavirus infections remaining at about 1,400 per day and Minnesota seeing some four to six COVID-19 deaths per day. The state's death toll is 13,153 since the start of the pandemic in March 2020.

Linda Boss was motivated Tuesday as she became one of the first Minnesotans to receive a new COVID-19 booster, which increases protection against original strains of the coronavirus and also the BA.5 and BA.4 variants that are causing almost all infections right now. The 79-year-old Roseville woman wanted the added protection ahead of a church group trip to Ireland this month to learn about Celtic culture.

"I didn't happen to have any reaction at all, but sometimes there is a reaction and I wanted to get that over with before I was ready to take off," she said.

Booster appointments were available at many retail pharmacies on Tuesday and at the state's Mall of America vaccination site Thursday. The state's Duluth site will provide the boosters when it opens as scheduled Sunday. All booster shots for people 12 and older involve the new formulation.

Infectious disease experts are perplexed by the COVID-19 numbers this summer that haven't increased but haven't declined either. COVID-19 patients filled 425 inpatient beds in Minnesota hospitals on Tuesday, including 40 people in intensive care. That is well below the peak of 1,680 hospitalizations during last winter's pandemic wave, but it leaves Minnesota in a rut between 200 and 600 hospitalizations since early March.

Those flat-line trends have inspired public confidence, though. Last week's traffic at retail and entertainment destinations in Minnesota was 5% above average for the first time since Labor Day weekend 2021, according to Google, which uses aggregate cell phone usage to assess mobility. Retail traffic was 20% below normal in late January during the omicron COVID-19 wave.

Mobility levels in workplaces have remained 20% below typical in Minnesota all summer, but levels in bus and train stations have steadily increased. Buoyed by State Fair traffic, transit mobility levels were only 5% below normal last week, an improvement from 13% below normal at the same time last year and 33% below normal the year before that.

Minnesota's COVID-19 prevention strategy this fall will be based more on individual efforts rather than collective requirements such as mask mandates. One step announced Thursday was the expansion of the COVIDaware MN smartphone app, allowing for people with positive home test results to anonymously alert close contacts of exposure risks.

The app uses Bluetooth technology on mobile devices to determine if infected people were in close contact with others. Notification until now has only occurred with publicly reported COVID-19 test results.

While Gov. Tim Walz hailed the new Moderna and Pfizer boosters as "another step forward in fighting COVID-19," some health officials worry that public overconfidence and vaccine skepticism could reduce their uptake. Minnesota ranks second-best among states in its rate of COVID-19 boosters, but only 65% of its adults have received the recommended shots.

Provisional federal approval of the new boosters was based on human clinical trials of initial versions that were tailored against the BA.1 omicron variant, and based on mouse research on updated versions that targeted BA.5 and BA.4. Approval in advance of human data ensured that the boosters would be available while these variants remain dominant.

While this approach is commonly used to approve seasonally updated flu vaccines, skeptics might criticize its use with the newer COVID-19 vaccines, said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy.

The new COVID-19 boosters appear safe and as good or better than older versions, he said, "but when people say this vaccine has only been tested on mice, at that point that becomes a reason for people not to get vaccinated."

Boss wasn't one of those people. She has sought COVID-19 vaccines and boosters whenever recommended, only once experiencing mild arm soreness as a result. She got her COVID-19 booster in one arm Tuesday then her flu shot in the other arm.

"I happen to believe in vaccines and the value of vaccines," she said. "Some people don't but I just happen to think, 'yup, they seem to work for me.' "