Once 70% of seniors are vaccinated by the end of March, Minnesota's COVID-19 vaccine rollout will move on to people with underlying health conditions and workers at high risk for infection.
The next phase, unveiled by state health officials Thursday, will be in four tiers, eventually getting to all Minnesotans 50 and older and finally expanding this summer to any adults left in the general public.
"The next phase is going to protect Minnesotans at higher risk of exposure and severity of illness," Minnesota Health Commissioner Jan Malcolm said.
Health officials hope the new, rough timetable will reassure anxious Minnesotans who haven't had any idea when they will be eligible for vaccination. The pandemic has caused 6,450 deaths and 481,831 known infections with the novel coronavirus that causes COVID-19.
Vaccination might occur even faster because the plan is based on continued 5% growth in weekly doses to Minnesota. Increased shipments are likely, especially with a third COVID-19 vaccine — one by Johnson & Johnson — nearing federal approval.
"This is predicated on our current allocation of vaccines," Gov. Tim Walz said. "Everything I see leads me to believe it is not going to be less, it is going to be more."
Walz said Minnesota is on pace to complete its vaccination goal for seniors by the end of March, despite some people being hesitant and others not returning to the state until winter is over. "We are continuing the focus on those seniors until we hit about 70 percent," he said.
After that, the highest priority has been assigned to 45,000 workers in food processing plants, which have seen many outbreaks in the pandemic.
"The food supply of the entire nation relies on us," Malcolm said. "There are many reasons to prioritize this group."
People with high-risk medical conditions will also be first in the next wave.
That includes people receiving cancer treatment and those with sickle cell disease, Down syndrome, chronic obstructive pulmonary disease, congestive heart failure and anyone immunocompromised due to organ transplants.
Together, those conditions account for 75% of all COVID-19 deaths in the state, Malcolm said. "It is only going to take us a matter of weeks to vaccinate these groups," she said.
In subsequent tiers, people with one or more qualifying underlying health conditions will become eligible, as will workers in other essential industries, including manufacturing, public transit, police and fire departments, grocery stores, restaurants, agriculture and the postal service.
Additional medical conditions that will become eligible in late spring include cancer, chronic kidney disease, heart conditions, obesity, type 2 diabetes and pregnancy.
While the U.S. Centers for Disease Control and Prevention considers smokers at elevated risk for COVID-19, the state's vaccine rollout plan does not prioritize them. Malcolm said their elevated rates of health conditions such as COPD will likely qualify them earlier, anyway.
Employees in 21 essential industries will qualify for shots between April and late spring. Combined with those with at-risk chronic conditions, the state estimates that 2.6 million Minnesotans will be eligible in that time period.
Along with the 1.7 million who qualified as health care workers, long-term care residents, seniors and school and child-care workers, so many state residents will have been offered the vaccine that there will be only 300,000 adults left when the process opens up to the general public by summer.
"This is America, folks," Walz said. "Pretty much everybody's got one underlying health condition or something. If you look at all those groups, the number at the end is pretty small."
Details on how eligible individuals will get notified are being worked out, Malcolm said, but employers and health care systems will play a role.
"We will be working with each sector to figure out what is the best approach to get the vaccine to their workforce," she said. Minnesota food processing plants have expressed interest in having vaccine clinics in their facilities.
People with chronic medical conditions will most likely be contacted by their medical providers.
Minnesotans can also register with the state's vaccine connector website, which collects information about qualifying medical conditions and essential industry jobs. The system is supposed to notify people when they become eligible for the shot.
State Sen. Karin Housley, R-St. Mary's Point,welcomed the vaccination goal for seniors but said that many find the rollout difficult to understand.
"This is a step in the right direction, and I'm committed to holding [the governor] accountable," she said. "I've heard from seniors across the state who have been confused by this constantly changing information."
The state on Thursday reported that 783,214 people in Minnesota have received first doses of the two-dose Pfizer and Moderna COVID-19 vaccines, and that 386,256 of those people have completed the series. The state projects that more than 42% of senior citizens in Minnesota have received a first dose.
People 65 and older have suffered 89% of Minnesota's COVID-19 deaths, including five of seven deaths reported on Thursday. Four of the deaths involved residents of long-term care, despite vaccines being offered in all nursing homes in the state and an increasing number of assisted-living facilities.
The state also reported 996 diagnosed infections and a 3.7% diagnostic testing rate that is below the state's 5% caution level that suggests uncontrolled viral spread.
The number of COVID-19 patients in Minnesota intensive care beds declined to 50 on Wednesday, with another 215 patients who are not receiving critical care.
Total COVID-19 hospitalizations declined this week to a level not seen in Minnesota since mid-September, but the number of those patients in ICU beds declined to a level not seen since April. At its peak on Dec. 1, Minnesota had 399 COVID-19 patients admitted to ICU beds.
Dr. Andrew Olson of M Health Fairview said the more rapid decline in ICU admissions suggests that the oldest and most vulnerable patients are getting vaccinated, so fewer people needing hospital care are suffering severe cases of COVID-19.
"We're probably seeing a benefit of that," said Olson, M Health Fairview's director of COVID hospital medicine.