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An uptick in weekly COVID-19 vaccinations in Minnesota has state health officials hopeful that people are heeding warnings about the latest variant-fueled wave of the infectious disease and getting more children lined up for shots before the start of the school year.

While people in high-risk locations for coronavirus transmission should "double down" by wearing masks per new federal guidelines and taking other precautions, state Health Commissioner Jan Malcolm said they aren't alternatives for vaccinations.

"Even though we're talking about masks as another additional layer of protection ... the absolute best thing we can do is just get vaccinated as soon as you are eligible," she said.

More than 3.1 million eligible people 12 and older have received at least a first dose of COVID-19 vaccine in Minnesota, but the number of people receiving shots declined dramatically over the summer as pandemic activity receded. While the 40,779 shots administered in the week beginning July 18 is less than the amount being given per day at one point this spring, it nonetheless represented the first weekly increase since at least early June.

"We are grateful that people are taking another look and taking action to get vaccinated," Malcolm said.

The turnaround in Minnesota's vaccination trend comes amid the emergence of a fast-spreading delta variant of the coronavirus that is believed to be causing 85% of new infections in the state. Half of Minnesota's infections over the past two months have occurred in the past two weeks — with the state reporting another 632 on Monday and six more COVID-19 deaths.

The positivity rate of diagnostic testing has risen from a low of 1.1% to 3.3% and the number of COVID-19 hospitalizations has increased in Minnesota from 90 three weeks ago to 229. The state's totals in the pandemic are now 613,325 infections and 7,674 deaths.

With the delta variant causing substantially higher infection levels in Southern and Western states, the Centers for Disease Control and Prevention last week urged mask-wearing in all K-12 schools and in counties with substantial or high transmission levels.

In the week since that recommendation, Minnesota has seen counties with such transmission levels increase from 14 to 45 — though only Dodge, Lake, Meeker, Nobles, Rock and Wilkin counties had high levels as of Monday and the rest are in the lower substantial range.

Announcements about new mask or vaccine requirements emerged across Minnesota on Monday as health and business leaders responded to the rising cases and new federal guidance.

Target starting Tuesday is requiring face coverings for workers, regardless of their vaccination status, and strongly recommending them for customers in areas with substantial or high risk of transmission. Cub issued a similar announcement for its supermarkets, while Securian said workers volunteering to come to its St. Paul office must wear masks.

All metro counties are in the substantial transmission range, but Malcolm acknowledged some volatility and that smaller counties in particular could have high levels one day and lower levels the next. With a state mask mandate unlikely because Gov. Tim Walz no longer has the emergency authority to issue it, Malcolm said state health leaders are talking with local leaders about how to address the volatility. She noted that local businesses and governments are encouraged to enact whatever mask mandates or policies they deem appropriate.

"There's just a lot of virus moving around the country and it's here in Minnesota as well," Malcolm said. "It is this new, much more transmissible delta variant. So it's a good idea to kind of heighten our alert and pay attention to some of those basic preventive strategies that we know help to diminish transmission."

The slight increase in vaccinations occurred ahead of the state's announcement last week of $100 for new vaccine recipients. Minnesota at one point had been on track to provide at least first doses of vaccine to people 16 and older by July 1, but now it appears unlikely to reach that goal until the end of August.

First-dose vaccination levels remain highest, at 91%, among people 65 and older who are at greatest risk of severe COVID-19 illness and death. The rate among people 12 to 15 is only 42%, but it increased over the past week as parents sought to have children receive two doses of Pfizer vaccine before the start of the school year.

Vaccine requirements with some exceptions for medical and religious reasons were announced Monday by the Minneapolis-based Allina and Fairview health systems and the University of St. Thomas in St. Paul — which wants students and staff immunized before they return to campus in the fall.

A first vaccine dose by Oct. 1 is expected for more than 28,000 Allina employees, while immunization by Oct. 31 will become a condition of employment for about 32,000 Fairview workers.

"We think this is the move that we have a moral obligation ... to make — to protect our patients who put their lives in our hands every day," said Dr. Andrew Olson, director of COVID hospital medicine for M Health Fairview.

The Fairview requirement applies to workers at Ebenezer Senior Living, the health system's chain of long-term care facilities. Senior care providers have been slow to mandate vaccine for fear of losing workers in an industry that already struggles with staffing shortages, but Olson said: "We must not let the thing that is expedient get in the way of doing what is right."

South Dakota-based Sanford Health announced in July a mandate for employees to be vaccinated by Nov. 1. Last week, Mayo Clinic announced that its workers must either get vaccinated or go through an hourlong education session by next month.

Health officials remain confident in the effectiveness of the vaccine despite the emerging variant. Minnesota on Monday reported 4,477 breakthrough coronavirus infections in 2.9 million fully vaccinated individuals — an infection rate of .15%. The breakthrough infections in Minnesota include 455 people who were hospitalized and 56 who died of COVID-19.

Staff writers Christopher Snowbeck and Dee DePass contributed to this report.