State officials have earmarked 35,000 COVID-19 vaccine doses for senior citizens this week — the highest total so far — at more than 100 locations, including hospitals, clinics and pharmacies.

The move represents a shift away from reliance on nine state-sponsored community vaccination sites that opened two weeks ago toward established local providers, long the backbone for delivering influenza and other vaccinations.

"The goal here is to improve access closer to home with more COVID-19 vaccines being available," said Health Commissioner Jan Malcolm.

While the nine state sites helped move more doses out of freezers and into arms, health officials have always said the sites were meant to be temporary staging grounds for the vaccine rollout to communities.

"We've said from the very beginning that most Minnesotans will end up getting vaccinated in the places that we are accustomed to getting most of our health care," Malcolm said.

The state will open new vaccination sites in Minneapolis and Duluth this week that together will have 6,000 appointment slots available to seniors who are randomly selected from the existing waiting list of over 200,000.

The winners of this week's vaccine lottery will be notified late Tuesday or early Wednesday.

"A third site in southern Minnesota is in the works," Malcolm said. "Additional sites are likely in the future as vaccine supply from the federal government increases."

Because some state residents lack insurance or don't have regular health care homes, there will be a continuing need for some publicly run sites, she said.

The state sites operating over the past two weeks will not be taking new appointments, but they will be open to those who had scheduled appointments for second doses, which typically come three to four weeks after the initial shots.

An online locator map was launched Monday to help people find local providers administering the vaccine, though some locations might restrict eligibility to existing patients or a subset of those 65 and older.

Even with an expected 16% increase in federally controlled shipments to Minnesota this week, Malcolm cautioned that there will be a limited number of doses available to vaccinators.

A boost in performance

Minnesota's major medical providers already were offering some vaccine to elderly patients over the past week as they gradually completed vaccination of health care workers.

Their approaches differ somewhat, though; Duluth-based Essentia Health has been contacting select patients 65 and older, while the Mayo Clinic is starting with patients who are 80 and older.

School and child care workers will get shots at either the Minneapolis site, 35 local public health agencies or some pharmacies.

Eligible workers will be notified by their employers about how to schedule the shots.

The state will open up its waiting list to new registrants at some point but will not be adding names this week.

The Minnesota Department of Health reported that as of Saturday, 441,922 state residents — about 8% of the state's population — had received at least one COVID-19 vaccine dose.

Officials said that 19.2% of those 65 and older have gotten at least one shot.

The nine pilot sites, plus a one-time Xcel Energy Center event for teachers, provided more than 27,200 Minnesotans with first doses of the vaccine over the past week.

Minnesota had lagged in national comparisons of COVID-19 vaccine efficiency, partly because medical providers were assigning doses to appointments that were scheduled days away.

The state mass vaccination sites appear to have boosted Minnesota's performance. Minnesota now ranks 21st among the states in total COVID-19 vaccine doses administered per 100,000 people, according to the Centers for Disease Control and Prevention. It had ranked as low as 45th last week.

Sen. Karin Housley, chairwoman of the Senate's Aging and Long-Term Care Policy Committee, called on the Walz administration Monday to accelerate efforts to distribute the vaccines to hundreds of community pharmacies and independent health clinics — many of which are still waiting for the shots to arrive.

"We understand that there's a limited supply of vaccines … but that's all the more reason that we need to prioritize the vaccines that we do get," the St. Marys Point Republican said. "It is imperative that [seniors] are the only priority to receive the vaccines in the coming weeks, while the doses keep coming into the state."

The Health Department reported Monday that 727 Minnesotans have tested positive for COVID-19 on a testing volume of 21,432. Two more fatalities were announced.

So far, 462,528 Minnesotans have been sickened by the coronavirus and 6,202 have died.

Of the new deaths announced Monday, one was a resident of a long-term care facility.

All together, 3,930 nursing home or assisted-living residents have died since the pandemic was first detected in the state last March.

People who have underlying health conditions, such as heart, lung or kidney disease, are more susceptible to coronavirus complications.

A total of 387 people were hospitalized due to COVID-19, with 92 of them needing intensive care. Hospitalization levels have fallen substantially since late November.

A hike in doses

Minnesota has a record supply of 98,000 COVID-19 vaccine doses this week, according to state infectious disease director Kris Ehresmann.

Of those doses, about half will be used to vaccinate people in the highest priority group, including some health care workers and group home residents.

The supply increased because the federal government raised the state's weekly allocation by 11,000 doses.

Another 18,600 doses were reallocated from a stockpile set aside for nursing homes and assisted-living facilities that was not being used.

"They will get those doses back from our allocation," Ehresmann said. "We are using the doses that they didn't need this week to get into arms."

Ehresmann noted that as the state finishes vaccinating its first priority group — which includes 500,000 health care workers and long-term care residents — it is moving on to 1.1 million Minnesotans who are 65 and over, as well as school and child care workers.

"There's just not enough vaccine for everyone to be vaccinated all at once," she said.

It was unclear when the state will set vaccination plans for essential workers who were supposed to be next in line, including transit, food and grocery employees.

"With the limited vaccine supply, it will be a while before we are getting into additional groups," Malcolm said.

Staff writer Chris Serres contributed to this report.