The first vaccinations in Minnesota with the first COVID-19 vaccine are scheduled to start Tuesday at the Minneapolis VA Medical Center and next week at hospitals and clinics statewide.

Thousands of doses of the Pfizer COVID-19 vaccine started arriving this week in Minnesota, with the VA hospital being the first recipient of 2,925 doses on Monday along with Sanford Bemidji Medical Center, Olmsted Medical Center in Rochester and the Cass Lake Indian Health Service.

"This is the day we've all been waiting for," said Minnesota Gov. Tim Walz, who was at the Minneapolis VA Monday morning to see the arrival of the first vaccine shipment.

Initial doses are being prioritized for health care workers at elevated risk of viral exposure and nursing home residents who suffer higher rates of severe COVID-19.

Broad distribution to the public isn't expected until late winter or early spring of 2021.

Some vaccinations of health care workers already took place Monday in states such as New York and Ohio. However, broad distribution in Minnesota won't start until next Monday, so that providers can complete state training on the handling of the vaccine this week and have time to sign up volunteers so that no doses are wasted.

"Do I want this pandemic over as soon as possible? Like everyone else, absolutely," said Paul Krogh, the pharmacist leading vaccine distribution for North Memorial Health. "I want to do this right, though."

Vaccination has been termed the "end game" for COVID-19, which has caused at least 4,462 deaths and 381,841 known infections among Minnesotans and prompted Walz to shut down bars, restaurants, fitness centers and entertainment venues for four weeks to try to slow its spread. Walz is expected on Wednesday to announce whether he will extend the order or let it expire on schedule this Friday.

Minnesota expects to receive 46,800 doses this week of the COVID-19 vaccine manufactured by Pfizer and granted emergency use authorization status last week by the U.S. Food and Drug Administration. Combined with a second vaccine made by Moderna and submitted for FDA approval, the state expects 183,000 doses by the end of the year.

Health officials scrambled this weekend to complete educational and training information for vaccine providers based on last-minute federal guidance about the Pfizer vaccine, said Kris Ehresmann, state infectious disease director. Some complications to consider include that people shouldn't receive the COVID-19 vaccine within 14 days of receiving the flu shot or any other vaccine.

"Our commitment is to make sure that everyone feels comfortable down to the vaccinators — that they're comfortable administering that vaccine safely," she said.

Other states did largely "ceremonial" vaccinations on Monday but will take a few days before launching their broader vaccine campaigns, she added. Federal facilities operate independently from the state, which is why the Minneapolis VA is starting its vaccinations sooner.

Federal and state advisory groups have determined that health care workers and long-term care residents should be vaccinated first but that initial doses won't be enough even for them. So they further prioritized the types of health care workers for the first shots, primarily those treating COVID-19 patients or working in environments such as emergency rooms where the risk of viral transmission is higher.

North Memorial expects to receive 975 doses Tuesday and nearly 5,000 within two weeks. The health system will use the next week to train its vaccinators, answer questions of high-priority workers and schedule vaccinations starting Monday at its flagship hospital in Robbinsdale as well as Maple Grove Hospital and two clinics, Krogh said

"We have to as health care providers give people information about what we know, and what we don't know, so they can make an informed decision," he said.

Knowing who wants the vaccine will be important in avoiding waste, he added. The Pfizer vaccine must be kept in storage below minus 70 degrees Celsius until it is ready for use. After initial thaw, the vaccine can be kept in regular cold storage for five days. Once it is reconstituted with saline, the vaccine must be used in six hours.

Krogh said his placement on the priority list for vaccine isn't clear but that he would take it when offered. While nobody knows the potential long-term complications, he said most vaccine adverse effects emerge in six weeks and that clinical trials showed no serious problems in recipients after eight weeks.

"It's going to be a pathway back to some normalcy," he said. "It's going to be a while, though. We can't just take our masks and throw them in the garbage yet."

Vaccine arrival occurred on Monday as state health officials reported improving but high levels of viral transmission in Minnesota.

Pressure on Minnesota hospitals has eased. The state's pandemic dashboard showed 319 patients with COVID-19 in Minnesota hospital intensive care beds on Sunday, a decline from 402 on Dec. 1.

The positivity rate of diagnostic testing dropped to 12.4% on Dec. 3, down from a peak of 15.5% on Nov. 11. The rate is a closely watched indicator of the pandemic, because it shows the rate of viral spread, regardless of the number of diagnostic tests performed.

The pandemic is following a course that health officials predicted. A peak in diagnosed infections in mid-November was followed by a wave of hospitalizations and then deaths.

The state reported a total of 460 COVID-19 deaths in the seven-day period ending Sunday, the deadliest one-week stretch in the pandemic. There were 3,018 new cases and only 18 COVID-19 deaths reported on Monday, but a lower death number was expected because daily tallies throughout the pandemic have been lower on Mondays.

Staff photographer Aaron Lavinsky contributed to this story.