Shipments of the first COVID-19 vaccine could arrive in Minnesota next week, and by year's end, the state expects to receive 183,400 doses.

The arrival of the vaccine holds the promise of reshaping the pandemic, but the highly infectious virus is likely to continue spreading for several months because it will take time for most people to get inoculated.

The federal government, which controls the distribution of the vaccine to the states, has told Minnesota officials that the first shipment will contain 46,800 doses of the Pfizer vaccine, which is expected to get federal regulatory approval on Thursday.

Within the two following weeks, a vaccine from drugmaker Moderna is expected to arrive, adding another 136,600 doses for health care workers and long-term care residents who will be the first in line.

All of those doses will be used to provide the first shot to 183,400 health care workers and long-term care residents. The required second dose, given three to four weeks later, will arrive in shipments scheduled for next year.

"We are at the worst part of the worst part of this pandemic," Gov. Tim Walz said Tuesday. "Just because this vaccine is coming now, it is not a panacea to get through this."

Walz said the positivity rate of diagnostic testing at the state's saliva-testing sites rose above 20% on Tuesday, which could be a warning sign of increased viral transmission due to the Thanksgiving holiday. The impact of the holiday on the pandemic will emerge over the next week or so, due to the delay between viral transmission and the emergence of symptoms.

New daily coronavirus cases are down from the highs reached in November. Another 3,080 COVID-19 infections were reported Tuesday by Minnesota health officials, one of the lowest daily reports in several weeks, although testing was relatively low, with 27,432 test results sent to the Minnesota Department of Health on Monday.

Twenty-two more people died from COVID-19 complications, 15 of them residents of long-term care facilities.

So far, Minnesota has seen 359,203 confirmed infections and 4,027 deaths.

It has been known for some time that the initial vaccine shipments will come in drips, rather than a flood, requiring health officials to set priorities for who would be first in line.

"We do know that even with these initial relatively few doses ... that we are not going to be able to give as much vaccine as is needed," said Minnesota Health Commissioner Jan Malcolm.

The first shot is expected to be given around Dec. 21, either to health care employees where they work or to nursing home residents.

As manufacturing ramps up, widespread distribution of several different vaccines could come by mid-2021.

"It will probably be six months before this humongous vaccination campaign is underway and becomes part of the routine way that we do vaccinations in Minnesota," Malcolm said. Eventually they will be given at clinics and pharmacies.

There will be no state mandate that residents are required to get the shot, Walz said.

Kris Ehresmann, state infectious disease director, estimated that there are 298,000 Minnesotans who are considered to be at the highest risk among the 500,000 health care workers and long-term care residents in the state.

First priority will be given to front-line health care workers in COVID-19 hospital units, emergency departments and nursing homes along with paramedics, COVID-19 testing personnel and people who give the shots.

Residents in nursing homes will also be in the highest priority group.

"That's where our most vulnerable Minnesotans reside," Ehresmann said.

Once the highest priority groups are vaccinated, state plans call for several more phases of distribution, expanding the pool to assisted-living residents, health care workers who were not in the first group, and then on to group home residents and others in residential care facilities.

Beyond that, vaccinations are expected to be expanded to include essential workers, such as fire and police, as well as education, transportation and food and agricultural workers.

People with high-risk medical conditions and the elderly will also be ahead of the general public, although a federal immunization advisory group has yet to make recommendations about the priorities beyond health care workers and long-term care residents.

Malcolm said that several groups are contacting health officials, trying to get higher priority.

"We appreciate that folks are interested in getting the vaccine,\" she said. \"We are absolutely committed to getting the vaccine to every Minnesotan. In the meantime we ask for your patience."

She also cautioned that the number of doses expected from the federal government could fluctuate.

"Just within the last few days we had multiple updates of less vaccine coming than we thought," Malcolm said.

While the number of doses might change, Minnesota has set up a system, drawing on its experience with other vaccines, including the administration of 2.1 million influenza vaccines over 13 weeks.

The doses will be sent to 25 hubs throughout the state, which in turn will distribute them to 118 satellite sites.

Because the Pfizer vaccine must be stored at extremely cold temperatures, practice runs of shipments have taken place across the country, with Dakota County Public Health serving as the state's test location.

A test shipment arrived there last Wednesday. Although it did not contain vials, the package maintained the proper temperatures. A supply kit, along with syringes and rubbing alcohol swabs, comes with each shipment.

Even though the state expects to get a shipment next week, it is delaying the rollout by one week to train workers on how to give the vaccine, which must be mixed with a saline solution.

"These vaccines are pretty complex," Ehresmann said.

One reason health care workers are high priority is to ease the stress on hospitals, which typically run into capacity problems because nurses and other workers get COVID-19 or must isolate because of a high-risk exposure.

Among 93 hospitals that reported occupancy data to the state, 33 indicated that their intensive care units were more than 95% full. However, pressure has eased over the past week, with 359 patients requiring intensive care, down from a high of 402 on Dec. 1.

There were an additional 1,245 COVID-19 patients in non-ICU beds, a one-week decline of 10%.

Most people experience mild or no symptoms if they get sick from the coronavirus, though they remain infectious. Those with underlying health conditions, such as heart, lung or kidney disease, are most likely to develop complications.

Since the pandemic began, an estimated total of 314,957 — 87% of all known cases — are considered to be no longer infectious and do not require isolation.

Walz unveiled the state's vaccine plan with DFL and Republican leaders of the Minnesota Legislature, hoping to show unity despite deep divisions over business shutdowns and other state restrictions to try to slow the pandemic.

State Senate Majority Leader Paul Gazelka hedged on whether he would take the vaccine when it is his turn but said that is because he had COVID-19 and researchers are still assessing whether people have short- or even long-term immunity after infection. The Republican offered support to the distribution plan led by Walz, a DFLer, whom he has fiercely criticized for other decisions during the pandemic.

"I think it's important for the population to be open to taking this vaccine," Gazelka said, "because it will wipe out this virus."

Staff writer Jeremy Olson contributed to this report.