Roughly one in five Minnesotans have received the COVID-19 vaccine, including the state's health commissioner as of Wednesday, to protect against a coronavirus that has caused 493,013 known infections and 6,705 deaths in the state.

The totals include nine deaths and 922 infections reported Wednesday by the Minnesota Department of Health. Of the 1,103,353 people in Minnesota who have received vaccine, 615,432 have completed the series either by receiving two doses of the Pfizer or Moderna vaccines or a single dose of the new Johnson & Johnson alternative.

State officials lauded the progress, noting that Minnesota is among the fastest states in vaccine administration, but said it must continue in order to shield the state from SARS-CoV-2 and some more infectious variants of the virus.

"The variants are a concern that's out there and it feels like a race to get folks vaccinated," Gov. Tim Walz said.

Part of the strategy included boosting confidence in the Johnson & Johnson vaccine, which has been questioned because clinical trials showed it less effective at preventing COVID-19 overall but equally effective at preventing hospitalizations and deaths.

State Health Commissioner Jan Malcolm chose to receive the new vaccine Wednesday and encouraged people to take advantage of whatever types are immediately available to them. With federal guidance permitting unmasked visits between fully vaccinated people, Malcolm said she looked forward to dinner with friends.

"I'm actually surprised how emotional this day is," said Malcolm, 65, moments before receiving her shot at Courage Kenny Rehabilitation Institute in Golden Valley. "I think it represents the hope that I have heard about and seen in friends and colleagues who have had the vaccine. It's a really big deal."

All three vaccines work in the most important ways, said Dr. Frank Rhame, an Allina Health virologist who led a clinical trial of the Johnson & Johnson vaccine in Minneapolis last fall.

"I do not fear getting mild COVID, personally," he said. "I don't want to be hospitalized, I don't want to be on a ventilator, and I don't want to be dead. All of the vaccines seem to be really good against that."

An ongoing COVID-19 outbreak in Carver County is a concern, because it involved young athletes in organized sports and a more infectious B.1.1.7 variant first identified in England. On Wednesday, the state reported 114 infections in that cluster, including 29 confirmed to involve the variant and 49 with genomic sequencing analysis pending.

The outbreak is troubling because it parallels the spread of B.1.1.7 in England, where people weren't concerned at first because initial cases involved young adults who rarely suffer severe COVID-19, said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy.

"A sporting event is the ultimate mix-and-match kind of environment," said Osterholm, because children and teens can spread the virus to athletes from other towns.

Severe COVID-19 is rare in children, who are ineligible for vaccine for now because it wasn't tested in younger people. (Only the Pfizer vaccine is available to people 16 and older; the age cutoff for the other two is 18.)

Children could spread the virus to others at greater risk, though, including senior citizens who have suffered 89% of the COVID-19 deaths. Eight deaths reported Wednesday involved people 65 or older while one involved a Crow Wing County resident in the 45 to 49 age range.

Minnesota initially prioritized limited vaccine for health care workers, educators, long-term care facility residents and senior citizens. The state on Tuesday expanded eligibility to 1.8 million people with qualifying health conditions or key front-line occupations, because 68% of Minnesota seniors have received vaccine.

Minnesotans have an added incentive to seek the vaccine based on new guidance from the U.S. Centers for Disease Control and Prevention for people who are fully vaccinated — which means they received their final doses at least 14 days ago. In addition to visiting unmasked with one another, fully vaccinated people can visit with unvaccinated people from single households if they are at low risk of severe COVID-19.

Even those visits present risk, though, said Dr. Gregory Poland, director of Mayo Clinic's vaccine research group. "Each individual has to make that calculus, that decision, for themselves, but this gives us leeway or warrant to do so."

The CDC still discourages spring break travel, which Poland said could produce the same uptick in COVID-19 that occurred after many holidays.

"Every time we have a big travel holiday in the U.S. we can count on a surge in cases over the two to six weeks following that, followed by increases in hospitalizations, followed by increases in deaths," he said. "We've done that experiment and we've done that multiple times in the U.S."

The CDC website ranks Minnesota 17th for its per capita rate of COVID-19 vaccine administered. State health officials noted that Minnesota ranks second among states in an alternative measure of vaccine performance — the percentage of available doses that have been administered.

Minnesota had ranked among the worst states in the nation in this measure two months ago, when many doses were being held for appointments scheduled days later, but used a series of state pop-up vaccination sites and other efforts to pick up its pace.

HealthPartners added its first drive-through vaccination site in Bloomington earlier this week, using the Johnson & Johnson vaccine for 600 daily appointments because it doesn't have the same complex freezing and storage requirements of the other two.

The health care provider also started offering vaccine appointments by invitation Wednesday to newly eligible adult patients with qualifying health conditions.

Jeremy Olson • 612-673-7744