The tail end of the latest national pandemic wave continued to worsen in Minnesota, where more than 1,000 people with COVID-19 filled inpatient hospital beds and the new infection rate remained seventh worst among states.

Health officials on Monday urged more people to seek new or booster doses of COVID-19 vaccine, despite an increase to 45,827 in the number of fully vaccinated Minnesotans who have coronavirus infections and the death of retired Gen. Colin Powell following a breakthrough case as well.

Gov. Tim Walz said a better vaccination rate could have reduced the severity of the latest wave, which hit the South hard this summer but moved north this fall as people moved indoors amid colder weather, and that Powell's death is a call for more vaccination, not less.

"Him getting it in a breakthrough case is reason to get vaccinated," Walz said, "and not a reason to pretend like these don't work."

The state on Monday unveiled a new incentive to boost its COVID-19 vaccination rate — offering $200 gift cards to new recipients 12 to 17 who receive their first dose between Oct. 18 and Nov. 30.

All recipients in that age range also can win one of five $100,000 scholarships to attend college in Minnesota.

Health officials noted that the latest breakthrough total represents 1.4% of the nearly 3.2 million fully vaccinated Minnesotans, and the vaccines remain strongly protective against severe illness and death.

Unvaccinated Minnesotans make up 40% of the state population — including children 11 and younger who aren't eligible for shots — but make up about 64% of the coronavirus infections identified in the past week.

Among all breakthrough infections, 2,178 involved hospital admissions and 263 resulted in COVID-19 deaths.

Breakthrough cases have been more common and more severe in seniors — with a median age of 74 for fully vaccinated Minnesotans who were hospitalized and of 81 for those who died of COVID-19, according to state health data.

From August through mid-September, more than 30% of all coronavirus infections have been in fully vaccinated Minnesotans, but that rate rises above 60% in seniors and drops below 10% in eligible teenagers.

A higher breakthrough rate in seniors has been expected, because the age group has a first-dose vaccination rate of 94% that is well above the overall rate of 73% among all Minnesotans 12 and older, according to state data.

Seniors also were among the first groups to become eligible for vaccine last winter, so the high rate of breakthrough infections could reflect some waning immunity over time or the fact that seniors usually have weaker reactions to vaccines in the first place.

Powell had been treated for a form of blood cancer in recent years, and Minnesota Health Commissioner Jan Malcolm said such underlying health conditions carry elevated risks of breakthrough infections as well.

"Especially for folks of more advanced age and with underlying health conditions, boosters are going to be a really important strategy," she said.

A partial state review of more than 1,900 COVID-19 breakthrough hospitalizations in Minnesota through Oct. 8 showed that 356 had underlying conditions such as obesity, diabetes or tobacco use, and 81 had compromised immune systems because of cancer treatments or organ transplants.

Minnesota's totals in the pandemic reached 8,436 COVID-19 deaths and 758,252 infections, including 29 deaths and 2,868 infections reported on Monday. The positivity rate of diagnostic testing in Minnesota also increased to 8.4% — the highest rate since Dec. 14, when COVID-19 vaccine first became available in the state.

"Our infection rates are way too high," Walz said, but he noted that Minnesota's rate of recent COVID-19 deaths remains among the lowest in the nation.

One concern is that hospital space is limited — with nearly 96% of available ICU beds occupied by patients with COVID-19 or other unrelated medical conditions. Minnesota hospitals on Friday had 1,007 COVID-19 patients admitted to inpatient beds, including 246 in ICU beds.

Walz said the Minnesota National Guard this week is identifying personnel who can be quickly trained to work in skilled nursing facilities, and that would free up beds in hospitals by allowing them to transfer patients out when ready.

"It is a short-term fix but it should relieve some of that pressure," said Walz, adding that admissions to state-operated psychiatric facilities increased 25% to take more mental health patients out of crowded hospital ERs.

Walz had announced his plan to mobilize the Guard last week, noting that 400 hospitalized patients could be transferred if skilled nursing beds were available. Another 70 Guard members are being deployed to increase COVID-19 testing access in Minnesota.

Minnesota's vaccination progress includes nearly 230,000 people who have received third shots — either recommended extra doses for people with immunocompromising conditions or third booster doses recommended for recipients of the two-dose Pfizer COVID-19 vaccine.

Boosters are recommended in Minnesota for Pfizer recipients who are seniors or are older than 49 and have underlying health conditions, but also can be given to younger adults with health problems or occupation risks for coronavirus exposure. Booster recommendations for the two-dose Moderna and single-dose Johnson & Johnson vaccines are expected soon as well.

Correction: Previous versions of this story misstated the number of hospital admissions and deaths for breakthrough infections.