Minnesota's hospital trade group is "extremely disappointed" in a new state COVID-19 vaccine allocation system, saying it deprives some rural communities of doses needed for patients.

"We believe the vaccine allocation process has reached an untenable crossroads," said Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association (MHA).

In a strongly worded letter to Minnesota Health Commissioner Jan Malcolm on Friday, Koranne said some of MHA's members, which include independent hospitals and health care systems, are facing three weeks without any vaccine allocations.

He criticized changes made two weeks ago that put more than 50 rural providers into a lottery, with only five or six chosen to get vaccine each week. "It was a surprise move — a pretty shocking move on a Friday evening," Koranne told the Star Tribune. "The state just turned the spigot off of the vaccine to these rural, smaller health care providers."

Previously, vaccine distribution worked through eight regional health care coalitions long used to coordinate preparedness and response services across the state.

The change did not affect providers in the Twin Cities, Duluth and Rochester. "End the lottery system and immediately return to using the regional healthcare coalitions," Koranne wrote to Malcolm.

Minnesota Department of Health officials said Friday that they would be making changes soon. "We informed [providers] the state would be moving away from the randomization process for small and mid-sized providers and that was confirmed in an email today," the agency said in a statement Friday.

The provider lottery is different from the lottery for Minnesota seniors who have signed up to get vaccinated. There are more than 200,000 on the waiting list.

The provider lottery leaves rural health providers uncertain about how many doses they will get as seniors wait to be vaccinated at the local clinic or hospital, said Koranne, who was also critical of the state's community vaccination sites. "These are our patients. If we want to get Minnesotans vaccinated, we do not need the state to reinvent the wheel," he said. "We know the wheel. We have the infrastructure."

State health officials have said the sites are part of a "vaccination ecosystem" typically used with all vaccination campaigns, such as the flu vaccine. "Not every Minnesotan can access care through private health care providers," the agency said Friday. "We need to make sure everyone has somewhere to get the vaccine."

The state has set aside 7,000 doses for those 65 and older to be randomly chosen next week to get shots at two state-sponsored sites in Minneapolis and Duluth. Another 10,000 doses are earmarked for school and child-care workers. Health care providers were allocated 39,800 doses, which can be used for employees and patients over age 64.

The lottery affects small and midsize rural providers.

"In the smaller towns, this is turning into a big, big issue. And it's all created by the state," Koranne said. "We just need them to turn back to the system that was working. It's appalling what they've done."

On Wednesday, Malcolm sent a letter to vaccinators acknowledging that "changes in your allocation week to week have created challenges for you." She added that by Feb. 15, "We hope we will be ready to make that transition" back to the regional health coalitions.

But Koranne wants the old system to return by Monday. "Hope is not a strategy," he said. "It has to happen this Monday. It's been three weeks and we have heard from thousands upon thousands of Minnesotans who are calling their local clinics in these towns and wanting answers."

While some hospitals and clinics are awaiting supplies of vaccines, a new federal program with pharmacies will open up another pipeline for vaccine vials to flow into the state. Like other vaccine rollouts, it will start small and doses will be limited.

The doses will go directly to retail pharmacies from the manufacturer and are not part of the state's weekly federal allocation.

Walmart was selected to administer COVID-19 vaccines in Minnesota in the initial phase. Walmart has not chosen which of its Minnesota stores will be giving the shots or when doses will be available.

Under the program announced Tuesday, 1 million doses will be sent to about 6,500 pharmacies nationwide starting next week, although some locations will get their supply in later weeks.

The federal government has not said how many doses will be going to each state.

Eligibility will be limited to people who qualify for the vaccine under state guidelines.

In Minnesota, that would include health care workers, emergency medical responders, school and child-care workers and those age 65 and older.

So far, 497,843 Minnesotans have received at least the first dose, and both doses have been given to 138,212 state residents.

State health officials estimate that 9% of the state's population has gotten at least one of the two recommended shots.

Among those 65 and older, the number is 23.1%.

Last week, 196,504 first and second doses were administered. As of Wednesday, 67,053 have been given since Sunday. Health care providers have 24 hours to report vaccinations to the state, while the long-term care program can have delays of up to 72 hours.

Twenty-two more deaths were announced by the Minnesota Department of Health on Friday.

All were age 60 or older. Six were long-term care residents.

The number of new COVID-19 infections reported to the state was 1,054.

Since the pandemic was first detected in Minnesota, 6,273 people have died from corona­virus complications and 466,224 have tested positive.

Diagnostic labs reported 38,947 test results to the state, down from more than 50,000 the previous day.

Minnesota's hospitals are caring for 362 patients with COVID-19-related complications, including 82 in intensive care.

Most who need hospital-level care have underlying health conditions that make them susceptible to the virus, including cancer, Down syndrome, obesity and sickle cell disease.

Glenn Howatt • 612-673-7192

Christopher Snowbeck • 612-673-4744