More than 3 million people have received COVID-19 vaccine in Minnesota. The state is behind pace on its immunization goals but has administered enough shots to slow the spread of the pandemic.

Minnesota leaders said vaccination progress shortened this spring's pandemic wave in Minnesota, reducing the positivity rate of COVID-19 testing from 7.5% on April 8 to 1.8% and lowering the number of COVID-19 hospitalizations from 699 on April 14 to 151.

"I am grateful for everyone who has gotten their shot and done their part to keep the virus from spreading — they are the reason we can safely gather together again, go out to eat at our favorite restaurants, hear live music, and cheer in the stadiums," Gov. Tim Walz said in a statement.

The Minnesota Department of Health on Wednesday reported 91 infections — only the second daily figure below 100 since April 2020 — and five COVID-19 deaths. The state's pandemic totals are 604,052 infections and 7,523 deaths.

While 66% of people 16 and older have received at least a first dose of COVID-19 vaccine, Minnesota is behind the pace of daily shots needed to reach its goal of 70% by July 1.

Minnesota needed just over 80 days after COVID-19 vaccine was available in mid-December to provide doses to 1 million people, initially reserving supplies for health care workers and long-term care facility residents before making senior citizens and teachers eligible in mid-January. It then took 36 days over March and April to reach 2 million, as the state expanded access to all people 16 and older. Reaching 3 million took 66 days, despite broad access to vaccine and the expansion of eligibility to people 12 and older.

The arc of vaccination progress in Minnesota is familiar, with the initial surge of demand giving way because of hesitancy and safety concerns among unvaccinated people, said Dr. Susan Kline, an infectious disease specialist at the University of Minnesota.

The initial expansion of vaccine to all adults was faster than expected — with doses being provided to more than 90% of Minnesota's senior citizens, who are at greatest risk of severe COVID-19 illness and death, she added. "Ideally, I'd like to see every [age group] get up to 90% vaccination, because that's going to really keep the rates of infection low."

State strategies have included the conversion of buses into mobile vaccine clinics to improve access for people with transportation barriers or busy work schedules. The state also offered $25 Visa gift cards or passes to state parks, Valleyfair and other attractions to 100,000 people who received their first shots on or after May 27.

So far, 9,906 people have registered for the vaccine incentives, even though more than 110,000 people have received their first doses in that time frame. The gift card remains the most popular option. All vaccine recipients are eligible for free or discounted beers or drinks if they bring proof of vaccination to participating breweries or distilleries.

Minnesota is among 24 states that have offered vaccine incentives, according to the National Governors Association, although the approaches have varied. While Maine has similarly offered free passes to attractions, Ohio and other states offered entries into cash lotteries. Vaccine recipients in Alabama can take two laps at highway speed around Talladega Superspeedway.

Cash historically has been the most persuasive in getting people to follow public health guidance, said Dr. Rebecca Wurtz, a U associate professor of public health who led efforts in the early 1990s to identify and treat people during a tuberculosis outbreak. Ethics guidelines typically call for amounts such as $25 that are large enough to nudge people into action but not so large that they do it just for the money.

People motivated by incentives might vary in whether they prefer the certainty of a small prize or a chance at big lottery winnings, but they are distinct from those with deep philosophical or political views against vaccine, she said. "Those people won't be moved by incentives. ... They actually would perceive themselves as not being about to be bought."

The motivations of the remaining unvaccinated Minnesotans are unclear, though a U study showed a decline in the share of people who were hesitant because of safety or other concerns from 37.5% in January to 23.9% in March.

State health officials remain confident in the effectiveness of the two-dose Pfizer and Moderna COVID-19 vaccines, and the single-dose Johnson & Johnson vaccine.

The rate of breakthrough coronavirus infections remains at just over 0.1% — with 2,995 cases found in nearly 2.7 million fully vaccinated Minnesotans. The total includes 317 people who were hospitalized — though some were admitted for other reasons and learned of their infections through routine testing — and 44 COVID-19 deaths.

Jeremy Olson • 612-673-7744