Minnesota public health officials are planning for the next wave of COVID-19 vaccinations, which will be targeted to essential workers and those over age 74.
The state is still working on getting shots to those in the highest priority group, including 500,000 front-line health care workers and long-term care residents.
It could take until the end of January before everyone in that group who wants the vaccine can receive it.
More than 1 million Minnesotans are estimated to be in the second wave — twice as many as the first, raising questions about how long it will take for large quantities of COVID-19 vaccines to arrive in the state.
The Trump administration had originally set a goal of vaccinating 20 million Americans by the end of the year. As of this week, 2.6 million doses have been given and 12.4 million doses have been distributed, according the Centers for Disease Control and Prevention.
Because the demand for the COVID-19 vaccine far outstrips supply, the shots will continue to be rationed and the general public may not have access until late spring or early summer, according to state infectious disease director Kris Ehresmann.
"We are not able to request more doses," she said, noting that the federal government controls the distribution using a formula based on each state's population.
"We are taking what comes to us and getting it to its final destination as soon as possible," Ehresmann said.
Minnesota has been allocated 297,350 doses this year, including some that were shipped to the state this week. The vaccine vials are shipped to 25 hubs — mostly major medical centers — that then distribute them to other locations.
Ehresmann said the distribution process, as well as the training that is required to administer and store the vaccine appropriately, can cause delays before shots can be given.
"This is a new vaccine with new processes that have to be put in place that adds some time to the process," she said, comparing it to the flu vaccine, which can more easily be given in large numbers faster.
About 38,300 people have received their first dose, based on reports to the state, which can lag. The federal government has set aside vaccines for the required second dose of both the Pfizer and Moderna vaccines, and they will be shipped when needed.
Once the highest priority group is vaccinated, the process moves on to the next group, which includes 235,000 workers in the state's schools, 199,000 in manufacturing, 102,000 at grocery stores, as well as police, fire, postal service, public transit and other employees in essential industries.
There are also about 388,000 Minnesotans 75 and older, although those who live in long-term care facilities will already have been vaccinated in the first phase.
Like the first group, the state will set priorities within the second group, known as "1b," about who will be first in line. Those recommendations are made by an outside vaccine advisory panel.
The Minnesota Department of Health on Wednesday said it is seeking public input on how to best distribute the vaccines, which will be reviewed by the panel.
Another 66 COVID-19 fatalities were reported by state health officials Wednesday, bringing the state's total to 5,262 deaths. Forty-three of the deaths were residents of nursing homes and assisted-living facilities.
There were an additional 2,019 new coronavirus infections. A total of 25,729 diagnostic test results were reported to the Department of Health, more than triple the 7,700 reported a day earlier.
Minnesota's hospitals were caring for 926 COVID-19 patients, including 207 that require intensive care. Overall, hospitalizations due to the coronavirus have fallen 48% since the beginning of the month.
Still, some hospitals are busy with non-COVID patients, with 30 of 93 hospitals reporting that they are at or above 95% of staffed bed capacity.
Most people who need high-level medical care from a COVID-19 infection have underlying health conditions that make them more vulnerable to complications from the disease. These include heart, lung and kidney disease.
Many people who get infected experience mild or no symptoms. Since the pandemic began, an estimated 395,679 patients are considered to be no longer infectious.
Although the vaccines on the market are about 95% effective against preventing symptomatic COVID-19 infection after the required two doses, there are still many unknowns.
"We don't have information on asymptomatic illness ... and we don't have information on the impact of the vaccine on infectiousness," Ehresmann said.