More than half of Minnesota seniors are up to date with COVID-19 vaccinations for the first time in months, raising protection levels among those at greatest risk from the infectious disease.

The vaccination progress comes amid persistent growth in COVID, though it is no longer a public health emergency. COVID hospitalizations have doubled in two months, reaching 535 on Tuesday, but remain below Minnesota's single-day record of 1,864 in November 2020 — before vaccine was available.

"We're in a better place than a year or two ago, but COVID-19 is certainly still here," said Kathy Como-Sabetti, epidemiology manager for the Minnesota Department of Health's Emerging Infections Group.

Minnesotans 65 and older remain most vulnerable, accounting for 93% of 468 COVID deaths since Oct. 1 — and 83% of the state's 15,505 COVID deaths overall, according to Thursday's weekly state update.

Seniors remain interested in vaccine, but some wonder if the shots are necessary because COVID isn't causing as many severe illnesses, said Dr. Beth Averbeck, a geriatrician and the senior medical director for primary care for HealthPartners. Others waited for a two-for-one visit when they received their flu shots, or got discouraged early in the fall when supplies of the new COVID booster were erratic.

"Early on, we never knew what the supply was, when it was going to come," she said. "Right now, we have enough vaccine."

Coronavirus infections plummeted at the start of 2023, but have gradually increased since mid-summer, according to tracking by the University of Minnesota. Its results are based on viral levels measured each week in wastewater from 38 treatment plants.

Lab testing in Minnesota has found some signs of the JN.1 coronavirus variant that has been blamed for COVID growth across the country. State officials don't believe that variant is responsible for the rise of COVID this fall in Minnesota, though, and suspect it is more from seasonal, indoor gatherings that spread the virus along with low vaccine uptake.

Seasonal influenza levels also are rising in Minnesota, which reported 225 flu-related hospitalizations this week.

Minnesota at one point had 70% of eligible residents and 90% of seniors fully vaccinated against COVID, but those numbers zeroed out last fall when the federal government recommended new boosters formulated to protect against the latest coronavirus variants.

Since then, nearly 1 million Minnesotans have received boosters, but only 18% of the population is considered up to date. Health officials encouraged more people to seek boosters, stressing that they appear to remain protective even though other viral variants are causing most COVID cases now.

St. Cloud-based CentraCare is reporting a record 400 prescriptions per week of Paxlovid, the antiviral drug that can reduce COVID severity if taken when symptoms first emerge.

Most are patients who test positive for COVID at home and then call CentraCare to see if they qualify for treatment, said Todd Lemke, CentraCare's director of regional pharmacy services. Insurance is providing more consistent coverage of the $1,500 to $2,000 treatment, but discounted and free supplies remain available, he noted.

Some patients are vaccinated, but many want the antiviral because they didn't pursue the booster and worry they lack protection, he said. "There are plenty of people who have been vaccinated but are no longer fully vaccinated."