A drop in COVID-19 cases among congregate care residents in Minnesota might be the first encouraging sign that the state's mass vaccination efforts are starting to pay off.

Last week's average of 64 cases per day among these residents was the lowest since September, said Kris Ehresmann, state infectious disease director. Surveys showed that 81% of the most vulnerable residents of nursing homes opted for the two-dose COVID-19 vaccine, and 13% have completed the series.

"Vaccine seems to be having a positive effect," she said, "In the weeks ahead, we think we will be able to say that with greater confidence."

The precise impact is complicated by the existing declines in pandemic activity in Minnesota, where there have been 6,210 COVID-19 deaths and 463,132 diagnosed infections with the corona­virus that causes the disease. The totals include eight deaths — three involving residents of long-term care facilities — that were reported Tuesday along with 633 more infections.

Minnesota hospitals reported on Tuesday that they had 394 total COVID-19 patients admitted to inpatient beds, including 84 who needed intensive care. By comparison, hospitals had 399 patients just in intensive care on Dec. 1.

The decline in COVID-19 occurred in a broader range of facilities — such as addiction treatment centers and independent-living complexes — than just the nursing homes and assisted-living facilities that have been targeted to receive vaccine.

Even glimmers of progress due to the COVID-19 vaccine are likely to fuel the frenzied search by senior citizens in Minnesota who are now eligible to be vaccinated. M Health Fairview started scheduling appointments at 8 a.m. Tuesday for patients 75 and older or health care workers to receive 7,800 first and second doses of vaccine. Slots were booked by 11 a.m.

"The vaccine demand for this group is massive," Fairview spokeswoman Aimee Jordan said.

Some expressed frustrations with the state rollout, which expanded access to senior citizens following progress in the vaccination of the priority group of 500,000 health care workers or long-term care residents.

The initial plan was to move on to 1 million people 75 and older and workers in front-line essential industries such as teachers, police officers and utility workers. Instead, Minnesota opened access to all seniors and only to teachers for now.

Health systems have set their own age limits for administration of limited initial doses — with CentraCare in St. Cloud open to patients 65 and older, and Mayo Clinic starting with the most vulnerable patients who are 80 and older.

Cancer survivor Rhonda Scharber, 71, was invited by Hennepin Healthcare to receive a vaccine, but the search has been a nightmare for her husband, Joe, who is the same age. His system, Allina Health, isn't scheduling anyone younger than 75.

Her husband received a text at 11:15 p.m. on Jan. 26 saying he was selected from a sign-up lottery for vaccination at a state community site. After two hours on hold, he learned at 1:15 a.m. the next day that all appointments were full and that he was no longer on the waiting list for consideration for the next week.

"I just feel like you get the runaround," Scharber said.

The state is replacing nine pilot sites across Minnesota with permanent community vaccination sites in Minneapolis and Duluth that will be administering 6,000 first doses later this week. Seniors on the existing waiting list were supposed to be notified Tuesday or Wednesday if they were selected for the events. Seniors who received doses at the nine original state sites will still use those sites for their second doses later this month.

At least 447,610 people have received first doses of COVID-19 vaccine in Minnesota, and 116,928 people have completed the series. Comparatively, the state is looking better — moving from 45th to 22nd among states in per capita doses administered, according to the U.S. Centers for Disease Control and Prevention.

Gov. Tim Walz credited new performance measures for hastening vaccine administration across Minnesota. The state is tracking major health systems by whether they administer 90% of COVID-19 first doses within three days of receiving them, and 100% in seven days.

The three-day requirement has proved trickier for providers; only three health systems are above the 90% threshold while four are below 80%. Those receiving vaccine shipments later in the week are finding it hard to meet the three-day goal if it straddles a weekend, while rural providers are slowed by the logistics of delivering the vaccine across larger regions.

Minnesota has a long way to go toward its goal of vaccinating at least 80% of residents 16 and older — a percentage that is believed will achieve "herd immunity" and stifle the spread of COVID-19.

Ehresmann said it could take 16 weeks at today's pace to get through the current eligible population, including roughly 1 million senior citizens, teachers and child-care workers. Broad community access to COVID-19 vaccine is months away.

Only roughly 2% of Minnesota's population has been fully vaccinated, but steady growth in that measure increases protection for the state, Ehresmann said. "Each dose that's administered in Minnesota is benefiting everyone."

Ehresmann encouraged continued mask-wearing, social distancing and other protections — and said that extends to people who have received their shots. The vaccines have been proven to prevent serious illness, but it is unclear whether they also prevent viral transmission.

"Until we reach the point we have 80% of our population vaccinated, everyone needs to continue with the community mitigation measures we have in place," she said.

Underscoring her concern was the reporting of new COVID-19 outbreaks in large groups, bars and sporting events since relaxation of restrictions last month. Updated state data on Monday showed two bar or restaurant outbreaks discovered in January and 21 involving sports.

Survey data on Carnegie Mellon University's COVIDcast showed as of Feb. 1 that Minnesota had one of the nation's highest rates of people going to bars. Only Alabama had a higher rate.

On the other hand, the survey data showed an above-average rate of 94% of Minnesotans who wear masks in public most or all of the time. Minnesota also ranks among the top five in the survey data for vaccine acceptance: 81% of residents saying they would receive COVID-19 vaccine if offered.