Minnesota's first COVID-19 vaccinations at two federal hospitals are being celebrated as turning points against a pandemic that has caused at least 384,164 infections and 4,483 deaths in the state.

Leaders at the Minneapolis VA Medical Center gathered with Gov. Tim Walz on Tuesday morning to watch the vaccination of nurse Thera Witte. She was the first of roughly 90 vaccinations at the hospital.

"The battle against the virus continues to wage, but this is at least a starting point on the road back," said Kurt Thielen, incident commander for the Minneapolis VA's COVID-19 response.

Thousands of doses of the Pfizer COVID-19 vaccine have arrived in Minnesota, with the Minneapolis VA and Cass Lake Indian Health Services (IHS) receiving shipments Monday.

The northern Minnesota IHS hospital wasted little time, holding a tribal ceremony Monday afternoon and vaccinating five tribal elders and five health care workers against an infectious disease that has been harsh on minorities. The per capita COVID-19 death rate is four times higher for Native Americans than it is for white Minnesotans.

"Once it's here ... why wait? Let's get it out there as quick as possible," said Bill Fisher, a spokesman for the Bemidji IHS region.

Other Minnesota health care providers planned to start vaccinations this week or next week, pending arrival of their shipments and the completion of state-required training in the handling and administration of a Pfizer vaccine that has a six-hour shelf life once it has been thawed and reconstituted with saline.

Pharmacy workers were taking selfies with the first box containing 975 doses that arrived at North Memorial Health in Robbinsdale Tuesday morning. Vaccinations will start there Monday.

Dr. Kevin Croston, North Memorial's chief executive, said it will be a relief to vaccinate staff members who "have been just grinding through this, coming into work every day with that fear … that they're going to get sick and they're going to go home and take it home to their families. If we can remove that risk for them, that is a win."

The start of vaccinations was a double dose of positive news in Minnesota along with improving measures of the pandemic's severity. The number of COVID-19 patients in Minnesota hospital intensive care beds dropped from 399 on Dec. 1 to 300 on Monday.

The state reported 21 more COVID-19 deaths on Tuesday and 2,340 new infections. Daily numbers have been lower on Tuesdays, but that nonetheless was the first daily count below 3,000 in six weeks.

Minnesota is in the final week of a four-week order by Walz that sought to slow viral transmission by closing bars, restaurants, entertainment venues and fitness centers. In a statement Tuesday night, his office indicated that Walz would keep indoor service at bars and restaurants shut down through the holidays, but that he would announce dial backs of other restrictions on Wednesday because viral transmission has slowed.

"Minnesotans did an awful lot of things [correctly] around Thanksgiving," he said.

The governor urged continued mask-wearing and social distancing to reduce transmission of the coronavirus that causes COVID-19. Walz said he worried about complacency because of the arrival of the vaccine.

Even with an expected 183,000 doses by year's end, Minnesota will only vaccinate one-third of its health care staff by mid-January, Walz said.

Initial doses are being reserved for health care workers at greatest risk of infection and long-term care residents at greatest risk of severe COVID-19. Mass public vaccinations aren't expected until late winter or early spring 2021.

Witte, an assistant nursing manager at the Minneapolis VA, received cheers from colleagues as she left her unit to get vaccinated Tuesday.

Protecting herself was only one motivation, she said. "It's the safety of my family, our communities and then here my colleagues and the veterans that we take care of."

Minnesota leaders expected hospitals and clinics to receive 46,800 doses this week and to complete state-mandated training that was posted online Tuesday following last-minute updates from federal health officials and Pfizer. Federal hospitals such as the VA have their own process and received doses above the state total.

In response to criticism that other states have started vaccinations, state infectious disease director Kris Ehresmann said Minnesota's training will ensure vaccine safety.

"We and our partners are working to move quickly in making vaccine available but never at the cost of safety or accuracy," she said. "Starting to vaccinate people tomorrow vs. a few days later won't make a huge difference in the grand scheme of things when it comes to changing the trajectory of the pandemic."

Pfizer's vaccine is administered in two doses, 21 days apart. A Moderna vaccine that is expected to receive federal approval this week also comes in two doses, 28 days apart.

Sanford Health completed its first vaccinations in North Dakota on Monday and in South Dakota on Tuesday and will start in Minnesota later this week following state training, said Jesse Breidenbach, Sanford's senior pharmacy executive director. "We're hopefully seeing a turning point here, where we're going to defeat COVID over the next several months."

HealthPartners planned to launch vaccination Monday at Regions Hospital in St. Paul and other sites and expected a 7,800 doses over the next two weeks that would cover the emergency department and critical care workers at highest risk for infection.

Health care providers said the Pfizer and Moderna vaccines cause immune system responses that can result in short-term symptoms, some of which can cause people to miss work. The VA is staggering vaccinations to prevent any resulting worker shortage, said Dr. Rajal Mody, who is leading the Minneapolis VA's vaccine planning.

Workers can come in with typical vaccine-related reactions such as muscle aches, he said, but are advised to stay home with fevers or telltale symptoms such as loss of taste that could suggest actual COVID-19 cases.

"We're already short-staffed ... from the pandemic," he said. "We don't want to add to that."

Staff writer Christopher Snowbeck contributed to this article.

Correction: Previous versions of this story misstated the time and place of the first vaccinations in Minnesota.