70% vaccination target could shift Minnesota's COVID-19 response

A relaxation of COVID-19 restrictions is expected to be announced Thursday along with a 70% vaccination target that could trigger significant reductions in remaining mitigation strategies in Minnesota.

Gov. Tim Walz declined to give specifics at a public appearance Tuesday, but in previous events he has said the next incremental changes would likely involve expanded capacity limits for businesses and entertainment venues. He predicted a "very normal looking summer" if Minnesota can proceed from a rate of 59% of eligible people who have received some vaccine to 70%, perhaps in June.

"Minnesotans have done what was asked," Walz said. "We out-vaccinated that surge where hospitals were getting overwhelmed in states like Michigan and now in Oregon. It didn't happen in Minnesota because we're still doing the mitigation efforts and we're still vaccinating. ... The projections look incredibly good."

Minnesota's daily pandemic report on Tuesday was the first since March 23 to report fewer than 1,000 newly diagnosed infections with the SARS-CoV-2 coronavirus that causes COVID-19, and the first since March 26 to show a positivity rate of COVID-19 diagnostic testing below 6%. Mayo Clinic's 14-day COVID-19 forecast also predicted a 22% decline in daily SARS-CoV-2 infections in Minnesota by May 16.

The state also reported that nearly 2.6 million people 16 and older have received at least first doses of vaccine — 59% of the total eligible population — and nearly 2 million of them have completed the one- or two-dose series. Walz said Minnesota is progressing at a rate of a percentage point every three days, but some indications suggest the state won't be able to maintain that pace.

The number of weekly doses administered — including first and second doses — has fallen in Minnesota from 405,870 in the seven-day period starting April 4 to 276,234 in the seven-day period starting April 25.

State infectious disease director Kris Ehresmann said progress was easier when motivated people waited in lines and scanned computers for appointments, but that it will take sophisticated outreach to get to remaining people who are either hesitant or have work or transportation obstacles.

Minnesota's goal for months has been a vaccination rate of 80%, but some epidemiologists believe viral transmission could be significantly slowed with a rate of 70%. If Walz announces a 70% trigger on Thursday, it would be the first time the state's pandemic response was tied to specific progress in vaccination.

Minnesota has measured itself by vaccination of all eligible people 16 and older because the Pfizer vaccine is available to people ages 16 and 17 while the cutoff is 18 for the Moderna and Johnson & Johnson versions. That is slightly different from the announced goal by President Joe Biden on Tuesday to provide at least a first dose to all American adults 18 and older by July 4.

The denominator for Minnesota's target could soon increase, Ehresmann noted. Federal health officials are expected to drop the age criteria for Pfizer vaccine down to 12, perhaps next week. About 283,000 Minnesotans are in the 12- to 15-year-old age range.

The spread of new, more infectious variants also could upset plans, because many projections of herd immunity through vaccination are based on the transmission rates that occurred earlier in the pandemic. The latest White House COVID-19 report on Minnesota, released Tuesday, showed that an estimated 68% of new infections in Minnesota are due to the more infectious B.1.1.7 variant first found in England.

Ehresmann said she is concerned that other variants that pose more infectiousness, or maybe vaccine resistance, are starting to spread within Minnesota, rather than just among people in the state returning from foreign travel. Sixty-five infections with the P.1 variant first found in Brazil have been identified through genomic sequencing of positive lab samples, and 88 infections with the B.1.351 variant first found in South Africa have been identified in the state.

Minnesota medical and pharmacy providers have wasted only 2,072 doses out of a supply of nearly 5 million — despite the complex freezing and thawing requirements of the Pfizer and Moderna vaccines.

Ehresmann said that conservative approach has resulted in some vaccine not being available in places where people were seeking shots. She said the state is considering a more aggressive strategy of making doses available in more places, even if it risks more waste.

"We need to shift the narrative on that," she said, "and focus on not wasting an opportunity to vaccinate rather than just focusing on wastage."

New strategies to increase vaccination have included walk-in access at Walmart pharmacies and Edina Public Schools offering doses directly to high school students Thursday and Friday.

The state on Tuesday reported 11 more COVID-19 deaths and 998 infections identified through testing — raising its totals in the pandemic to 7,174 deaths and 581,335 infections.

Walz has spoken with business, health and legislative leaders over the past week to develop a road map for the eventual end to all pandemic restrictions.