Minnesota tempers expectations for expanded COVID-19 vaccine rollout

State health officials warned Tuesday that a revised federal plan to prioritize initial COVID-19 vaccine for senior citizens could backfire if more doses don't accompany this massive expansion.

While agreeing with the spirit of the Trump administration's announcement Tuesday to offer vaccinations to those most vulnerable to COVID-19, state infectious disease director Kris Ehresmann said that would create a mismatch between the 60,000 new doses arriving in Minnesota each week right now and its 890,000 senior citizens. Prioritizing all adults with underlying health conditions would put another million people at the front of the line.

"We're all of a sudden, with this announcement, potentially adding a couple million people who will expect to be vaccinated," she said. "And if we are only getting 60,000 doses a week, that is going to be a real problem."

Minnesota has closely followed the federal guidance of the Advisory Committee on Immunization Practices (ACIP) on how to give limited initial doses against a COVID-19 pandemic that has caused 5,724 deaths and 438,867 diagnosed infections in the state.

A new state vaccine website on Tuesday showed that 144,503 first doses of the Pfizer and Moderna vaccines had been given to the highest priority groups of health care workers and residents of long-term care facilities. Among them, 7,392 people had completed the two-dose series.

The progress had state officials ready next week to announce the next phase of vaccinations to more than 1 million Minnesotans who are 75 or older or people such as police officers and teachers in front-line essential industries.

Now those plans are on hold as Minnesota officials await detailed guidance from the U.S. Department of Health and Human Services, which announced on Tuesday that it was departing from the ACIP recommendations and encouraging broader access.

"Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost," HHS Secretary Alex Azar said.

The new federal guidance isn't required but will likely influence many states — though Minnesota leaders said it is unclear if the incoming administration of President-elect Joe Biden will uphold it.

The federal change also included a commitment to release a massive supply of reserve COVID-19 doses, which had been held back to guarantee that people received second doses on time. Both vaccines are around 95% effective when given as scheduled.

Gov. Tim Walz celebrated the release of the reserve doses, noting that he and other governors called for this move and that the pace of manufacturing should ensure that second doses will be available.

"Minnesotans are ready for the COVID-19 vaccine — it is how we will crush this virus, save lives and finally resume normalcy," Walz said.

More than a dozen states have already deviated from the ACIP guidance regarding the first wave of vaccinations — with Florida allowing access to anyone 65 or older.

That move received criticism, though, as people in Florida struggled to sign up for limited vaccine slots and then waited in lines for hours.

"There's nothing easy about this when you have a limited number of doses come in and you try and protect the most vulnerable people first," said Michael Osterholm of the University of Minnesota's Center for Infectious Disease Research and Policy.

The ACIP guidelines prioritized health care workers because of their risks of infection with the coronavirus that causes COVID-19, and long-term care residents who are more at risk for severe illness and have suffered 64% of Minnesota's COVID-19 deaths.

Age has been perhaps the strongest indicator of risk. People 70 or older make up only 9% of known infections in Minnesota, but 83% of the COVID-19 deaths.

"[The federal policy switch] is definitely good news for older people in the state and it is absolutely a reflection of our efforts to prioritize older Americans for the vaccinations," said Will Phillips, state director of AARP Minnesota, which is fielding calls from members who are frustrated that they don't know when or how they will get the shots.

The state's vaccine website shows that 2.9% of Minnesota's population has received at least one dose, but the majority of shots have gone to people 49 and younger — corresponding to the demographics of Minnesota's health care workforce.

The new dashboard did not immediately make the raw vaccine data downloadable, disrupting its publication on the Star Tribune tracker and other websites. State leaders on Tuesday agreed with media requests to make the data available in that format.

Of 541,100 doses allocated for first and some second injections in Minnesota, 100,500 have been diverted to a federal program using chain pharmacies such as Walgreens and CVS to vaccinate long-term care residents. Worker shortages and other problems have slowed the startup of that program, though.

The change in federal policy could hurt Minnesota's vaccine strategy in some ways, because it includes plans to allocate more doses to states with older and sicker populations. Minnesota is healthier and younger on average.

States that have injected more doses also could get greater supplies. A tracker on the U.S. Centers for Disease Control and Prevention website ranks Minnesota 24th for its rate of COVID-19 vaccine doses administered — behind the Dakotas and Iowa but ahead of Wisconsin. Minnesota officials said that is an unfair comparison because some states received more of their vaccine allotments sooner than others.

States would be given a couple of weeks to adjust to the new vaccine allocation.

Staff writer Glenn Howatt contributed to this story.