COVID-19 vaccine has been a hot commodity in Minnesota, where more than 3 million shots have been given, but health officials are preparing for any decline in demand that could upset the state's drive to vaccinate 80% of eligible residents.

Campaigns to motivate key demographic groups could be expanded to increase the number of shots given in the pandemic that has caused 6,922 deaths and 535,182 diagnosed infections in Minnesota.

State Health Commissioner Jan Malcolm said Minnesota's distribution strategy has shifted a bit to earmark more doses for areas that have been underserved or are seeing rising COVID-19 rates, but that the state is "a ways away" from supply exceeding demand.

"We do anticipate that at some point in time there will be more vaccine available than there are people waiting in line to get the shot," she said. "At that point, we will work to recruit people and to double down on our effort to encourage people to take the vaccine."

Shots have been administered to 43% of all eligible people 16 and older and 83% of all senior citizens in Minnesota, which reached the 3 million dose milestone only three weeks after surpassing 2 million. The total of 1,900,248 people who have received vaccine in Minnesota includes 1,247,045 people who have completed the one- or two-dose series.

A new pandemic wave is surging despite this progress, though, spreading fastest among younger adults and teenagers who weren't eligible for COVID-19 vaccine in Minnesota until last week. The state reported 14 more deaths and 2,535 infections on Thursday and a 6.4% positivity rate of diagnostic testing that is above the state's 5% caution threshold.

The number of COVID-19 cases admitted to Minnesota hospital beds increased again — from a low of 210 on March 6 to 565 on Wednesday. The latest total included 131 people in intensive care beds due to respiratory problems or other complications of their COVID-19 illnesses.

Some health officials worry that a weakening interest in vaccine could come at a pivotal moment of elevated COVID-19 activity. North Dakota's per capita ranking of vaccinations has slipped over the past month, and Dr. Doug Griffin, vice president of Sanford Health in Fargo, said he worries about the level of hesitancy among people who have yet to receive their shots.

"We are concerned that we could see [a drop in demand] maybe a little sooner than we thought," he said.

The regional health system is moving as a result to make vaccines easier to access, offering its first walk-in COVID-19 vaccine clinics this week in Fargo and Moorhead.

Interest in vaccine remains strong for now in Minnesota, according to COVIDcast survey data. The most recent rate of Minnesotans indicating they have either received COVID-19 vaccine or would accept it if offered, is 87.2%. The national rate is 84.7%.

Maura Caldwell, creator of the popular Minneapolis Vaccine Hunters Facebook group, said appointments are still snatched up quickly, but that the nature of the demand has changed.

More people today will hold out for convenient locations or for their preference of the two-dose Moderna and Pfizer options, or the one-dose Johnson & Johnson option.

"People who were desperate are taken care of or are figuring it out," she said. "People who were kind of waiting on the sidelines are starting to feel like, 'Well, yes, I could get one now.' "

Thousands of appointments had been unfilled for clinics targeting Muslims in Minnesota this week, but they were filled within hours of Caldwell talking with local imams and receiving permission to post the opportunity for anyone.

State health officials are concerned about inequities in COVID-19 vaccinations, in part because age-adjusted death rates in the pandemic have been higher among racial and ethnic minority groups.

Imam Hassan Jama, executive director of the Islamic Association of North America, joined with state health officials in a conference call on Thursday and offered assurances that Muslim leaders support vaccination.

"Taking the COVID vaccine is permissible," he said, adding that receiving it over the next month during Ramadan "does not break one's fast because it's not considered food and drink."

Gov. Tim Walz on Thursday said that vaccination of key risk groups appears to be holding down the rate of COVID-19 deaths in Minnesota — which has the nation's 10th highest rate of new infections but the 40th highest rate of deaths. He also noted a relatively low rate of new infections among K-12 educators at a time when new, more infectious variants of the SARS-CoV-2 virus are spreading more quickly among students.

"Teachers are not getting COVID and they're not getting sick because we made that commitment early" to prioritize them for limited COVID-19 vaccine doses, Walz said.

Vaccination rates have leveled off in some early priority groups, though. The rate has hovered just above 80% among senior citizens for two weeks, and the vaccination rate among K-12 teachers and child-care workers has nearly reached 69% but has slowed as well.

Malcolm said she is "thrilled" that Minnesota has vaccinated so many senior citizens — a group that has suffered 89% of COVID-19 deaths — but that it will take new strategies to reach out and vaccinate remaining individuals in the initial priority groups. Some are looking for information from their local doctors or sources they trust, while others want more convenience in scheduling appointments.

"It's so important to meet people where they are," she said.

State health officials released new figures on Thursday regarding the more infectious variants in Minnesota, including the B.1.1.7 variant that could be responsible for up to half of new infections in the state.

Roughly 7% of samples from new infections undergo genomic sampling analysis to determine if they involve any of the concerning variants.

B.1.1.7 has been identified in 1,573 cases in Minnesota, said Dr. Ruth Lynfield, state epidemiologist. Roughly 4% of those patients have been hospitalized and five have died.