The first shipment of the COVID-19 vaccine to Minnesota could be enough for only about 24,000 people, but more will be on the way.
Hundreds of thousands of Minnesota health care workers and long-term care residents have been designated as being the highest priority for getting the shot, leaving state officials with tough choices to make on who will be first in line.
Minnesota health officials declined to say Thursday how much the state would receive of the 6.4 million doses that vaccine maker Pfizer is shipping to the United States in the first round.
But several states, including New York and California, have disclosed their allotments, giving clues to the distribution formula tied to each state's adult population.
Wisconsin health officials said this week they will be getting nearly 50,000 doses. Its adult population is roughly 5% higher than the 4.3 million adults in Minnesota.
Based on those numbers, as well as other state allocations, Minnesota is on track to receive about 47,000 doses. Like many of the COVID-19 vaccines being developed, each person needs two doses taken a few weeks apart to receive full protection.
The shipments are scheduled to start the week of Dec. 14, and more doses are expected to be delivered in subsequent weeks. Federal officials have said they hope to get 40 million doses from Pfizer and another drugmaker, Moderna, into the hands of the states, territories and six large cities by the end of the year.
The Pfizer vaccine is expected to receive an "emergency use authorization" from the U.S. Food and Drug Administration on Dec. 11, a step that would allow it to bypass normal approval protocols.
While the initial shipments will be small compared with the need, they will mark a significant turning point in the battle against the stealthy coronavirus.
"We've been talking about the light at the end of the tunnel," said state infectious disease director Kris Ehresmann. "It is there and it is getting closer."
Since late October, Minnesota has seen an unprecedented number of new infections, hospitalizations and deaths.
The Health Department on Thursday reported 92 new COVID-19 deaths — the second-highest one-day total of the pandemic, which has taken 3,784 Minnesota lives.
Hospitals had 376 COVID-19 patients in intensive care units, a slight decline from the previous day. Hospitals have freed up some space by delaying less urgent surgeries, but coronavirus patients accounted for 34% of all ICU beds.
Another 6,166 lab-confirmed infections were reported, bringing the total to 333,626 known cases, including 24,217 health care workers.
Health care workers are getting infected, often in nonmedical settings, but they are also required to quarantine if they have a high-risk exposure to someone with COVID-19.
That's one reason a federal advisory panel this week recommended that health care workers be among the first to get the COVID-19 vaccine.
Minnesota alone has 355,000 health care practitioners and support professionals, including 25,000 licensed physicians and 160,000 people licensed by the Minnesota Board of Nursing.
Some have more direct contact with COVID-19 patients than others but any patient presents a risk because of asymptomatic spread of the virus.
The Advisory Committee on Immunization Practices (ACIP), an independent advisory group that makes recommendations to the federal government on vaccine distribution, addressed how limited supplies of the vaccine could be handled.
"Jurisdictions might consider first offering vaccine to health care personnel whose duties require proximity [within 6 feet] to other persons," the group said in a report released Thursday.
Still, that leaves a fairly large group considering that health care workers include those in hospitals, long-term care facilities, outpatient clinics, home health care, pharmacies, emergency medical services and public health.
"I would make the plea that firefighters do deserve to be in that first phase," said Chris Parsons, president of Minnesota Professional Fire Fighters, a group that represents 1,800 firefighters and paramedics.
Many firefighters serve dual roles. Trained as paramedics and emergency medical technicians, they are often the first to arrive at a medical emergency.
"We are absolutely the front of the front line," he said. "We are the tip of the tip of the spear."
A St. Paul fire captain, Parsons recently went on a call to attend to a heart attack, only to find a house full of COVID-19-infected family members.
"We are usually operating in tight quarters so our exposure is very high," he said. "As cases in the state have gone up, we have seen a spike in cases among our members."
Among others being considered for the first doses are long-term care residents.
"We were thrilled to see the recommendations," said Patti Cullen, CEO of Care Providers of Minnesota. "Our best guess is the first limited batch of vaccines would be available toward the end of December but there will not be enough to go around to both [nursing homes] and assisted living."
Minnesota has about 78,000 long-term care residents. Priority could be given to the state's 22,000 in nursing homes because they tend to be sicker and most at risk for COVID-19 complications, ACIP said.
With the rapid pace of COVID-19 vaccine development, states are grappling with how to best distribute the shots.
"I give the states 'A' for effort. They are really trying but they are all over the map though in terms of preparedness," said Jennifer Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation. The biggest challenge for many will be a lack of funding.
"Many states have been underfunding public health for years," she said. "Now they are having to ramp up to an unprecedented level for a COVID vaccine."
The Health Department said it is not ready to release many details about the vaccine rollout, or supply, as it is still working with external agencies, including local public health agencies that will play a large role.
"We plan to provide as much of that detail and context as we can in a briefing early next week," agency spokesman Doug Schultz said.
Staff writer Chris Serres contributed to this report.