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What happens when everyone who wants a vaccine has it?

Minnesota health officials ponder approaching era of more vaccine than takers, and the need to recruit the hesitant in order to lift mask orders.

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Photo: Unsplash/Fusion Medical Animation
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MINNEAPOLIS — With all employees of Mayo Clinic having been offered vaccination for COVID-19, over 40,000 or 75% of the system's Midwest employees have received the shots, but that acceptance rate differs by position.

Over 80% of staff on site in Rochester have been vaccinated, Mayo Clinic Covid-19 vaccination program co-director Dr. Melanie Swift said during a news conference on Thursday, April 8. Swift added that at this time, just 65% of those who work remotely have said they plan to become vaccinated, however.

Half of that remote staff have now received the first of their shots, Mayo has vaccinated over 93,000 patients, and remote staff were only recently made eligible. Also, the clinic "continues to prioritize vaccination for high-risk patients," Swift said.

"Also, we allot a majority of vaccine to patients with high-risk health conditions."

Broadening this picture to the surrounding region, over 72,000 or 46.5% of Olmsted County residents are vaccinated with at least one dose, a figure equal to nearly 60% of those over 15 and therefore eligible. The population most at-risk of serious outcomes, those over 65, has nearly 90% vaccination, according to Graham Briggs, director of Olmsted County Public Health.

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All of these numbers suggest that the healthcare-focused region of the state will soon approach a deflection point, one that will eventually spread statewide, in which all those who desire vaccine will have received it, and yet the state remains below a coverage rate allowing masks to come off and social distancing to cease. Vaccine hesitancy has dropped somewhat, with just one-quarter of the population currently vaccine reluctant in the U.S. But were those percentages to hold, that's not considered herd immunity.

This approaching second phase to the effort will require persuading the hesitant — or enough of the hesitant — to become vaccinated such that population reaches 80% vaccination, or herd immunity. Should that fail to happen, health officials will then face a challenging decision of whether to pick the loosening of unpopular restrictions like masking and social distancing over the reluctance of the hardened vaccine-hesitant.

"We do anticipate at some point there will be more vaccine than people waiting to get shots," said state commissioner of Health Jan Malcolm at an afternoon news conference Thursday. "At that point we will be looking to recruit people, and double down on our efforts to encourage vaccine. I think we're a ways away yet from that point."

"It's going to take us time to get to an overall 80% level," Malcolm said. "It's a continuing education campaign. We've done focus groups and people were not saying they were never taking vaccine, they were saying they needed more information from people they know and trust."

"I do believe either at some regional or national level we're eventually going to have a 'take off your mask off day' once we see incidence in the community is low enough," said Briggs.

The rapid spread of new variants is slowing the planning for that event. But it's also the case that so far, the vaccines beat the variants.

"We haven't seen a variant that's worked its way around the vaccine yet," Briggs said. "But for every person that's infected, there's a chance that person generates a new virus. I don't think we're at a point yet where we can take our masks off as a community."

Variants have become the dominant strain in the state and are known to cause greater illness, but so far there is no indication that variants can evade vaccines, especially those that target a common element to all corornaviruses — the spike protein.

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Hastening this progress, health officials looked forward to the hope that federal regulators will issue guidance as early as next week on the ability to offer the Pfizer vaccine to those 12 and older. Currently it is only authorized for those 16 and older.

"Targeting this population helps in terms of interrupting transmission," Swift said. "As they return to in-person learning they are a vector for transmission to parents' family."

The B.1.1.7 strain is known to be more transmissible but also to affect young people more severely than the previous strain.

No cases of variant have been documented in Olmsted County, but Graham believes it is circulating and says "I think it's a matter of time until we identify it's circulating."

Following are the Minnesota Department of Health COVID-19 case rates, deaths, hospitalizations and vaccinations as of Thursday, April 4. Because all data is preliminary, some numbers and totals may change from one day to the next.

Statewide case rates

  • NEW CASES: 2,535
  • SEVEN-DAY, ROLLING AVERAGE OF NEW CASES PER 100,000 PEOPLE: 30.2

  • TOTAL CASES: 535,182
  • TOTAL RECOVERED: 510,959
  • SEVEN-DAY, ROLLING AVERAGE TEST POSITIVITY RATE: 6.4%

Hospitalizations, deaths

  • NEW HOSPITALIZATIONS: 4

  • ACTIVE HOSPITALIZATIONS: 565

  • TOTAL HOSPITALIZATIONS: 27,968

  • DEATHS, NEWLY REPORTED: 14

  • TOTAL DEATHS: 6,922

Vaccinations

  • FIRST DOSE ADMINISTERED: 1,900,190 and 43.1% of population

  • COMPLETED SERIES (2 DOSES): 1,247,037 and 28.3% of population

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Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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