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COVID-19 Vaccine Breakthrough Data
COVID-19 Situation Update
Updated 6/22/2023
Updated weekly on Thursdays at 11 a.m. with data as of 4 a.m. on the Tuesday prior, unless noted otherwise.
Note: Due to changes in COVID-19 vaccine recommendations and tracking, this page will no longer be updated after 6/22/23. COVID-19 vaccination continues to be one of the best ways to prevent severe illness and death.
COVID-19 vaccines are effective. However, some people who are vaccinated will still get COVID-19 if they are exposed to the SARS-CoV-2 virus. These are called "vaccine breakthrough cases." Vaccination can make illness less severe in people who experience a vaccine breakthrough infection. People who have completed at least a primary series are less likely to be hospitalized or die than people with similar risk factors who are not vaccinated. People who have received their bivalent booster have an even lower risk of hospitalization or death than people with similar risk factors who have only received monovalent doses of vaccine or people who are not vaccinated.
On this page:
Case Definition
COVID-19 Vaccine Breakthrough Data
Adult Vaccine Breakthrough Data
Pediatric Vaccine Breakthrough Data
Making Direct Comparisons in Raw Case, Hospitalization, and Death Counts
What Are Vaccine Breakthrough Cases Video
Information for Case Investigation and Reporting
Case Definition
Vaccine breakthrough after primary series* but no bivalent booster (vaccinated without bivalent booster):
A confirmed or probable SARS-CoV-2 infection occurring 14 or more days after the most recent dose of an FDA-authorized or approved COVID-19 monovalent vaccine (primary series or booster dose) in any person who completed at least a primary vaccine series but has not received a bivalent booster. The primary series requires one dose of vaccine for the Janssen (Johnson & Johnson) vaccines or two doses for the Pfizer, Moderna, or Novavax vaccines.
Vaccine breakthrough after a bivalent booster (bivalent boosted):
A confirmed or probable SARS-CoV-2 infection occurring 14 or more days** after a person has received a booster dose with an FDA-authorized or approved bivalent COVID-19 vaccine. Bivalent booster doses must have been received on or after 9/02/2022 for people age 12 years and older and on or after 10/12/2022 for age 5 – 11 years based on when the FDA first authorized bivalent booster doses for each group.
* Partially vaccinated people or people who received only a single dose of Pfizer, Moderna, or Novavax vaccines are excluded from these analyses.
** The 14-day lag for booster doses aligns with the case definition for vaccine breakthrough in a boosted person used in the CDC: COVID Data Tracker.
More about cases can be found in Cases & Variants.
COVID-19 Vaccine Breakthrough Data
All data is preliminary and may change as cases are investigated. Case and vaccine totals reflect only the results from laboratory testing and vaccinations that have been reported to the Minnesota Department of Health.
Data may not align exactly with the cases reported on other pages or dashboards due to differences in reporting lags and the frequency with which the data are updated.
- Unvaccinated: A person is considered "Unvaccinated" if they have not had any COVID-19 vaccines 14 or more days before their infection.
- Vaccinated with at least a primary series (pediatric data only): A child is considered "vaccinated with at least a primary series" if they have received the complete primary series of their vaccine AND at least 14-days have passed since they have completed their primary series. This includes children who have a received a primary series plus additional booster doses.
- Vaccinated without a bivalent booster: A person is considered "vaccinated without a bivalent booster" if they have received at least a complete primary series of their vaccine AND at least 14-days have passed since the completion of their primary series. Vaccinated without a bivalent booster also includes anyone who has received any number of monovalent boosters.
- Bivalent boosted: A person is considered "bivalent boosted" if they have received a dose of bivalent vaccine AND at least 14 days has passed since they received their bivalent booster. People for whom it has not been at least 14 days since their bivalent booster dose are considered "Vaccinated without a bivalent booster." Bivalent booster doses are only counted if they were administered on or after 9/02/2022 for people age 12 years and older and on or after 10/12/2022 for age 5 – 11 years based on when the FDA first authorized bivalent booster doses for each group. Note: Bivalent booster doses that are reported as first or second doses are classified as vaccinated with a bivalent booster.
- Total population that is unvaccinated: Estimates of the unvaccinated population are obtained by subtracting the number of Minnesotans known to have received at least a primary series of vaccine (including those who have received boosters) from the 2019 American Community Survey (ACS) 5-year Estimates by age for Minnesota at United States Census Bureau: Explore Census Data. Statewide estimates by age are based on ACS tables DP05 and S0101, except for the 5-11- and 12–15-year-old age groups, which are based on summing the county-level estimate based on ACS table B01001. The 5-11- and 12-15-year age groups have been split based on the assumption that ages are equally distributed within age groups.
- Total population that is vaccinated with at least a primary series, vaccinated without a bivalent booster, or bivalent boosted: Data for the total number of Minnesotan's who are vaccinated with at least a primary series, vaccinated without a bivalent booster, or bivalent boosted are obtained from the Minnesota Immunization Information Connection (MIIC).
- COVID-19 hospitalization: Includes patients admitted to the hospital for any reason within 14 days of a positive COVID-19 test.
- COVID-19 death: Deaths with a positive COVID-19 test AND either COVID-19 is listed on the death certificate OR clinical history/autopsy findings provide evidence that the death is related to COVID-19 without an alternative cause (e.g., drowning, homicide, trauma, etc).
- Rate per 100,000: Incidence rates per 100,000 are calculated as the number of people in each age group with a positive COVID-19 test (or hospitalization or death) who have not received a primary COVID-19 vaccination series (or who have received only primary series or a primary series + booster), divided by the total number of people in Minnesota in that age group who have not received a primary COVID-19 vaccine series (or who have received only a primary series, or who have received a primary series + booster) multiplied by 100,000.
- Age-adjusted rates: Weekly age-adjusted rates per 100,000 are obtained by taking the incidence rate per 100,000 and standardizing to the U.S 2000 Standard Population which can be obtained from the National Cancer Institute: Standard Populations (Millions) for Age-Adjustment.
- Incidence rate ratio: Incidence rate ratios are calculated by dividing the incidence rate among people who are not fully vaccinated by the incidence rate among people who are fully vaccinated (or by people who are fully vaccinated and boosted).
Adult (age 18+) Vaccine Breakthrough Data
Adult Age Adjusted Cases, Hospitalizations, and Deaths by Vaccination Status
- Adult Age-Adjusted Cases, Hospitalizations, and Deaths Data File (CSV)
- Age-adjusted rates for people who are bivalent boosted begins on the week beginning 9/18/2022, two weeks after the CDC approved booster recommendations for people aged 12 years and older.
- Vaccinated without a bivalent booster and bivalent boosted populations are mutually exclusive, a vaccine breakthrough infection is only counted in one of the two groups.
- As of 10/6/22, an improved method to match patient data and vaccination records was implemented. This methodology was applied to all cases going back to the start of reporting on vaccine breakthrough cases.
Adult Cases, Hospitalizations, and Deaths by Age Group
There was an error in the final visual of Adult Cases, Hospitalizations, and Deaths by Age Group posted 6/22/2023. The underlying data available in the csv file was not affected. The visual was corrected 7/13/2023.
- Adult Cases, Hospitalizations, and Deaths by Age Group Data File (CSV)
- Bivalent booster vaccinations are only counted beginning the week that starts on 9/18/2022, two weeks after the CDC approved bivalent booster recommendations for the 12 and older U.S. adult population. Time period filters that begin earlier than 9/18/2022 will still show information about bivalent booster data but the data used to calculate the bivalent boosted rates will not begin before 9/18/2022.
- As of 10/6/22, an improved method to match patient data and vaccination records was implemented. This methodology was applied to all cases going back to the start of reporting on vaccine breakthrough cases.
Pediatric (ages 5-17) Vaccine Breakthrough Data
Pediatric Cases and Hospitalizations by Vaccination Status
- Pediatric Age Adjusted Cases and Hospitalizations by Vaccination Status Data File (CSV)
- Data in this graph have been smoothed using a 4-week moving average. Moving averages combine the raw counts for the data from preceding days or weeks and then average them (e.g., a 4-week moving average combines data from the current week and the previous 3 weeks and averages them). They are useful for observing trends in data which have larger fluctuations over short periods of time because of small population sizes or rare outcomes. Raw data of the count and rate per week are still available in the downloadable CSV file.
- Data for ages 12-17 are included in the age adjusted rate calculations starting 7/4/2021. Data for ages 5-11 are not included in the age adjusted rate calculations until 12/05/2021 to account for the time it would take from when vaccines were first authorized for the 5-11 age group (10/29/2021) plus 21-days to allow for completion of the primary series, plus an additional 14 days to align with the case definition for a vaccine breakthrough infection.
- Age-adjusted rates for children age 12-17 who are bivalent boosted begins on the week beginning 9/18/2022, two weeks after the CDC approved booster recommendations for people age 12 years and older.
- Age-adjusted rates for children age 5-11 who are bivalent boosted begins on the week beginning 10/23/2022, two weeks after the CDC expanded booster recommendations for 5-11 year-olds.
- Pediatric deaths are not reported by vaccination status.
- As of 10/6/22, an improved method to match patient data and vaccination records was implemented. This methodology was applied to all cases going back to the start of reporting on vaccine breakthrough cases.
Pediatric Cases and Hospitalizations by Age Group
- Pediatric Cases and Hospitalizations by Age Group Data File (CSV)
- Data for children age 12-17 who are bivalent boosted begins on the week beginning 9/18/2022, two weeks after the CDC approved bivalent booster recommendations for people age 12 years and older.
- Data for children age 5-11 who are bivalent boosted begins on the week beginning 10/23/2022, two weeks after the CDC approved bivalent booster recommendations for 5-11 year-olds.
- As of 10/6/22, an improved method to match patient data and vaccination records was implemented. This methodology was applied to all cases going back to the start of reporting on vaccine breakthrough cases.
Making Direct Comparisons in Raw Case, Hospitalization, and Death Counts
- Notes about making direct comparisons between the number of people vaccinated with a primary series (or a primary series + booster) and people without a primary series:
- There are differences in the underlying population for each vaccination status. For example, Minnesotans who are older, have underlying health conditions, or work in high-risk settings are more likely to have a bivalent booster.
- This means more people in the bivalent booster populations are at increased risk of developing, becoming hospitalized, or dying from COVID-19 because of their age, health conditions, or types of exposures.
- Because the populations are different, you must make adjustments in order to directly compare them.
- Making comparisons without these adjustments does not provide a measure of how well the vaccine works.
- For more information, please watch What Are Vaccine Breakthrough Cases.
What Are Vaccine Breakthrough Cases Video
What Are Vaccine Breakthrough Cases?
- What Are Vaccine Breakthrough Cases Transcript (PDF)
- What Are Vaccine Breakthrough Cases (Audio Described) (YouTube)
- What Are Vaccine Breakthrough Cases Transcript: Amharic (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Arabic (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Chinese (PDF)
- What Are Vaccine Breakthrough Cases Transcript: French (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Hindi (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Hmong (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Karen (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Lao (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Nepali (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Oromo (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Russian (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Somali (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Spanish (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Swahili (PDF)
- What Are Vaccine Breakthrough Cases Transcript: Vietnamese (PDF)
Information and Resources for Case Investigation and Reporting
- Health Care: COVID-19
Minnesota guidance for reporting, evaluating and testing, infection prevention and control, and more.