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Fewer than 20% of Minnesotans are current on their COVID-19 shots ahead of the Christmas holiday, and health officials said Tuesday that that has them worried.

"The numbers have been improving recently, and though this is better than the vast majority of the nation, it is way below where we would like to see it," State Epidemiologist Ruth Lynfield said during a briefing on the high numbers of cases and hospitalizations the state is experiencing for COVID-19, influenza and the respiratory virus RSV.

Lynfield urged Minnesotans who aren't up to date on their COVID-19 and flu shots to get them now to allow time for their immunity to build before the holidays are in full swing, and to reduce the strain on the health care system. People can get both shots at the same time.

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Minnesota has seen "a heavy early-season surge" in flu cases, Lynfield said, with more than 2,100 hospitalizations and 41 reported deaths. Minnesota schools have reported almost 900 outbreaks of flu-like illnesses this year, and nursing homes have reported close to 40. Flu vaccination rates are running about 10% below normal, she said.

Minnesota residents getting COVID shots

Democratic Minnesota Gov. Tim Walz, second from right, and former Republican Gov. Tim Pawlenty, second from left, receive their COVID-19 vaccines on March 30, 2021, in Eagan, Minnesota (AP Photo/Mohamed Ibrahim, File)

The state is also experiencing an "early and severe" RSV season with more hospitalizations and emergency room visits than have seen in many years, Lynfield said. While RSV is a common virus that typically causes mild, coldlike symptoms for many people, it can be serious for infants and older people, and it has no vaccine. Since the beginning of September, RSV has led to nearly 1,500 hospitalizations, she said, including more than 900 in children under age 1. Several hospitals have been running at or close to full capacity.

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While there are signs of "moderation" in the RSV numbers and "potentially a bit of a downturn" in flu cases, Health Commissioner Jan Malcolm said it's too early to call it a trend.

Malcolm, who is retiring when Democratic Gov. Tim Walz's first term ends Jan. 3, led Minnesota's response to the COVID-19 pandemic from the start and defended restrictions that Walz imposed in its early days against Republican criticism. According to her department's weekly update, as of Thursday the virus had caused 13,773 deaths in Minnesota. She used the briefing to reflect back over the last three years.

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"We're very aware — I certainly am — that there's a lot of fatigue out there with COVID information, and there's a great desire, and an understandable one, to think of COVID as something in the past," Malcolm said. "But it is most certainly still with us, and it's important that people understand both the risks that do remain and the very important tools that we have now available to manage these risks."