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The delta variant-fueled COVID-19 surge in the Upper Midwest is now believed to be responsible for the deaths of four teenagers in Minnesota. 

The Minnesota Department of Health announced 45 deaths in Tuesday's situation update, including a teen aged 15-19. It's the fourth COVID death of a teenager since the start of the pandemic and all four have happened since mid-October of this year. 

Health officials have so far reported 801 deaths from COVID-19 in Minnesota in November, with delayed reporting likely to increase the monthly total in the days to come. There were 579 deaths in October and 353 in September. 

November 2021 ranks as the third-deadliest month of the pandemic in Minnesota. 

  1. December 2020 - 1,800 deaths
  2. November 2020 - 1,503 deaths
  3. November 2021 - 801 deaths
  4. January 2021 - 775 deaths
  5. May 2020 - 708 deaths
  6. October 2021 - 579 deaths
  7. October 2020 - 510 deaths
  8. April 2020 - 386 deaths
  9. June 2020 - 367 deaths
  10. September 2021 - 353 deaths

Health leaders remain confident that the vaccines will continue to protect against severe illness and death from the delta and omicron variants, though there are signals that omicron may be more likely to evade natural and vaccine immunity. 

"We're delighted that the initial cases who have had vaccine breakthrough have had mild illness," says Kris Ehresmann, director of infectious disease at the Minnesota Department of Health. "If we can prevent infection in the first place, great. But ultimately our goal with vaccination is to limit hospitalizations and prevent death. And so far, with limited data, that's what we've seen."

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