As COVID-19 cases start to rise again in Nebraska and more people wind up in the hospital, the ages of those patients are trending younger.

The average age of patients hospitalized at Bryan Health in Lincoln was 61 in January, but it dropped to 51 in March. That's the first time since last summer that most COVID-19 patients in Bryan's two local hospital campuses are younger than 60.

At CHI St. Elizabeth, half of the COVID-19 patients admitted over the past two days were younger than 60, including one who was younger than 18, although spokeswoman Katie Breidenbach said the majority of the patients hospitalized are still older than 60.

At Nebraska Medicine in Omaha, it's a similar situation. The hospital Friday could not provide actual numbers, but Dr. Mark Rupp said through a spokesman that he "believes it's accurate" to say the hospital has been seeing more younger patients lately.

Though hospitalizations are rising both locally and statewide, they remain comparatively low. For example, the Nebraska Department of Health and Human Services reported 128 hospitalized COVID-19 patients in Nebraska as of Friday, up from 102 Monday.

But that's half as many as there were two months ago, and it's a far cry from the pandemic high of 987 set in November.

In Lincoln, there were 24 COVID-19 patients hospitalized as of Friday, compared with 14 a week ago. The 27 patients hospitalized Thursday were the highest total in nearly a month. However, it's still considerably less than two months ago and nowhere near the peak of 168 reached near the end of November.

There are likely a couple of reasons that the age of hospitalized patients is trending downward.

One is that a significant portion of the older population has been vaccinated. Statewide, more than 70% of people older than 65 are fully vaccinated against the virus, and in some areas, such as Lancaster County, the number is even higher.

For example, as of March 7, Nebraska was averaging one COVID-19 case per 10,000 nursing home residents. As recently as mid-January, that number was nearly 150 per 10,000.

Nationally, nursing homes have seen a 96% decline in cases and a 91% decline in deaths since their peak right before Christmas, according to a report from the American Health Care Association and National Center for Assisted Living.

Another reason is that the state is seeing more cases of variant strains of COVID-19, which are more infectious and may cause more serious illness in younger people.

As of Wednesday, the state health department had reported 103 confirmed cases involving variant strains, more than triple the number from just two weeks ago.

Dr. Bob Rauner, president of the Partnership for a Healthy Lincoln and chief medical officer of OneHealth Nebraska, said he believes both factors are driving the trend toward younger hospital patients.

He pointed to Michigan, where a surge in COVID-19 cases has been driven largely by a tripling in the number of cases among children under age 19, and said Nebraska is likely seeing a similar — although less-pronounced — increase in cases among young people.

"But since the vaccine works and more older (people) are vaccinated, that also makes a difference," Rauner said.

Vaccines have proven effective at preventing COVID-19 infections so far, with Nebraska identifying only 15 possible cases among the more than 350,000 people who have been fully vaccinated.

But only about one-third of the fully vaccinated group is under age 55, and only about one-quarter is under age 45.

That's likely a factor in why infections are increasing among young people.

Douglas County, for example, saw a 58% increase in COVID-19 infections in the 20-39 age group last week compared with the previous week, and a 64% increase among people ages 40-59.

“This should serve as a reminder that we can’t let down our guard,” Health Director Dr. Adi Pour said in a Thursday news release.

Douglas County's seven-day average of cases had reached its highest level in two months as of Thursday.

Lancaster County is seeing cases rise, but not as fast. Its seven-day average of cases as of Thursday had risen to its highest level in a month.

Concern about rising cases and hospitalizations led Gov. Pete Ricketts on Wednesday to announce that starting Monday, anyone 16 and older is eligible to get a COVID-19 vaccine.

That marked a significant change for the governor, who up until this week had insisted that vaccines should be targeted at older populations that are most at risk of being hospitalized.

"We want people to get signed up. We want to get these vaccines out into people's arms," Ricketts said during his Wednesday news conference.

He said vaccinating as many people as possible is the best way to prevent the virus from spreading, "and especially with our increase in hospitalizations, we want people to get vaccinated as quickly as possible."