Limited amounts of Covid-19 vaccine mean those who want it will need to be patient.

British grandmother Margaret Keenan, 90, made history on Dec. 8 as the first person in the world to receive the Pfizer/BioNTech Covid-19 vaccine outside of a trial. Officials there declared the day as “V-Day,” as they began administering 4 million “jabs” – British parlance for vaccinations – to its citizens through the end of December. In sharp contrast, California is waiting for approximately 2.16 million vaccines to come through by the middle of this month once the U.S. Food and Drug Administration approves, Gov. Gavin Newsom announced Dec. 7. Only a small fraction are expected to come to Monterey County in the first shipments.

Health care workers and residents of long term care facilities will be vaccinated first, as ruled by the U.S. Centers for Disease Control’s Advisory Committee on Immunization Practices and affirmed by California’s own vaccination workgroup. Monterey County Health Officer Edward Moreno told the Board of Supervisors on Dec. 1 that as of that date he was only expecting 3,000 vaccines to come to the county, based on the state receiving 327,000 doses by Dec. 15. “You can imagine how many health care workers we have in Monterey County. The 3,000 doses will go quickly,” he said.

One estimate is that there are 2.4 million health care workers in the state, more than the 2.16 million doses to be delivered this month. Newsom said the number of doses will increase each month.

On Dec. 9, Moreno told reporters during a briefing call that updated vaccine dose numbers for the first round are 2,925 doses from Pfizer and 4,700 doses from Moderna. The county will be able to order more vaccines on a weekly basis through the California Department of Public Health. 

Since both vaccines require two doses a month apart, after the first month the state shipments will include both new orders and follow-up doses.

Moreno told supervisors the county is preparing for cold storage and distribution through the same channels used for annual flu vaccines. The Pfizer vaccine requires ultra cold storage, the Moderna vaccine can be held in normal freezers or for shorter periods in regular vaccine refrigeration units.

Who gets the vaccines and in what order is still being hammered out. The California Department of Public Health recently published a complex list of tiered recommendations for Phase 1 in case of limited supplies, down to what type of health workers, patients and facilities will be prioritized, with the oldest workers and patients ahead of younger ones. It’s expected that as more vaccines are delivered each month, the circle of who is eligible to receive a vaccine – if they want one – will widen.

Also near the top to receive vaccines are “essential workers,” and that definition being debated, as various labor groups in agriculture, education and elsewhere lobby the state to define their workers as essential, farmworkers especially. Assemblymember Robert Rivas, D-Hollister, vice chair of the Latino Caucus, says that with farmworkers three times more likely to contract the virus than others, they should receive the vaccine right behind health workers.

“When you look at the data – who has tested positive, who is at greatest risk and who has died because of this virus – farmworkers are at the greatest risk than anyone in the population,” he says. On Dec. 7, the first day of the legislative session in Sacramento, Rivas co-introduced Assembly Bill 93 with Eduardo Garcia, D-Coachella, which prioritizes farmworkers, grocery clerks and others in the food industry for rapid testing and vaccinations. Still needed is messaging to encourage those hesitant to take the vaccine.