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California will receive 327,000 doses of coronavirus vaccine by mid-December. Who gets them?

Gov. Gavin Newsom announced on Monday that California could receive as many as 327,000 doses of a coronavirus vaccine as early as mid-December, with another round of supply anticipated three weeks later.

Newsom said he "did not want to give the specific date quite yet" for when exactly the pharmaceutical company Pfizer plans to send a shipment to California, but said it's expected before the end of the year.

"We are anticipating 327,000 doses of the vaccine, Pfizer, to come in within the next few weeks," Newsom said.

The pharmaceutical company announced last month that its vaccine was more than 90% effective, and quickly applied for emergency use soon after. Since then, states have ramped up their vaccine preparation and distribution plans.

In California, the first phase of its vaccine distribution program prioritizes health care workers at the highest risk of infection, working in both clinical and non-clinical settings.

California is home to up to 2.4 million health care workers, according to the state Department of Public Health's Community Vaccine Advisory Committee. Around 1 million work in acute care hospitals. Close to 145,000 work in nursing homes.

The first vaccine delivery won't cover every health care professional, the advisory committee warned during a meeting on Monday. It instead approved a plan that prioritizes those who come into direct contact with patients positive for COVID-19 and those at the highest risk of exposure. The committee therefore recommended the state "sub-prioritize" workers in certain facilities, depending on the location and how vulnerable the populations are being serviced.

The tiered blueprint specifically places acute care, correctional and psychiatric hospitals and nursing homes at the top of the list, along with paramedics and other emergency responders.

Then health workers in intermediate care facilities, homes and community clinics could gain access to the vaccine, in addition to those working as public health field staff or in urgent care, rural clinics or correctional facilities. The third tier includes less risky settings like dentist offices, laboratories and specialty clinics.

Above all, "health departments should prioritize supplies to facilities serving the greatest proportion of vulnerable persons," the committee's notes include.

From there, the state would move to vaccinating other Californians vulnerable to the worst of COVID-19, along with some essential workers, like farm laborers, police officers, child care staff and teachers. The state's Department of Public Health plan also emphasizes Black and brown communities disproportionately affected by COVID-19.

In addition to triaging essential and health care workers, other tricky logistics include cold storage and making sure people come back for two doses, which both Pfizer and another promising company, Moderna, require.

"These are challenging vaccines," Newsom said, "because they are the ultra-low temperature storage vaccines. They also require a second dose, which we anticipate in three weeks."

Still, the vaccine couldn't come at a better time. Newsom warned during a press conference that the state is experiencing an alarming surge in new cases that are outpacing even the worst point of the summer peak.

The two-week positivity rate has hit 6.2%, and public health officials are warning that health care workers are already overwhelmed with an influx of COVID-positive patients. Hospitals could soon see another flood of coronavirus cases within a few weeks, following the Thanksgiving holiday, with the possibility that some ICUs reach capacity by mid-December.

Given the urgency, California Health and Human Secretary Mark Ghaly said the state is preparing to build "trust and trustworthiness" in the effort to get as many Californians vaccinated against COVID-19 as possible. A California expert panel was set up to review vaccine efficacy and safety data following any progress out of Washington.

That public confidence, Ghaly said, will ensure that as more doses of the vaccine become available next year, "a number of individuals will avail themselves of it and will have that additional tool to protect themselves and their community."

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