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A vaccine vial was ready for use as critical staff at the Kaiser Permanente Lone Tree Medical Offices received their first doses of the Moderna vaccine for COVID-19 on Dec. 23, 2020, in Lone Tree. (Kathryn Scott, Special to The Colorado Sun)

Colorado again made significant changes to its coronavirus vaccination plan on Wednesday, moving older Coloradans and essential workers, such as teachers, up in priority. But big questions about how it will all work remain unresolved.

Gov. Jared Polis said at a morning news conference that people 70 and older are now eligible for vaccination in counties that have completed inoculations of frontline health care workers. That means those older Coloradans are now placed alongside police, firefighters and paramedics in the state’s new Phase 1b of its vaccination priority scheme.

COVID-19 IN COLORADO

The latest from the coronavirus outbreak in Colorado:

  • MAP: Cases and deaths in Colorado.
  • TESTINGHere’s where to find a community testing site. The state is now encouraging anyone with symptoms to get tested.
  • VACCINE HOTLINE: Get up-to-date information.

>> FULL COVERAGE

Also moved into Phase 1b: Teachers and others who work in education, food and agricultural workers, postal workers, people working in manufacturing, transportation workers, grocery workers, journalists reporting in the field and people who provide services to those experiencing homelessness.

The state had originally planned to keep Phase 1b relatively small, to reflect the limited supplies of vaccine coming into the state and the interest is precisely targeting how those would be administered. In the state’s earliest plan, Phase 1b contained around 100,000 people.

But the phase is now one of the largest in the entire plan, containing more than 1.3 million people, according to the Colorado Department of Public Health and Environment. That is nearly a quarter of the state’s entire population.

This chart shows Colorado’s prioritization plan for allocating coronavirus vaccine, as of Dec. 30, 2020. The new plan moves Coloradans age 70 and older, as well as a host of essential workers including teachers, higher in priority. (Provided by the Colorado Department of Public Health and Environment)

Polis said the state decided to prioritize older Coloradans after learning from its data that those 70 and older account for 78% of the state’s coronavirus deaths. The changes also bring the state in line with new federal recommendations issued earlier this month.

“To end the acute phase of the crisis, the potential for overrunning our hospitals, bringing the death rate down, saving lives and ending the pandemic, we wanted to use those initial doses on age 70 and up,” Polis said.

While Colorado officials have said they now have enough vaccine to inoculate all frontline health care workers in the state’s Phase 1a, Polis said some counties are still working their way through that list. That means some parts of the state will be able to start vaccinating older Coloradans next week and some won’t — though Polis did not say which counties fall into which groups and the state Health Department did not provide an immediate answer, either.

Several county health departments said on Wednesday following Polis’ announcement that they would need more time to complete their vaccinations of frontline health care workers and come up with plans for how to vaccinate people in Phase 1b.

The state is also far from completing vaccination of its other highest-priority group: staff and residents of nursing homes and other long-term care facilities. That campaign, which is being run by the pharmacy chains Walgreens and CVS, isn’t expected to finish administering initial doses until mid-January.

It is also unclear exactly how Phase 1b will be rolled out, and there appeared to be confusion around the announcement of the changes.

On Tuesday and Wednesday, officials in Eagle and Summit counties, for instance, announced that the counties would begin vaccinations for residents 75 and older. Polis later said he expected counties would change their plans to reflect the new state plan, which they subsequently did.

MORE: Summit County offers coronavirus vaccine to residents over 75 starting Thursday

And there was also confusion about a second priority group. Polis said during his press briefing that Coloradans ages 60 to 69 will be given priority in the state’s Phase 2 of the vaccine rollout, which should begin in spring. A chart sent out by CDPHE as Polis spoke, though, showed that age group as 65 to 69. By Wednesday night, CDPHE had updated the chart to show the Phase 2 age group as 60 to 69.

Polis said older Coloradans should call their local hospitals or community health clinics to check on vaccine availability and schedule appointments. But some hospitals quickly announced that they have no vaccine available for the general public.

The large health system HealthONE, which operates several hospitals in the Denver metro area, said it is still vaccinating all of its workers.

It was unclear if the state yet has a comprehensive plan to ensure equal access to the vaccine and avoid the kind of chaos seen in Florida, where seniors have been camping out overnight in long lines outside vaccination centers. In response to question from The Sun, a CDPHE spokesperson said Wednesday night that more information would be provided in the coming days and might not come until closer to January 15, when the state is now projecting to have given vaccinations to all frontline health care workers who want one.

“The state is actively working with local public health agencies to determine which additional providers will vaccinate members of the 1a and 1b groups, and we are regularly onboarding new providers,” the spokesperson wrote in an email.

CDPHE says some counties are planning for mass vaccination clinics, though it did not name them. In Summit County, officials said older residents should schedule an appointment online, with vaccinations to be given in partnership with Safeway and City Market.

Polis said the state estimates it will take four to five weeks to give initial doses to all Coloradans 70 and older.

The state Demography Office estimates that there are more than 560,000 Coloradans who are 70 and older, nearly 10% of the state’s population. But some counties that are more rural and remote — such as Hinsdale and Mineral — have higher percentages of older residents.

CDPHE estimates Phase 1b will also include around 628,000 frontline essential workers and 125,000 first responders and non-frontline health care workers.

It remains uncertain when those other groups in Phase 1b will become eligible for their shots. Polis said local health departments would work to identify eligible businesses and employers within their counties and would then contact those businesses to set up vaccination times.

Joe Pumo, RN, administers the shots to all critical staff at the Kaiser Permanente Lone Tree Medical Offices as they receive their first doses of the Moderna vaccine for COVID-19 on December 23, 2020 in Lone Tree, Colorado. Sixty-one staff members will receive the vaccine at this office, with a total of 4,000 doses distributed at 18 different medical offices throughout the Colorado Kaiser network. (Kathryn Scott, Special to The Colorado Sun)

Dr. Anuj Mehta, a pulmonologist with Denver Health who helped draft the state’s initial vaccination plan, said guidance from the state will need to remain flexible, in order to allow local health officials and doctors to respond best to local conditions.

“I think that this is going to fall on providers and local public health authorities,” Mehta said Wednesday during a meeting of a medical advisory group connected to the Governor’s Expert Emergency Epidemic Response Committee, which offers Polis recommendations on how to respond to the pandemic.

The state expects that Phase 2, when younger people with high-risk health conditions and other essential workers become eligible for vaccination, won’t start until spring. Phase 3, the final phase when all healthy adults who have not already been vaccinated become eligible, won’t start until summer, Polis said.

Still, Polis said he is optimistic that the end is in sight.

“This is our final major hurdle toward ending the pandemic,” he said.

John Ingold is a co-founder of The Colorado Sun and a reporter currently specializing in health care coverage. Born and raised in Colorado Springs, John spent 18 years working at The Denver Post. Prior to that, he held internships at...