Pictured are Moderna COVID-19 vaccine doses from the initial 100 delivered to Montgomery County officials on Dec. 23. Credit: Photo from Montgomery County

This story was updated at 10:53 a.m. on Jan. 6, 2021, to include information about the county’s vaccine priority groups in Phase 1. It was also updated at 12:22 p.m. on Jan. 6, 2021, to correct an age requirement for Phase 1C.

As COVID-19 vaccines are administered to health care workers and nursing homes across the county, there have been questions about where everyone else fits into the inoculation phases.

Currently, health care workers, nursing home residents and employees, vaccinators, medical providers, and first responders are receiving vaccine doses as part of the initial round of vaccinations in Phase 1A.

According to a list of vaccination priority groups sent to the County Council and council staff members on Tuesday afternoon, each subgroup of Phase 1 is further split into priority tiers. Council Member Hans Riemer provided a copy of the list to Bethesda Beat Wednesday morning.

Dr. Travis Gayles, the county’s health officer, wrote in a Tuesday email to the council and its staff members that the list is based on information county officials received from the state on Monday.

Here’s who is eligible in each phase and priority tier. Unless otherwise noted, the list for Phase 1 only includes people unable to work from home and unable to control social distancing in the listed industries.

Phase 1A

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Tier 1:
● Hospital personnel
● Long-term care facility staff members and residents
● Developmental Disability Administration group homes
● Assisted living facilities
● Rest and rehabilitation programs

Tier 2:
● EMS
● Vaccinators (local health department, school nurse, etc.)
● Testing sites — testers and onsite registration staff members
● Public health — COVID-19 response
● Urgent care providers
● Primary care providers

Tier 3:
● Dental practices
● Pharmacists
● Other health care professionals (outpatient specialties, optometrists, physical therapists, podiatrists, community health workers, in-home nursing staff, etc.)
● Detention centers staff members
● Homeless shelters staff members
● Law enforcement (patrol/public-facing)
● Fire rescue
● 911 dispatchers
● Behavioral health (non-telehealth) — residential/recovery, etc.
● School nurses (non-vaccine/non-testers)
● Lab workers
● Morticians and funeral home employees
● Surgical centers
● Other providers licensed by the Maryland Department of Health

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Phase 1B

Tier 1:
● Adults ages 75 and older

Tier 2:
● Public transit workers (transport for senior citizens and people with disabilities)
● Education sector (teachers and support staff)
● Child care workers
● Food and agricultural workers
● Postal Service workers
● Grocery store workers
● People experiencing homelessness
● People in detainee centers

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Tier 3:
● Manufacturing workers

Phase 1C

Tier 1:
● Adults ages 65 to 74

Tier 2 — People 16 to 64 years old with high-risk medical conditions, including:
● Cancer
● Chronic Kidney Disease
● Chronic Obstructive Pulmonary Disease
● Heart conditions
● Immunocompromised state
● Obesity/severe obesity
● Pregnancy
● Sickle Cell Disease
● Smoking
● Type 2 Diabetes, Type 1 Diabetes
● Asthma (moderate-severe)
● Cerebrovascular disease
● Cystic fibrosis
● Hypertension or high blood pressure
● Immunocompromised conditions (from blood or bone marrow transplant, immune deficiencies, HIV, prolonged use of corticosteroids or other immunosuppressive medication)
● Dementia, ALS, other neurologic issues
● Liver disease
● Pulmonary disease
● Thalassemia

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Tier 3 — Essential workers not previously in Phase 1A or 1B, including:
● Transportation and logistics
● Water and wastewater
● Food service
● Shelter and housing (construction, etc.)
● Finance (banks, etc.)
● IT and communications
● Energy
● Legal (state’s attorney, public defenders, judiciary, etc.)
● Media
● Public Safety (engineers, etc.)
● Public health workers — non-COVID-19 response
● Social & Human Services (Aging, DSS, Human Services) — field/in-home services
● Continuity of government (elected officials)

On the document, county officials noted that the county government has received 12,900 doses of the Moderna vaccine and has been vaccinating public health vaccinators, COVID-19 testing staff members, and clinical services employees since Dec. 23.

“The health department is prepared to respond to anaphylaxis/severe allergic reactions after the COVID-19 vaccination and is pre-screening individuals to determine if there are any contraindications or precautions,” the document stated.

Hogan releases more details about phases

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On Tuesday afternoon, Gov. Larry Hogan released more detailed information than the state had previously shared about additional eligibility for a COVID-19 vaccine in each inoculation phase, as well as timelines for when each group is anticipated to begin receiving vaccinations.

The state is currently distributing vaccine doses to people in Phase 1A.

The state previously listed hospitals, local health departments, and pharmacies for administration to health care workers, nursing home residents and staff members, and first responders as being in Phase 1A.

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The state added medical providers, correctional health care staff members and officers, and front-line judiciary employees to the 1A list on Tuesday.

“I want to ensure the people of Maryland that we are going to leverage every single resource at our disposal to get more shots into more arms as quickly as we possibly can in a safe and orderly way,” Hogan said at a press conference on Tuesday afternoon.

About 500,000 people across the state are now included in Phase 1A.

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As registrations to be vaccinated in Phase 1A tail off, officials will move to Phase 1B, instead of waiting to get everyone vaccinated in each phase, Hogan said.

Phase 1B, expected to begin in late January, has about 860,000 eligible people.

It previously included assisted living, group homes, and other congregate facilities, as well as people at higher risk of severe COVID-19 illness.

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However, on Tuesday, Hogan added “continuity of government” staff members, K-12 school and day care faculty and employees, and adults age 75 and older.

Phase 1C — anticipated to begin in early March — includes 772,000 people.

It is not listed on the state’s website, but Hogan provided details of who would be eligible in 1C.

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There was no estimate provided for when Phase 2, which includes 1.1 million people, would begin.

As of Tuesday afternoon, more than 76,900 COVID-19 vaccine doses in Maryland had been administered. The state has allocated and distributed 270,150 doses. There was no indication of how many of those might have been second doses of the vaccine to an individual person.

Of those 270,150 doses, roughly 60% went to hospitals, 22% went to pharmacies to administer in nursing homes, 13% went to local health departments, and 5% went to “others.”

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Hospitals have administered 34% of the vaccines they have received, while local health departments have administered 32% of the doses they have been given.

CVS and Walgreens pharmacies, which have partnered with the federal government to administer vaccines in nursing homes, have administered about 14% of the doses they have received.

Hogan said CVS informed the state that not all of the vaccines it has administered were included in the state’s count and the numbers are being updated.

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If current and future vaccinators do not administer at least 75% of their first-dose allocations, they might have future allocations reduced until they can prove their ability to meet capacity.

If any providers can’t administer all of their allocated doses, the doses will be moved to the local health department, Hogan said.

Hogan also announced that the state is deploying Maryland National Guard emergency vaccination support teams to local health departments to help administer the vaccine shots and provide logistical support, starting Wednesday. In addition, 700 volunteers from the Maryland Responds Medical Reserve Corps can assist with vaccinations.

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On Tuesday, Hogan issued an executive order for all providers to report vaccination data to the state within 24 hours after vaccines are administered. The data will be made public.

Hogan urged residents to be patient as vaccinations are administered in each phase.

“It’s a massive undertaking,” he said.

More information can be received through regular state alerts by texting “MdReady” to 898-211, or at the state’s website at COVIDlink.maryland.gov.

Briana Adhikusuma can be reached at briana.adhikusuma@bethesdda-remix.newspackstaging.com.