Maine may prioritize its oldest residents and the essential workers who are most at risk of exposure when the vaccination program moves into its next phase in the coming weeks, the state’s top public health official said on Monday.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said his agency hasn’t finalized its plans for rolling out Phase 1B of the vaccinations, which includes those 75 and older, and essential workers such as grocery store clerks, postal employees, teachers and police officers. The state is in the middle of immunizations in Phase 1A, which includes health care workers, paramedics, and staff and residents of nursing homes, with so far more than 33,000 vaccinations given and some front-line health care workers preparing to receive the second of two doses.

Phase 1A includes 130,000 people, while Phase 1B, which is likely to begin in February, comprises an additional 200,000 individuals, according to the Maine CDC.

“Everyone will still be part of Phase 1B, but in terms of where we like to start our efforts – recognizing we’ve got to start somewhere – maybe we start with groups within 1B, the very oldest or the very highest risk of exposure,” Shah said in a media briefing Monday.

Shah said for seniors, “maybe we start with an even higher bracket of age category and then move lower.” Maine people who are 75 and older make up 107,000, or roughly 8 percent, of the state’s 1.3 million people. Elderly patients are the most vulnerable to dying of COVID-19, with about 85 percent of deaths among those age 70 or older.

Some seniors have criticized the Mills administration for putting elderly Mainers in the same spot in the vaccine line as essential workers, such as grocery store clerks.

Shah said on Maine Public radio on Monday that essential workers – such as grocery store clerks and police officers – interact with the public and have represented a large percentage of people who have contracted COVID-19, so vaccinating them will help prevent illness and transmission. But protecting the elderly is also a high priority.

Shah said the vaccine prioritization could be similar to how the shot is being given to health care workers. The highest priority were those working in intensive care and emergency departments, followed by those with less exposure to COVID-19 patients, and working outward in “concentric circles.”

As with seniors, front-line workers could be prioritized depending on their level of risk, Shah said.

“Are there some front-line workers even more front-line than others and thus may be at higher exposure? These are the questions we have been asking,” Shah said.

Maine reported 376 new cases of COVID-19 and one additional death on Monday.

The number of new cases has been slightly lower in the last three days than last week – with case counts less than 400 as opposed to in the 500s or 700s – but it wasn’t immediately clear whether Maine is experiencing a lag in reporting cases related to the holidays. The first two days after Christmas, Maine reported lower case counts, but the daily case counts jumped after that as labs caught up with their backlog.

Shah said the impact of the holidays on case counts is still “too early to tell.” He said in addition to a slowdown in labs reporting test results to the Maine CDC, some people who otherwise would have gotten a test may have delayed doing so because of the holidays.

Maine’s daily COVID-19 case numbers are far outpacing the summer and early fall, when the state was experiencing about 30 new cases per day statewide. Overall, Maine has had 25,968 confirmed cases of COVID-19 and 360 deaths.

Shah said on Maine Public’s call-in radio show that Maine lately seems to have achieved a “high plateau” in cases, although he cautioned that could still change.

“I have reasons for hope and optimism,” Shah said, regarding the increased supply of vaccines this winter and spring that potentially could bring an end the pandemic later this year.

The seven-day average of daily new cases stood at 521.3 on Monday, up from 433.4 a week ago and 225.6 a month ago.

Vaccines continue to roll in, with 33,425 people having received the first dose of the vaccine. The first people to be vaccinated in Maine include front-line health care workers, staff and residents of nursing homes and paramedics. Maine is expected to receive a shipment of 17,075 doses of the Moderna and Pfizer vaccines this week, which will bring the total number of doses shipped to Maine to more than 81,000.

Shah said the number of doses that the state receives in the next weeks and months will to a large extent determine what can be done, and that the state would need to receive at least 50,000 doses per week to alleviate “supply constraints.”

Maine is currently receiving about 15,000 to 20,000 vaccine doses per week.

Shah said it’s difficult to predict how the rollout will develop because at this point in the mass vaccination program “it’s like we’re just pulling out of the driveway and looking at the speedometer.”

Currently, 186 Mainers are hospitalized with COVID-19, with 53 in intensive care.

Shah said a more contagious variant of COVID-19 has not yet been detected in Maine, but it’s likely just a “matter of time” before it arrives. A few states have detected the variant, including California, Colorado and New York. Shah said the vaccine still will be highly effective against the new variant, but knowing the new strain is more contagious makes wearing masks and social distancing even more important.

“Ultimately, the vaccine will be our best defense, but right now it can’t be our only defense,” he said.

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