While the first phase of the COVID-19 vaccine distribution marches ahead, no one quite knows yet how the next phases of distribution will work.

The Centers for Disease Control and Prevention released broad new distribution guidelines on Sunday, fleshing out the order in which Americans will get access to COVID vaccines. 

The new guidelines offer local health officials a bit more direction, but they say there are still too many unknowns for them to release any plans.

“We have some tentative plans in place, but nothing is completely finalized yet,” said Kathryn Goodman, a spokeswoman for the Blue Ridge Health District (formerly the Thomas Jefferson Health District). “It’s frustrating because we can’t share and answer every single question right now, but we are working hard on this. It is a very fluid situation.”

What is clear is frontline healthcare workers and residents of long-term care facilities go first, and that phase is underway.

As of Monday, more than 1,250 of the University of Virginia Medical Center’s healthcare workers had received their first dose of the Pfizer vaccine. Meanwhile, a handful of Charlottesville nursing homes report that they will receive doses of the vaccine for their residents in January.

That is all part of Phase 1A, per the CDC’s latest guidelines.

Once everyone in the 1A group is vaccinated, local health districts will move on to phase 1B — people aged 75 and older and certain essential workers. Following that group is now a phase 1C, which includes people between 65 and 74, people with high-risk medical conditions and other essential workers.

Exactly what defines an essential worker, or a high-risk medical condition is still a bit vague. It’s also unknown how health officials intend to verify that a person qualifies in one of these categories or where vaccines will be available.

“But before we can even get to those folks, we have to get through Phase 1A, which is our highest risk healthcare workers,” Goodman said.

Some of those plans, too, are still forming.

Right now, local long-term care facilities are scheduled to receive vaccines from either CVS or Walgreens. CVS began distributing vaccines nationally Monday, according to a company spokesman. Several local nursing homes say they will receive those vaccines in early January.

Hospitals, meanwhile, are vaccinating their own staff. The UVA Medical Center received nearly 3,000 doses of Pfizer’s vaccine a week ago and expects to receive more doses in the coming weeks to offer to its more than 17,000 employees. 

That leaves the local health district responsible for vaccinating thousands of non-hospital affiliated healthcare workers — think primary care doctors offices, ambulance services, free clinics, dental practices, home health workers, hospice, dialysis centers and others.

The local BRHD does not yet have any COVID-19 vaccine to distribute. It will likely receive its first doses of the newly authorized Moderna vaccine in the next two weeks, Goodman said.

“We are working fast on plans for distributing the vaccine through Phase 1A,” Goodman said. “There’s a lot of frontline healthcare workers that are really important.”

That whole 1A process may take longer than anticipated. Virginia as a whole has received about 110,000 fewer doses of COVID vaccine than it expected in December. That means there will not be enough in the state to finish Phase 1A this year.

That early setback may delay the future phases.

“It depends now on how much vaccine is produced and distributed,” said Brookie Crawford, a spokeswoman for the Virginia Department of Health. “When you think that each phase gets bigger, it gets harder to predict.”

Locally, health officials now say it will probably be summer before a vaccine becomes widely available to the general public.