Because there aren’t enough vaccine doses yet to meet demand, a coalition of Bay Area health officers on Wednesday urged all health systems to prioritize COVID-19 vaccines for people 65 and older — a group dying at far-and-away the highest rates during the pandemic — and move some essential workers further down the list.

“We need to be direct and honest with the public that, although we want to vaccinate everyone, right now we just don’t have enough vaccine to do so,” said Dr. Sara Cody, Santa Clara County’s health officer and director of public health. “Given limited supply of vaccine, we must prioritize vaccinating those at greatest risk of death or serious illness.”

Recent changes in state rules have shifted the priority list, with doctors, nurses, and nursing home patients in the first group eligible to be vaccinated, called Phase 1A, and people 65 and older in the second group, which is called Phase 1B. Also in that second group, however, are “essential workers” of all ages, including teachers, police firefighters, paramedics, childcare workers, farm workers, and transportation workers, along with Californians living in close quarters prone to outbreaks, like homeless people and inmates.

Statewide, there are 3 million people in the Phase 1A group and 8.5 million more in the Phase 1B group.

Health care providers and political leaders are being heavily lobbied by unions and other groups representing various occupations, and receiving thousands of calls from members of the public wanting their shots now. But California received only 1 million doses of vaccine this week from the federal government. As of Wednesday, 3.8 million Californians have received at least one dose.

Many county health departments and private health care providers like Kaiser, Sutter and others are already giving priority to the elderly.

The science is clear. Statewide, the majority of COVID cases are happening in younger people. But most deaths are occurring among older people.

As of Wednesday, 74.4% of the 41,811 people in California who have died from COVID-19 were age 65 and over, according to data from the California Department of Public Health. Another 18.8% of the deaths were people 50 to 64 years old. Only 6.7% of the deaths have occurred in people under 50.

Men represent 57% of all statewide deaths. Women 43%.

But when it comes to the number of cases, 70.3% of Californians who have tested positive for COVID-19 are under age 50. There are breakdowns by race also. Nearly half of the deaths, or 46%, were Latinos, while 32% were White, 12% were Asian and 6% were Black.

“Three out of four COVID-19 deaths in Marin are among residents age 75 or older,” said Dr. Matt Willis, public health officer for Marin County, which has the highest per capita older adult population of any county in California. “A vaccine offered to a resident above age 75 is 300 times more likely to save a life than a vaccine offered to someone under the age of 50.”

In Wednesday’s announcement, Marin, Napa, Santa Cruz, and Solano counties said they are prioritizing residents age 75 and older.

Contra Costa, San Francisco, San Mateo, and Santa Clara counties said they are prioritizing people age 65 and older. All the counties are doing that in addition to continuing to vaccinate healthcare workers in Phase 1A, many of whom already have received a first dose.

Alameda and Sonoma counties did not join the other counties in calling for priority to be given to older people.

At a news conference Wednesday to announce the opening of two large vaccination sites at the Oakland Coliseum and Cal-State Los Angeles, as part of a program announced by President Biden to build 100 federal vaccine sites, Gov. Gavin Newsom noted that in the past few weeks California and other states have begun to receive more doses.

The state went from vaccinating 50,000 people a day a month ago to 150,000 a day now. Biden has ordered 200 million more doses from Pfizer and Moderna. Vaccines from Johnson & Johnson and other companies are expected to be approved in the coming weeks, increasing supply.

Hospitalizations from COVID have fallen 30% in recent weeks, and the number of cases has dropped from 60,000 a day statewide a month ago to about 10,000 a day now.

“We are moving forward aggressively and I think you will see those vaccination numbers continue to increase,” Newsom said. “We are mindful that we have to get more support and supply not just from the federal administration but more support and supply directly from these manufacturers.”

Many of the problems in vaccine supply have been due to the Trump administration not providing states as many doses as it had promised, said Dr. John Swartzberg, a professor emeritus of public health at UC Berkeley. Add to that, the Trump White House did not have a national vaccine distribution plan, and did not give states sufficient funding to set up mass vaccination centers. Biden took office 13 days ago.

“I can’t blame the states or the county health departments,” he said. “The blame goes to the federal government.”

Swartzberg said that California’s state government bears some responsibility for the slowdown. He said the tier system that Gov. Gavin Newsom originally rolled out was too complicated and rigid, leaving too many doses in freezers. Some medical providers also have held back doses to ensure that doctors, nurses and other medical workers would have second doses available.

As of Wednesday, California’s number were improving:  64% of the doses it has received have been given out.

Last month, Newsom allowed anyone 65 and over to be moved up the priority list for shots as a way to get more vaccine administered.

In the coming weeks, the situation should improve, Swartzberg said, urging patience.

“I appreciate the frustration,” Swartzberg said. “I’m frustrated too. But try to step back from the situation and say ‘I can protect myself from being infected. I can wear a mask, I can socially distance. I can stay at home.’ That will pretty much assure you won’t get infected. You can buy yourself time until the system is working and the vaccine is plentiful.”