California is in the throes of another COVID-19 surge — cases are skyrocketing and hospital beds are filling up quickly. On Tuesday, hospitals had 3,300 more COVID patients than at the beginning of this month, state health officials said.

But a glimmer of hope has emerged in the last leg of 2020: The first batch of vaccines could arrive in early December.

On Friday, the pharmaceutical company Pfizer announced that it had requested approval for emergency use authorization from the U.S. Food and Drug Administration.

Pfizer’s vaccine has shown an efficacy of 95% against COVID-19 “with no serious safety concerns observed to date,” said Albert Bourla, the company’s CEO.

Moderna’s vaccine has similar results. AstraZeneca announced Monday that its vaccine was, on average, 70% effective.

Distribution details are still developing, and it remains unclear how many doses California will get before the year’s end.

Dr. Frances Collins, director at the National Institutes of Health, has said that if all goes to plan, he expects 40 million doses to become available nationwide in December. Both the Pfizer and Moderna vaccines, which are first in line, require two doses, meaning 20 million people could be vaccinated that month. California gets just a slice of that.

Manufacturers and the federal government will likely distribute doses based on state conditions and population size, said Dr. Mark Ghaly, the state’s Health and Human Services Secretary.  “So California should get a significant and even the highest amount of vaccination based on those distribution plans,” he said Tuesday.

So when can most people expect to get one? How much will it cost? And how much longer will Californians be urged to wear a mask?

Here’s what we know so far about the state’s vaccine rollout.

If you’re not a health worker, don’t expect a vaccine soon

Initial vaccine supply will be limited. To help decide who gets a vaccine first, the state is adopting a three-phase plan from the U.S. Centers for Disease Control and Prevention. The state’s plan will guide counties, which will be in charge of on-the-ground coordination.

So far, we know that health workers and first responders who are likely to treat or be exposed to COVID-19 patients will go first. On Monday, Gov. Gavin Newsom said the state would first target 2.4 million health care workers. Those workers are also being divided into subgroups, in case of a shortage in the first rounds.

Health workers will be followed by those living in congregate settings, such as nursing homes, along with other essential workers and people who are at higher risk of falling severely ill, including people 65 and over.

The definition of an essential worker in the distribution guidance has not yet been determined, Ghaly said. Teachers, for example, will be a priority so that children can return to school, he said. But where exactly teachers and others will fall in the state’s priority ranking will be decided in coming weeks.

Everyone else will likely have to wait a few more months. “Mass vaccination is unlikely to occur anytime soon,” Newsom said. Public health officials have estimated broader vaccine availability will come in the spring.

State health officials have appointed more than 65 advocacy, labor and businesses organizations to a new community advisory committee to help ensure that the vaccine is distributed equitably.

“The point of having all these groups at the table is to avoid blind spots,” said Anthony Wright, executive director of Health Access, one of the committee member organizations. “If we’re not mindful of our most vulnerable populations, we’re undermining our efforts to (control) this pandemic.”

Cost shouldn’t be an issue

Out-of-pocket costs for a COVID-19 vaccine are likely to be low, if anything at all. According to the CDC, doses purchased with taxpayer dollars will be free. Providers, however, can charge for administering the vaccine, which insurance would cover.

“For those who are uninsured and those in the Medicaid program, they should rest assured…the state is going to step in and make sure that the cost of vaccination in no way gets in the way of someone’s decision to be vaccinated,” Ghaly said on Tuesday.

California has ‘second set of eyes’ on vaccines’ safety

Last month, Newsom announced that the state would form its own panel of experts to review efficacy and safety data of any vaccine candidate.

California’s experts have already reviewed the first two phases of clinical trials for the Pfizer and Moderna vaccines and have no concerns so far, Newsom said on Monday. His panel will review Phase 3 data within 24 hours of it becoming available, he added, noting that the state’s review process would not slow vaccine distribution.

This process is in addition to the FDA’s review. The idea behind the work group, made up of public health and immunization experts from across the state, is to instill trust among the public, Newsom has said.

Still, challenges lie ahead

If people are looking to buy stocks, dry ice would be a good investment, said Dr. Rais Vohra, Fresno County’s interim health officer. That’s because counties and health care providers are scrambling to get their hands on both ultra-cold freezers and dry ice to help store Pfizer’s vaccine, which needs to be kept at minus 70 degree Celsius — that’s extremely cold.

“Not a lot of those freezers exist,” Vohra said. “The flu vaccine doesn’t need to be ultra cold.”

Moderna’s vaccine can be stored in a standard freezer.

Primary care doctors and other community providers may not be able to offer the first vaccines available because they may not have the freezers needed to store it, Dr. Martin Fenstersheib, Santa Clara County’s COVID-19 testing officer, told county supervisors at a meeting earlier this month.

Newsom said the state is looking to acquire 16 ultra-cold temperature freezers and 61 smaller freezers. He said the state already has identified regions to distribute these freezers, focusing on more rural areas that might have a hard time obtaining their own.

Hospitals seeking their own freezers are already bumping into supply issues. “They are in many cases back-ordered until the spring,” said David Simon, a spokesperson for the California Hospital Association.

Yes, you’ll likely still have to wear a mask after you get a vaccine

No vaccine candidate is 100 percent effective. And experts say while a COVID-19 vaccine is likely to protect you from serious illness, it remains to be seen whether it will keep you from passing the virus to someone else. Scientists also don’t know yet how long a vaccine’s protection will last.

The three leading vaccine candidates all require two shots, spaced a few weeks apart, so you won’t be fully protected after your first dose. You’ll want to continue to wear a mask to protect others until most people are fully immunized — and that could take many months.

“While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others,” the CDC notes.

Public health experts worry about misinformation, spread widely on social media by anti-vaccine activists and others, that has led some Americans to fear the coming vaccines. The politicization of vaccine development also has contributed to distrust.

A Gallup poll conducted in October found that about 58 percent of Americans would agree to be vaccinated against COVID-19 vaccine, compared to just 50 percent in September. In California, about half of Republicans said they would “definitely or probably” get the vaccine compared to about 56 percent of Democrats or independents, according to an October poll conducted by the Public Policy Institute of California. Demographics matter, too: In that poll, only about 30 percent of African-Americans said they would get vaccinated, compared to about 62 percent of whites.

The CDC offers advice for finding credible online information on vaccines in general and more specific information on COVID vaccine safety. The New York Times’ Coronavirus Vaccine Tracker also offers frequent updates on vaccine progress.

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