State officials said Tuesday they’re starting to offer COVID-19 vaccines to people older than 75 and a long list of essential workers, including child care workers, teachers and first responders as part of a newly refined “Phase 1b.”

Efforts are already underway to inoculate an estimated 40,000 health care workers at hospitals and 10,000 residents of long-term care facilities, but it’s gone slower than officials hoped.

An estimated 109,000 people in Hawaii are older than 75 and will be next in line.

Deciding who will be eligible in the next cohort of essential workers was “a large topic of debate,” Lt. Gov. Josh Green said at a press conference.

Officials provided a new list Tuesday that included first responders and emergency services dispatchers, correctional officers and staff, federal, state and local government employees who are essential for government operations, transportation infrastructure and critical utilities workers, teachers and child care staff and U.S. Postal Service employees.

How and where to launch vaccination sites and avoid long waits are questions still being worked out, according to Dr. Libby Char, director of the Department of Health, who advised residents to check Hawaiicovid19.com next week for more details about how to sign up to get the vaccine.

“It’s been three weeks since we began receiving vaccines and we’ve developed a rhythm and process for focus points of distribution,” she said. “Plans are underway for a larger distribution site, a couple of sites actually, in order to provide greater access and options for the community.”

To date, Hawaii has received 83,000 doses in the first phase. Few side effects have been reported, she said.

“Fortunately, to date, most people are only experiencing a sore arm for a day or two,” Char said. “Some also note headaches and fatigue for a couple of days.”

A hotline at 808-586-8332 will field calls on weekdays to provide the public with more information about how to sign up.

The state has seen some delays in vaccine shipments, but Gov. David Ige said Tuesday Hawaii is on track to receive doses proportional to its population.

The first COVID-19 shot was delivered at The Queen’s Medical Center in Honolulu in December. The second doses for those medical workers have arrived, according to Ige. That second shot is considered necessary to achieve immunity.

Green said he expects 80% of Hawaii residents will get the vaccine, around the number needed to create “herd immunity.”

The vaccine campaign comes as Oahu and Maui counties record slight upticks in new infections that officials believe may be linked to holiday gatherings.

Once Phase 1b is complete, adults older than 65, people with medical conditions and other unspecified essential workers will be offered the vaccine as early as March in Phase 1c.