ST. CLAIRSVILLE –The first round of COVID-19 vaccine is expected to arrive in Belmont County Dec. 22, but the precise plan for administering the shots to the public remains somewhat unclear.

Rob Sproul, deputy commissioner of the Belmont County Health Department, said it has been established that hospital workers, nursing home staff and residents and assisted living employees will be first in line for the vaccine. Beyond that, he said, much remains to be determined.

“The shot is voluntary, not mandatory,” he added, noting he does not yet know if local hospitals will require their employees to receive the vaccine. He said those facilities do require staff to be vaccinated against influenza.

Sproul said Belmont County would receive the Moderna vaccine, rather than the Pfizer vaccine that requires ultra-cold storage between -117 and -176 degrees Fahrenheit. He said Belmont County does not have facilities to properly store the Pfizer vaccine, which received emergency approval from the Food and Drug Administration on Friday. The Moderna vaccine is next in line for approval and does not have to be stored at such low temperatures. Local West Virginia counties will receive the Pfizer vaccine, as will some Ohio cities such as Columbus and Cleveland.

A second round of shots is expected to go to paramedics and emergency medical technicians as well as some health department staff. Sproul said — based on his experience with H1N1, or the swine flu — health department nurses who administer the vaccine and interact with patients likely will receive the vaccine in this round, but he and other non-medical staff members probably will not.

He added it is unclear when some home health and nursing facility employees will be vaccinated. He said those associated with hospitals might get shots sooner than those that are not.

“We’re still trying to figure out how that’s going to work,” he said. “That’s a little bit of a gray area we’re trying to pin down.”

Sproul is uncertain about how much guidance for distribution is coming from the U.S. Centers for Disease Control and Prevention, but he said Gov. Mike DeWine does have “some discretion” in determining the process. The goal, he said, is to first vaccinate people who are most vulnerable to the illness as well as those who care for them. He added he is not certain whether nursing home visits will be permitted after residents and staff have been vaccinated.

Sproul said other essential workers — such as school teachers, law enforcement officers and firefighters — will receive shots in a different tier of the vaccination program, but the timing and order of administering those shots has not yet been established. The same is true for prison workers and inmate populations, who are in high-risk settings because of their close quarters.

“It’s somewhat frustrating,” Sproul said of the current uncertainty. “I would like to see a better layout of all phases. The governor is still looking at that.”

Retail and service workers rank even further down the list.

Next in line will be elderly individuals who live at home independently, since older people are more likely to suffer complications if they do contract the coronavirus. Sproul said these residents will be able to go to local pharmacies at retailers such as Walmart, Kroger and “a lot of different places” to get their shots.

Sproul said he is eager to learn more about exactly how people’s eligibility for the two-dose vaccine will be determined. When people receive each shot, he said, that information will be recorded in a computerized system and reported to the county health department.

He added that the order in which shots are administered could be based on how many doses the county receives. He said the county was awarded a Public Health Emergency Preparedness grant to cover some of the costs. As part of that application, the county had to report how many EMTS it has, which may be one factor that determines how many doses will be received.

“We’re still watching and waiting … we haven’t got all the details yet,” he said.

He remains optimistic about delivery of the shots once they become available.

“Some counties received the packaging already to see how quickly it would ship and how it would arrive,” he said. “It sounds like that went without a flaw, so that’s a logistical nightmare they are doing a good job with.”

Across the Ohio River, frontline health care workers also are scheduled to receive the first of the first wave of COVID-19 vaccines, but it remains an open question when other West Virginians will be inoculated against the disease.

Wheeling-Ohio County Health Administrator Howard Gamble said the exact order of who will get the vaccine to is a joint matter between the West Virginia Department of Health and Human Resources and the state medical system. The rollout is divided into three phases, and the leading edge of Phase One concerns frontline workers: those working in emergency rooms, intensive care units and — if hospitals have one — dedicated COVID wings.

Within those groups, priority will be determined among those with the most risk of exposure, with consideration given to how many doses of vaccine are available. After that point, other health care workers are scheduled to receive the vaccine, including workers and residents at long-term care facilities, constituting the bulk of Phase One.

Gamble said the vaccines available to long-term care residents and workers would come close behind those for frontline workers, within a matter of days — as long as the supply chain remains strong.

Following health care and long-term care, Gamble said, those in “critical infrastructure” will round out Phase One, including those who staff mass testing clinics and first responders, such as firefighters, police and emergency medical service personnel.

Gamble said prison populations will come “a little later,” clarifying that “a little” meant a week or a week and a half, and inoculation efforts would focus on guards and other personnel who interact with inmates, rather than administrative staff.

Phase Two of the Mountain State rollout involves mass immunization clinics held throughout communities, which may be initially based on targeted populations. At certain locations and times, those fitting certain criteria may come and register and receive their vaccinations.

Phase Three will see the COVID vaccine be readily available at doctor’s offices and pharmacies for the general public.

Gamble said COVID-19 testing continues.

“We’re in the height of flu season, and we want to be testing so we don’t have someone with symptoms going into a mass vaccination clinic; if you have symptoms, you shouldn’t be vaccinated,” he said. “If you have a reaction of any kind, what’s to say it’s your seasonal allergy or illness you have, or is it your vaccine? … We need to make sure the population is well, we’ve controlled the disease to a level, and if we do have a reaction, it’s the vaccine, and they’re not coming down with actual COVID.”

Alan Olson contributed to this report.