SACRAMENTO — California counties begged for more coronavirus vaccine as the state added a potential 4 to 6 million people to those eligible for the sought-after doses.

State public health officials followed federal guidance Wednesday by announcing that people 65 and older could get the two-dose vaccine.

But Los Angeles County, the nation’s most populous with 10 million residents and an epicenter of the COVID-19 outbreak, said it couldn’t immediately provide them because it hasn’t yet inoculated health care workers, who have first crack at the vaccine.

Only about a quarter of some 800,000 had been inoculated, Public Health Director Barbara Ferrer said.

“We’re not done with our health care workers and we actually don’t have enough vaccine right now to be able to get done more quickly,” Ferrer said. “We haven’t heard back from the state about vaccine availability and how it would be distributed.”

California has seen virus cases and hospitalizations explode since the fall, though in recent days the numbers have flattened. Still, newly reported cases over the last seven days in the nation’s most populous state have far outpaced others, such as Texas and Florida — the second- and third-most populated U.S. states.

California on Wednesday reported another 589 deaths, bringing the total to more than 31,000 and nearly 34,000 new infections, some of which will inevitably lead to more hospitalizations and deaths. There also is concern about another COVID-19 surge after January as people who unsafely gathered for New Year’s Eve start to sicken.

California had received more than 2.4 million vaccine doses as of Monday, but only a third of them have been used. The state aims to administer nearly 1.5 million vaccine doses by Friday — still a small portion of what’s needed for herd immunity in a state with nearly 40 million people.

Local Governments Moving Quickly to Set up Massive Vaccine Distribution Sites

Nearly 50 state lawmakers signed a letter to Gov. Gavin Newsom on Wednesday noting that incoming President Joe Biden’s administration has announced its intent to release “nearly all available” vaccine to the states and asking for counties to receive supply updates and a “reliable” four-week forecast on expected vaccine quantities.

They also asked the governor to expand authorization for who can administer doses to include nursing students, retired medical workers, firefighters and National Guard members with medical training.

Newsom said the state’s priority is to deliver vaccines “as quickly as possible to those who face the gravest consequences.” He urged patience for those not yet eligible, saying: “Your turn is coming.”

Local governments, meanwhile, are moving quickly to set up massive vaccine distribution sites in the hopes they can convince state and federal officials to send them more doses.

Santa Clara County public health officials say the county of 2 million people only has enough vaccine to dose people age 75 or older. Officials said they asked the state for 100,000 doses but had received 6,000.

“It’s almost like a beauty contest. And this should not be a beauty contest. This is about life and death,” Santa Clara County Supervisor Cindy Chavez said.

In Orange County, a vaccination site opened Wednesday at a Disneyland parking lot that officials boasted could eventually vaccinate up to 7,000 people daily.

”Can you send us 4 million doses?” county Supervisor Doug Chaffee said in a news conference appeal to Biden.

More than 10,000 people have scheduled an appointment for a vaccination through the county’s Othena online registration, with thousands more awaiting their chance.

Gary Dohman, 81, said his son made the appointment for him to get the vaccine Wednesday at Disneyland. Dohman tried to do the same for his 79-year-old wife but the system was so overloaded with requests she couldn’t get one until Thursday.

Dohman, who is being treated for cancer, said he hasn’t been able to go anywhere since the COVID-19 pandemic hit except for doctor’s appointments, so he was eager to get the vaccine.

Many County Officials Say They Don’t Know How Vaccines Are Being Used

“I’ve been in a house since March,” he said. “I’m 81 years old. There’s a few things on my ‘bucket list’ I’d like to accomplish yet.”

Dosage forecasts for counties also have been complicated because some hospital and nursing home workers — up to 50% in some counties, according to some limited studies — have refused early vaccination out of various safety concerns that public health officials say are unfounded.

Many county officials also said they don’t know how vaccines are being used in their areas. The shipments are going to county public health departments but also to hospital chains and pharmacies that serve multiple counties; they don’t have to tell local officials how they are using them.

That’s made it difficult for local governments to plan for meeting their goals of vaccinating a majority of their residents by mid-summer.

Santa Clara County supervisors have proposed a new law that would require large health care systems to “produce detailed, written plans and timelines” for vaccine distribution and to make those plans public.

“We want to create an environment where there is zero competition, maximum collaboration,” Chavez said. “But the longer it takes for a response, the more the scarcity mentality is going to kick in and cities, counties and states will start pushing each other.”

Sutter Health said it first offered the vaccine to health care workers and will start vaccinating patients who are 75 years or older “later this week.” Kaiser Permanente said it is following prioritization guidelines from state and federal officials.

San Diego County, home to 3.3 million people, has received more than 241,000 doses. Officials said adding 65-year-olds would make about 500,000 more people eligible but it’s an open question as to when doses will arrive.

“We expect more vaccines to arrive soon but we don’t know when and we don’t know how many,” said Nathan Fletcher, chairman of the San Diego County Board of Supervisors.