CNN  — 

State health departments and governors’ offices across the country are finally being told by the US Centers for Disease Control and Prevention and Operation Warp Speed how many doses of the coronavirus vaccine they will initially be receiving once the vaccine is authorized, and it’s not enough.

With the Pfizer vaccine emergency use authorization expected later this month, and perhaps also for the Moderna vaccine, states are learning there’s not enough for them to fully vaccinate those designated as their first and top priority.

Earlier this week, the CDC’s Advisory Committee on Immunization Practices recommended that the very first batch of Americans to get vaccinated should be frontline health care workers and residents of long term care facilities such as nursing homes. Together, they add up to about 24 million people.

Federal officials estimate about 40 million vaccines will be available by the end of the month if both Moderna and Pfizer get US Food and Drug Administration authorization – only enough to vaccinate 20 million people, because two doses are needed for each person.

But even that number will fall short. Pfizer is only expected to have 6.4 million doses of vaccine ready by mid-December.

A CNN analysis of 27 states’ vaccine data showed that none were getting enough vaccine in the first shipment to vaccinate all their first priority group, including health care workers and long-term care residents. CNN was able to confirm the expected size of the first shipment of vaccine for at least 43 states, and the number of people prioritized in a least 27 states.

Now states must decide how they will ration the vaccine among their top priority groups and how the small first installment affects the timetable of when groups down the line can be vaccinated. Some states are already being forced to triage – choosing which health care workers are a higher priority than others.

California must vaccinate 2.4 million healthcare workers first and Gov. Gavin Newsom said earlier this week that the state is only receiving 327,000 doses of the vaccine from Pfizer to start with.

Since that covers just a fraction of the healthcare workers needed to get vaccinated, Newsom said Thursday the state would be trimming its list of top priority group of healthcare workers even further to decide who gets vaccinated first.

“It’s one thing when you hear the national news about, well, we broadly all agree that our healthcare workers and skilled nursing residential care and assisted living facilities should be prioritized, but that is millions and millions of people. When you only have a few hundred thousand doses of vaccines – doses, you need two doses – you can cut that in half in terms of the total number of people that actually will be fully vaccinated. We have to look at some prioritization of those doses, and we’ve done just that,” Newsom said Thursday.