As the coronavirus pandemic continues to rage across the country, state and Vineyard, the Island’s public health community is rapidly mobilizing to coordinate the early phases of a broad vaccine rollout on the Island.

But the logistical challenges of stitching together a complex patchwork of state and local stakeholders, as well as delays at the federal level, have meant that many facets of the rollout — including administration and the timeline for its general availability — remain in the early stages.

Currently, according to the state’s phased rollout guidelines, the vaccine will not be available to the general public until at least April, with earlier phases not beginning until February for residents 75 and older, those with underlying conditions and front line workers.

Vaccine administration on Island remains in its first phase, focused on front line health care workers, long-term care facilities and first responders.

In interviews and emails, this week health officials on the Island confirmed the estimated timeline and said they are beginning discussions about how to widely administer the vaccine to priority groups. A team that includes health agents, hospital pharmacists and Island Health Care staff are meeting weekly to coordinate the process, although nothing has been decided beyond phase one vaccinations.

“It’s being built as it’s being flown,” said IHC director Cynthia Mitchell, describing the vaccine rollout.

Meanwhile, the Island has seen its highest daily coronavirus case numbers since the pandemic began, with health officials reporting more than 70 confirmed cases since last Friday, and 25 on Wednesday alone. On Thursday, case counts dipped again to six.

The Martha’s Vineyard Hospital also reported on Tuesday its first readmission of a Covid-19 patient who had been previously discharged. In an email, hospital spokesman Marissa Lefebvre said the patient was in fair condition, and that due to privacy concerns the hospital could not disclose when the patient had been previously admitted.

Statewide, Gov. Charlie Baker on Thursday announced an extension to the state’s strict gathering limits and capacity requirements. Nearly all businesses have been required to reduce capacity to 25 per cent, and indoor gatherings are limited to 10 people. Hospitals are also required to suspend most elective surgeries and meet daily to manage capacity.

But even as case numbers surge, the prospect of a vaccine remains a bright — yet still distant — light at the end of winter for Vineyarders.

Since arriving on the Island in the second week of December, the vaccine has been administered to approximately 350 front line health care workers at the hospital and Island Health Care, the Island’s federally qualified community health center. Front line health care workers are at the top of a growing pyramid of priority groups set up by the state.

The hospital had administered a total of 292 vaccine doses as of Wednesday, and IHC had received 100, administering 60, according to executive director Cynthia Mitchell. Volunteers at TestMV, the Island’s asymptomatic testing site, have all received the vaccine, Ms. Mitchell said.

After federal delays pushed back a shipment of vaccines for the Windemere nursing home and long-term care facility, hospital head of operations Claire Seguin said in an email that the vaccine would be arriving shortly, with the first doses scheduled for Jan. 12. Under the federal program, CVS will administer the vaccine to all interested Windemere residents and staff. The second dose is scheduled for Feb. 2, Ms. Seguin said.

On Monday, Jan. 11, the hospital will be administering the first batch of its vaccines to Island first responders. The hospital received a shipment of 275 doses, which will go to fire, police and emergency services personnel. Clinics are also scheduled for first responders on January 15, 16, and 19, Ms. Seguin said.

“We are working closely with the Island boards of health to develop a distribution plan as we learn more about the vaccine rollout from government leaders,” Ms. Seguin said in a statement.

The process has been coordinated by IHC, the hospital and the Island boards of health, who compiled lists of Island first responders, as well as other priority groups, and requested vaccine quantities from the state. Tisbury health agent Maura Valley said the extremely targeted approach to phase one made the requests relatively simple.

But the next steps in the vaccine’s rollout are more complicated. According to state guidelines, people involved with congregate housing, including jails and shelters, will come after first responders, followed by home-based and non-Covid-facing health care workers. The Island has not yet received those vaccines, health officials said.

Phase two, which will run from February through April, lists groups in order of priority as individuals with two underlying conditions, people over 75, early education and K-12 workers, transit, grocery store, utility, food and agriculture, sanitation, public works and public health workers. Individuals with one underlying condition, and those over 65, will proceed thereafter. The general public comes next.

“We’re still working on phase one, which is easier because it’s just medical personnel,” Ms. Valley said. “Phase two is more people. We really need to work on coming up with a plan for how we’re going to do a mass vaccination on the Island. So we’re meeting and going over the options so that when it does come time and the vaccine is available, we’ll be ready to go and have a full plan in place.”

Ideas include the use of the TestMV site at the high school, as well as separate, daily clinics for specific priority groups.

“The [recent] flu clinic was designed to be a dress rehearsal for the Covid vaccine,” Ms. Mitchell said.

But the particulars of the Covid-19 vaccine make distribution more difficult than flu shots. Unlike the flu, the Covid vaccine is given in two doses and requires a 15-minute waiting period to ensure patients don’t have an anaphylactic reaction. Different vaccines are also made by different companies, including Pfizer and Moderna, with each one requiring specific storage, shipping and handling instructions.

“We are working on making sure that we have a plan in place and know how we’re going to get the vaccine out to the priority groups as we receive it,” Ms. Valley said. “Unfortunately, we don’t have the specifics yet. But as soon as we do, we will get that in place and out to the public.”

For most Islanders, that day remains at least three months off.