Two major shifts in the Trump administration’s policy for releasing COVID-19 vaccines left state and county leaders reeling on Tuesday.

As COVID-19 deaths are soaring nationwide, the federal administration announced it would no longer withhold the second doses it had been saving for residents who had gotten a first dose — both approved vaccines require two separate doses to be fully effective — and also that people age 65 and older are now eligible for the vaccine as well as those who are immunocompromised.

New York State had been following the earlier guidance from the Centers for Disease Control and Prevention and had started vaccinating two tiers:

— 1a for public-facing health-care workers and for nursing home residents and workers; and

— 1b for essential workers like teachers, police and firefighters, and for people 75 and older.

Governor Andrew Cuomo in a call with reporters on Tuesday afternoon called it a “loaves and fishes situation.”

New York State gets 300,000 doses a week and now 7 million New Yorkers are eligible for the vaccine, Cuomo said. Tier 1a has about 2.1 million New Yorkers; tier 1b, for whom vaccinations started on Monday, has about 3.2 million.

“You just added 1.8,” he said of the 1.8 million New Yorkers who are 65 and older, which does not include New Yorkers who are immunocompromised.

“Immunocompromised is a category that can be defined a number of ways,” said Cuomo. “Obviously it’s people with cancer, chronic kidney disease, COPD, Down syndrome, heart conditions; obesity can be considered immunocompromised, pregnancy, sickle cell, smoking can classify a person as immunocompromised, type 2 diabetes is immunocompromised, asthma — so that has to be defined.”

He also noted that many nurses and doctors, in the first tier, had still not been vaccinated, which he considers essential both to control spread of COVID-19 and also to care for those ill with the virus.

On Tuesday morning, before the federal directive was widely publicized, Albany County Executive Daniel McCoy said counties were already overwhelmed with requests for vaccinations.

Since eligibility for tier 1b opened Monday, he said, the county is trying to identify residents 75 and older. He urged them to sign up on the state’s website and not to call the county’s health department, which is busy investigating a record number of COVID-19 cases as well as giving vaccinations.

On Wednesday, the county would be giving 500 vaccinations, McCoy said.

“We want the 75-year-olds. We want the Black and brown communities. We want to give the shots to the most vulnerable people here in Albany County first and foremost,” he said.

His own office was overwhelmed with calls, McCoy said. “Last night was the first time in 10 months I shut my phone off,” he said as people he knew from his childhood were calling asking for shots for their elderly parents.

People were calling from New York City, saying they would drive three hours to Albany to get a shot, McCoy said. “Our call volume went through the roof.”

He stressed, “The state is handling it.”

On his call with reporters, Cuomo said, “The county health departments should focus on the essential workers, police, fire, et cetera. That’s who they deal with. City health departments and pharmacies, the general public because they’re best equipped to handle the general public.”

Cuomo surmised that the federal government changed its guidance because of the highly transmissible strain of the virus from the United Kingdom spreading in the United States.

“We found eight more cases, so we have 12 in New York and we have 80 in the country and that is what’s panicking the federal officials with good reason because this is a much higher rate of infection,” he said.

According to the CDC website, as of Tuesday night, just four cases were listed for New York State with 72 nationwide.

Cuomo has long called for COVID-19 testing for airline passengers. On Tuesday, the federal government announced that, effective Jan. 26, international travelers coming to the United States will have to have a negative test for COVID-19 within three days of their flight.

Cuomo also announced on Tuesday that the state is opening five vaccination sites — one at the University at Albany uptown campus is opening on Thursday, Jan. 15.

New Yorkers can check their eligibility for a vaccination on the state’s Am I Eligible site, and, if they are eligible, can sign up for emailed or text messages.

New Yorkers may also call the State Vaccination Hotline at 1-833-NYS-4VAX (1-833-697-4829). 

McCoy’s parting advice on Tuesday morning was this: “It’s gonna take time, people. You have to be patient.”