Florida and Texas have started vaccinating people 65 and older against the coronavirus, breaking with CDC guidelines

• Florida and Texas residents ages 65 and older are now able to get coronavirus vaccines.
• The decision bucks the Centers for Disease Control and Prevention's recommendations that frontline workers and people older than 75 should be next.
• "The problem is people that are 73, 74 would be in the back of the line for a young 21-year-old worker who's considered 'essential,'" Gov. Ron DeSantis of Florida said.

Florida and Texas have started to distribute coronavirus vaccines to residents over age 65.

Last week, Gov. Ron DeSantis of Florida issued an executive order allocating vaccines to nursing-home residents and staff members, people 65 and older, medical workers, and anyone deemed "extremely vulnerable to COVID-19." Texas did the same a few days prior, giving the green light for people 65 and older, along with those who have certain preexisting conditions, to start getting vaccinated.

"The focus on people who are age 65 and older or who have comorbidities will protect the most vulnerable populations," Imelda Garcia, the chair of Texas' expert vaccine-allocation panel, said in a statement.

These decisions go against guidelines set by an advisory group at the Centers for Disease Control and Prevention. The CDC recommended that healthcare workers and nursing-home residents and staff members should be first in line, followed by other frontline workers and all people over 75. These recommendations, the group wrote, are meant to "preserve functioning of society" and "decrease death and serious disease as much as possible."

But in Florida and Texas, younger frontline workers have been bumped out of the next phase of vaccinations.

"The problem is people that are 73, 74 would be in the back of the line for a young 21-year-old worker who's considered 'essential.' That doesn't, I think, make sense,'' DeSantis said at a press conference on Wednesday.

Neither state has finished vaccinating everyone in the first priority group.

Literal vaccine lines have formed

The few places in Florida and Texas that started administering vaccinations to people older than 65 quickly exhausted supply.

The Department of Health in Lee County, which includes Fort Myers, started vaccinating people ages 65 and older on Monday. County staff members reported that they expected to have 300 doses available at one site on Monday, three sites on Tuesday, and three sites on Wednesday.

Photos from the local outlet The News-Press showed Fort Myers residents lined up at the Estero Park and Recreation Center on Sunday evening, 19 hours before the clinic site was set to open.

By the next morning, the line stretched around the building. The clinic ran out of doses by noon.

—Dannielle Garcia WINK News (@Dannielle_Garci) December 28, 2020

Similarly, the Wise Health System in Decatur, Texas, began giving shots to residents in the 65-plus age group on a first-come, first-served basis on Wednesday. People lined up more than two hours before the clinic opened, and doses ran out by 8:30 a.m.

"We know that the 65+ clinic did not go as smoothly as we would have liked," the Wise Health System wrote on its Facebook page on Wednesday. "The decision was made to provide the vaccine to this critical age group on Tuesday morning and it was implemented in less than 24 hours."

Each state decides how to distribute its vaccine supply

The CDC guidelines for distributing the Moderna and Pfizer-BioNTech vaccines say that after healthcare workers and nursing-home residents and personnel, the next doses should go to people over 75 and frontline workers outside healthcare - such as teachers, agriculture workers, grocery-store employees, and public-transportation workers. Then should come Americans ages 65 to 74, along with people under 64 who have high-risk medical conditions, and any other workers considered essential.

The US has 24 million healthcare workers and nursing-home residents and staff members. As of Saturday, 9.5 million vaccine doses had been distributed. Florida, specifically, is expected to receive 970,000 doses this year, but the state has 1.1 million healthcare workers and 270,000 nursing-home residents, according to The Washington Post. Texas has about 1.4 million healthcare workers and 300,000 people in nursing homes, but Gov. Greg Abbott said the state would get 1.2 million doses this month.

"There is no need to ensure all of your 1a group has been vaccinated before starting 1b vaccinations," John Hellerstedt, the commissioner of Texas' Department of State Health Services, wrote in a letter to healthcare facilities on Wednesday, referring to the first two tiers of vaccination recommended by the CDC.

The CDC instructions are just guidelines - it's up to states to prioritize their shots. A recent Kaiser Family Foundation report found that 45 states were following the CDC recommendations. Massachusetts, Nevada, New Hampshire, and Wyoming deviated slightly by including law enforcement in their first round of vaccinations. Massachusetts is also including incarcerated people and those in homeless shelters in its first group.

Texas, meanwhile, decided residents' occupations wouldn't be the deciding factor, at least not yet.

"Texas has clearly come down on the side of, 'We're going to focus on those who are at greatest risk of illness and death,'" Jen Kates, a senior vice president at the Kaiser Family Foundation, told CNBC.

'Our priority is the elderly'

In Florida, approximately 4.4 million residents are older than 65, and more than 3 million are above 70. From May to August, 78% of coronavirus deaths in the US were people ages 65 or older.

"Our priority is the elderly population," DeSantis said during the Wednesday press conference.

Brett Giroir, the assistant secretary for health at the US Department of Health and Human Services, said the decision made sense.

"Because those are the people who go to the hospitals. It's not the frontline 24-year-old worker who is at low risk of getting the infection and at very, very low risk of getting serious results from that," Giroir told "Fox News Sunday," adding, "as the hospitals fill up, the first priority really needs to be to save lives and reduce the burden on hospitals."

Essential workers, however, face an increased risk of exposure to the coronavirus, and a disproportionate share are poor and nonwhite.

"Black and Hispanic workers in Florida are disproportionately dying of COVID," Dr. Terry Adirim, a pediatric emergency-medicine physician at Florida Atlantic University, told the Palm-Beach Post, adding, "these are the people working in the grocery stores, delivering the grocery, driving the buses, putting their lives at risk so those of us who can work from home can work from home."

Even if few younger workers become seriously ill, staff outbreaks could strain hospitals' ability to provide care as people with COVID-19 miss work.

But COVID-19 has also killed many young people. One study found that from April through June, more than 3,300 Americans ages 18 to 34 were hospitalized with COVID-19, and 21% required intensive care. About 3% died.

From July to August, people ages 20 to 29 accounted for the largest proportion of known coronavirus cases in the US - more than 20%.

Aria Bendix and Hilary Brueck contributed reporting.