California made more than 4.4 million people with health risks newly eligible for the scarce COVID-19 vaccine this week, but the state also has quietly dropped millions who are vulnerable to the disease due to their age or occupation from any mention in its priority plan.

And many of those 50-to-64-year-olds and other essential workers facing exposure on the job are left wondering whether they’ll ever be prioritized, or left to join the mosh pit with everyone else when the U.S. opens the doors to anyone wanting a vaccine, perhaps as early as May.

“”It’s folks who are 62 and 64 that we’ve been hearing a lot from and are really concerned,” said Fred Buzo, associate state director for AARP California, noting that more than 93% of the state’s deaths have been among people aged 50 and older. “There’s a worry that by putting so many other people into the queue, not just the 50-plus, but the 65-plus are going to fall even further behind.”

The disappearance of 50-64-year-olds and other workers who had been listed as a next priority phase from the state’s online vaccine information website appears to have happened in February. But it’s gotten more notice since President Biden last week said he expects eligibility to be opened up to all adults and older teens May 1, and after California’s expanded eligibility this week didn’t include those groups. The California Department of Public Health did not respond Wednesday to questions about the next eligibility phase.

Asked about the change at a news conference this week, Gov. Gavin Newsom indicated other groups would be prioritized as part of an unfolding “stairstep,” with exposure risk and age “our primary factors in terms of prioritization.” But Newsom, adding that “our North Star continues to be equity,” didn’t say which groups might be next in line, or when.

“I anticipate that over the next days and weeks, you’ll continue to see, as more and more supply comes into the state, a loosening, moving our way toward where the puck is going May 1, where we loosen up for everybody and all the tiers are completely removed,” Newsom said. “So we anticipate that cadence.”

The vaccine effort nationally and statewide has been chaotic and uneven as manufacturers of the authorized shots — Pfizer, Moderna and Johnson & Johnson — scramble to ramp up production while government leaders try to prioritize who should get the doses based on highest risks for exposure or death from the coronavirus.

Since vaccines first became available in December, California has changed its prioritization plan repeatedly. Adding to the confusion, its current scheme doesn’t quite align with recommendations by the U.S. Centers for Disease Control and Prevention.

The CDC recommendations, drawn from an independent panel of medical and public health experts, put as the highest priority health care personnel and vulnerable elderly and disabled residents of long-term care facilities.

The CDC next prioritized people 75 and older whose age puts them at higher risk of dying from the virus. That phase also includes frontline workers in essential jobs with high exposure risk, including public safety, grocery, food and agriculture, teachers and day care workers, postal and public transit workers. After that, the CDC’s priority includes ages 65-74, those 16-64 with specified health risks, and other essential workers including energy, construction, finance, law and communications.

California started with a similar plan, intending to cover about 3 million people statewide.

But then the state changed course with the next phase, starting with those 65 and older as well as education and childcare, food and agriculture and emergency services workers, about 12 million people total. A second part included workers in transportation, critical manufacturing, industrial, commercial and residential services, the incarcerated and the homeless.

California’s next phase was to include people aged 50-64, and those aged 16-49 with specified health risks. Workers in energy, water, chemicals, finance, government and communications were also included in that phase. But that phase is no longer is listed on the state’s COVID-19 vaccination distribution plan.

Instead, this week the state opened up eligibility Monday to 4.4 million people, including those with with cancer, kidney disease, diabetes, heart disease, sickle cell disease, severe obesity, mental illness, the developmentally disabled, pregnant women, addicts, as well as the incarcerated, homeless, public transit and airport workers. Left off are the 50-64 age group and some other occupations that had been next in line.

All told, 19.4 million of California’s 40 million residents now are eligible for vaccines — 4.5 million have already been fully vaccinated, and 4.3 million have received one of the two shots required for the Pfizer and Moderna vaccines.

But just 47.5% of those aged 65 and older and 20% of those age 50-64 have received at least one vaccine dose, compared with 32.6% of people aged 18-49, who account for 6.7% of the state’s COVID-19 deaths. Those younger people qualified for a shot because of their occupation or disability.

Middle-aged and older Californians have been frustrated seeing their age group eligible in other states or counties. Alaska and Mississippi have made vaccines available to everyone 16 and older. Among large, populous states, New York and Florida are vaccinating people 60 and older, and Texas is among five states where those 50 and older already are eligible.

In the Bay Area, Solano County has started offering vaccines to those 50 and older who live or work there.

“”As someone in my fifties, I was excited to know that I was scheduled to be eligible for the vaccine,” said Raymond Yee, 54, an Albany personal technology consultant. “I was angered to be dropped from the priority list without adequate explanation of the rationale by the state. I understand that there are many other Californians who are more vulnerable than I am. However, it would have been much better not to have been promised a place in the scheduling only to have that taken away from me.”