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Missouri will open coronavirus vaccinations to more than 2.5 million residents Monday, state health officials said Thursday.

The change will occur as the state begins approving more groups to receive the vaccinations, Missouri's Vaccine/Planning Team told reporters.

The first phase of people qualified to receive the vaccine included patient-facing health care workers, residents and staff of long-term care facilities, home health providers and EMS personnel.

That phase shifted Thursday toward people in public works positions, non- patient-facing public health workers, first responders, and critical infrastructure and government.

It should be noted — much like boarding an airplane — even though a person's group has already been called and the state has opened vaccinations to following groups, people from earlier groups may still receive the vaccinations.

Document: DHSS COVID-19 Vaccination Phase 1B Order

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Gov. Mike Parson said expansion of people approved to receive the vaccine is moving a little faster than officials had expected.

"This all coincides with the plan we've got in place since October," Parson said. "We'll continue to stay focused on that execution of that plan."

The demand is much higher than the supply, he said. State officials can't determine the exact vaccine supplies arriving in Missouri because supplies are coming in from the federal level.

"Whatever capacity I need as governor to make sure we get this vaccine in people's arms the quickest, the safest, we will do that," Parson said, "through whatever avenues I have to help with that process."

The state knows the number of people in the phase that opens Monday will be in the millions.

That phase includes state residents who are 65 and older and any adult with cancer, chronic kidney disease, cardiopulmonary disease, heart conditions, weakened immune systems due to organ transplant, sickle cell disease, Type 2 diabetes mellitus, pregnancy, and intellectual or developmental disabilities.

The Centers for Disease Control and Prevention have recommended the vaccinations for pregnant women, members of the vaccine planning team said Thursday.

And the team made other adjustments to who is included in the latest group to be opened for vaccination based on concerns from communities. Particularly, people with Down syndrome are at greater risk of severe symptoms from COVID-19 than other groups.

Missouri is one of 11 states that included people with intellectual and developmental disabilities as those whose risk is higher.

Individuals included in groups approved to begin receiving the vaccines should work through their employer or physician to receive it. Or they may contact their health provider or local pharmacy to find out how to access the vaccine. Information about where vaccines in your area was to be available today at MOStopsCovid.com.

Employers may request to provide vaccinations by filling out a form on the site. The Missouri Department of Health and Senior Services encourages employers and associations representing people in activated phases to use the list to connect with a vaccinator or regional vaccine implementation team in their area and make a plan for vaccinating their employees.

The Cole County Health Department officials are asking people to fill out a survey on the department's website, and based on availability and whether their group qualifies, will contact people who have taken the survey and provide them with instructions on how to schedule an appointment.

"We know one of the most common questions among Missourians right now is when it will be their turn to be vaccinated, and we are greatly encouraged by the interest in the vaccines from the public," DHSS Director Dr. Randall Williams said in a news release. "Each day, our team is monitoring the amount of vaccine available and making sure it is distributed so that people can receive the vaccine as quickly as possible. We are so thankful to our hundreds of clinical partners throughout the state who are making that happen."

At least 27 percent of residents who qualified for the first wave of vaccinations (front-line health care workers and residents and staff in nursing homes) have received at least their first dose of the vaccines. Missouri has received doses of the Pfizer and Moderna vaccines. Each thoroughly tested vaccine has proven more than 90 percent effective against the coronavirus. Each requires two injections (three to four weeks apart)

As of Thursday, suppliers had shipped more than 410,000 doses of the vaccines to the state. That includes doses that haven't yet arrived on site. More than 190,000 doses have been administered.

Missouri health officials estimate 22,000 Missourians have received both doses.

Federal partners have told the state that Missouri's supply is "ramping up," Missouri Vaccine/Planning Team members said. Second doses the feds held back are coming shortly.

The state wants to activate the next vaccination phases, like the groups included this coming Monday, so there are people ready to go. It doesn't want the vaccine sitting on the shelf (even though it has a shelf life of six months).

Another vaccine from Astra Zeneca and a single-dose Johnson & Johnson vaccine are expected to receive approval and begin distribution in February.

The availability of vaccine in February is expected to grow rapidly.

All COVID-19 vaccinations are free, having been paid for by the federal government.

"We know as we move into the next level that we are talking in the millions," Parson said, and acknowledged there are limited supplies. "We'll be prepared for that. And we're going to move forward."

This article was updated at 4:45 p.m. Jan. 14, 2021, with additional information.

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