AUSTIN, Texas (AP) — How soon Texas nursing home residents will have access to the first coronavirus vaccine shots is under discussion as Republican Gov. Greg Abbott expects an initial round of 1.4 million doses to begin arriving later this month.

Across the country, states are drafting plans to determine who will go to the front of the line when the first doses of COVID-19 vaccine become available. Nonbinding guidelines adopted this week by the Centers for Disease Control and Prevention put health care workers and nursing home patients first.

Texas has put hospital staff, nursing home workers and paramedics at the top of the list — known as “Phase 1A” — followed by a group that includes outpatient medical employees, pharmacists, funeral home workers and school nurses. Nursing home residents were not among those first tiers in Texas but that list could be revisited, said Chris Van Deusen, a spokesman for the Texas Department of State Health Services.

“Nursing home residents are still under discussion," Van Deusen said in an email. “With the CDC’s advisory committee recommendation this week that nursing home be in 1A, that could be a change for Texas.”

Early estimates from Texas health officials identified more than 1 million workers in frontline medical jobs. The vulnerable population in Texas includes more than 137,00 nursing home residents and nearly 4 million residents over the age of 65, according to a draft of the state's COVID-19 vaccination plan released in October.

Texas has a statewide population of about 29 million.

The American Health Care Association/National Center for Assisted Living issued a letter to governors as officials in a handful of states have released priority lists that do not put long-term care residents in the very first group of Americans to be vaccinated. “We want to make sure long term care residents and caregivers are given the vaccine first as there are real life and death outcomes at stake,” the group said.

On Wednesday, the Association of Texas Professional Educators expressed confidence that teachers in public schools would be included in the second phase of access to the vaccine, although state officials have not yet revealed the next stage of recipients.

The first doses of the vaccine are set to arrive as for a third day in a row Texas surpassed 9,000 hospitalized coronavirus patients on Thursday. This is the most since July, when hospitalizations peaked at nearly 11,000 during a deadly summer surge. State health officials on Thursday also reported 244 new coronavirus deaths, the most since July 30.

Officials in North Texas on Thursday said they would have to shut down bars and reduce capacity to 50% at stores, restaurants and other businesses after the area's hospitalization rate for patients with COVID-19 went above 15% for seven consecutive days. The shut down and reduction in capacity was triggered by a rule announced in October by Gov. Greg Abbott, who allowed bars to reopen and other businesses to expand capacity as long as COVID-19 hospitalizations stay below 15%. A similar shutdown affected several Central Texas counties earlier this week.

In El Paso County, which has been hit hard by a weekslong surge of coronavirus cases and deaths, officials on Thursday said they were hopeful as new cases and hospitalizations have been going down. El Paso Mayor Dee Margo said the area is seeing the lowest seven-day hospital occupancy since Oct. 14. Cases in the border area began rising on Oct. 1, overrunning its hospitals and funeral homes as 14 mobile morgues had to be set up. Officials said new cases have been steadily going down since peaking in early November.

“We’re at the crossroads right now of understanding what’s going to happen after Thanksgiving,” El Paso County Judge Ricardo Samaniego, the county’s top elected official, said Thursday about worries of another spike after last week’s holiday. “I am cautiously optimistic, but I’m really concerned as to what’s going to happen because of what’s happening around the country.”

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Associated Press writer Juan A. Lozano in Houston contributed to this report.