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California expanded COVID-19 vaccine eligibility to an estimated 4.4 million people Monday, allowing those with certain health conditions and disabilities to get inoculated.

The state’s health department outlined conditions that put people at risk for serious illness from COVID-19, and officials are urging others not to try to skip the line. Those aged 16 to 64 with the following conditions can now get the vaccine:

  • Cancer (current with debilitated or immunocompromised state)
  • Chronic kidney disease (stage 4 or above)
  • Chronic pulmonary disease (oxygen dependent)
  • Down syndrome
  • Immunocompromised state from solid organ transplant
  • Pregnancy
  • Sickle cell disease
  • Heart conditions, excluding hypertension
  • Severe obesity (with a Body Mass Index >= 40 kg/m2)
  • Type 2 diabetes mellitus (with hemoglobin A1c level greater than 7.5%)

Also, according to the state, people with disabilities can get vaccinated if the following applies:

  • A COVID-19 infection is likely to result in severe, life-threatening illness or death
  • Or getting COVID-19 will limit the person’s ability to receive ongoing care or services vital to well-being and survival
  • Or providing adequate and timely COVID-19 care will be particularly challenging as a result of the disability

Also eligible are family members who care for regional center members at high risk of complications or death from COVID-19. That includes those who provide direct care to the regional center consumers with cerebral palsy, down syndrome and epilepsy. Eligible family members must get documentation from their regional centers, verifying the qualifying condition of the family member cared for and caregiver status, according to the state health department

State and county officials are strongly encouraging that people in those groups get their vaccines from their primary health care providers. If that’s not possible, they can sign up to be inoculated at a mass vaccination site.

Los Angeles, Riverside, Orange, Ventura and San Bernardino residents can use the state’s appointment website MyTurn or call 833-422-4255 to find appointments at mass vaccine sites, pharmacies, mobile clinics and other providers. There are also appointments at L.A. County-run sites.

Though they can choose to do so, residents don’t have to provide vaccination sites with documentation to prove they have one of the listed conditions. Instead, they’ll be asked to self-attest that they have a serious condition or disability.

This is part of an effort by the state to remove barriers to vaccination, but it has raised concerns about line-cutting, which young and healthy people were already doing.

That’s what makes the latest vaccine expansion “challenging,” said L.A. County Department of Public Health Chief Science Officer Dr. Paul Simon.

“This expansion, I think, will be challenging,” he said. “We don’t feel that our frontline staff are in a position to screen and make decisions about who or who is not eligible.”

“If someone simply attests to the fact that they have a serious condition or disability, they will be approved for vaccination. We urge people not to take advantage of that,” Simon said. “We all have a moral obligation to make sure that vaccine is reserved for those that are at greatest risk.”

The major expansion to millions more now eligible for the vaccine comes as supplies remain limited, with the state designating 40% of its doses for communities hardest hit by the coronavirus and 10% for educators.

In addition to people with health conditions and disabilities, the state also expanded eligibility to public transit workers, and people who live or work in a congregate residential settings, like detention facilities and homeless shelters.

And the state isn’t done vaccinating people who have already been eligible for the doses. Less than half of Californians 65 and older have been vaccinated so far, according to state data.

Here’s more on how to sign up for the COVID-19 vaccine in Los Angeles, Orange, Riverside, Ventura and San Bernardino counties.