New Jersey will begin coronavirus vaccinations on Thursday for residents 65 and older, as well as people 16 and older who have high-risk medical conditions, Gov. Phil Murphy announced.

It was not clear how quickly the state would be able to inoculate all of the almost 4.5 million newly eligible people who want the vaccine; shots are given by appointment only, with each provider having a limited number of doses each day.

The decision, in line with the federal government’s new recommendation that states start expanding the pool of eligible vaccine recipients, was based on the expectation that the U.S. will soon ship many more doses to the states, Murphy said.

“Our vaccination program is ramping up,” he said at a Wednesday news briefing.

New Jersey becomes the first state in the region to offer vaccinations to seniors and people with preexisting conditions that make them vulnerable to COVID-19. Pennsylvania has not said when it will begin vaccinating the next group; Philadelphia said Tuesday the city could start doing so as soon as Jan. 25.

New Jersey has not said when essential workers, who will be eligible in the next phases in Pennsylvania and Philadelphia, will start getting the vaccine.

Pennsylvania’s top health official on Tuesday indicated the state also planned to follow the new federal guidelines opening the vaccine to people 65 and older or with high-risk conditions, but the state has not formally announced who will be eligible in the next group. The Department of Health did not have an update Wednesday.

Philadelphia’s plan, released Tuesday, provides for people 75 and older along with anyone with a high-risk medical condition to be vaccinated in the next stage.

» READ MORE: Essential workers, people 75 and up, and others will be vaccinated next in Philly

As New Jersey pushed ahead on the vaccine, hospitals there were preparing for a surge in cases that health officials predicted could start next week, based on a rising rate of transmission and outbreaks throughout the state. There were 6,922 new cases Wednesday, a state record for a single day.

The state is averaging nearly 100 deaths a day, with the average number of daily deaths up 53% over the last two weeks.

Modeling shows hospitalizations could soon top 4,500 after hovering in the 3,000s for weeks, Health Commissioner Judith Persichilli said.

Murphy said it would “ring a lot of alarm bells” if the state were to reach 5,000 virus patients in hospitals. During the first wave of the coronavirus last spring, more than 8,700 were hospitalized at one point.

“This month into early February is make-or-break time … based on everything we know,” Murphy said.

In Pennsylvania, hospitalizations have been dropping, but the seven-day average number of deaths was climbing steadily, hitting a record high Wednesday of 216 per day, according to an Inquirer data analysis. Wednesday was the sixth day in the last eight on which the state has reported more than 200 people died.

Pennsylvania reported 7,960 new cases on Wednesday. Philadelphia announced 590 cases and 24 deaths.

And the nation set a new record for deaths in a single day, reporting 4,327, representing those recorded Tuesday, according to data from Johns Hopkins University.

Changing fast

Pennsylvania reported 299,954 partial doses administered and 42,624 full doses administered on Wednesday. Philadelphia reported more than 52,500 first doses and 10,800 second doses administered on Wednesday.

New Jersey reported 236,503 first doses and 28,045 second doses administered.

For now, eligible New Jerseyans can contact a vaccine provider in the state — designated sites or some hospitals and health-care centers — to schedule an appointment. The state will also start sending notifications about making appointments to the more than 1.2 million people who preregistered online.

» READ MORE: I received the COVID-19 vaccine, but I can’t let my guard down | Expert Opinion

Since the vaccine first arrived in the Garden State in mid-December, only health-care workers and residents of long-term care facilities have been eligible for inoculations, joined recently by police and firefighters. Murphy said some in those groups are still getting vaccinated; he compared the process to an airline boarding passengers by sections.

“They don’t wait for the last person or persons in 1A to get on the plane before they begin the process of boarding 1B,” Murphy said.

As in every other state, the challenge is simple math: millions are eligible for the vaccine, but only thousands of doses are coming in each week — and often in smaller shipments than expected. The governor said health officials were working on how to distribute the incoming doses efficiently to more people.

“Our assessment is that’s gonna begin to balance out,” he said. “I think you get through the next six to eight weeks, we’re in a dramatically different place.”

Plea for funds

The Philadelphia School District will reopen six school buildings to students for the first time since March to conduct special education assessments for students who need in-person evaluations.

The assessments will start Jan. 25 and will serve about 600 students. They will be staffed by district personnel, including Philadelphia Federation of Teachers workers, with safety protocols. Students and staff will take rapid COVID-19 tests before participating, Superintendent William R. Hite Jr. said in a statement.

» READ MORE: Indoor dining will return to Philadelphia on Saturday. Will it help restaurants?

Meanwhile, Pennsylvania officials renewed a plea for more federal funding to continue a program that pairs long-term care facilities fighting coronavirus outbreaks with nearby academic medical centers.

Department of Human Services Secretary Teresa Miller said at a Wednesday briefing that the initiative, which helped facilities with infection control, testing, protective equipment, and crisis staffing, led to smaller, less severe outbreaks at nursing homes, personal care homes, and assisted living facilities.

After the program started in July, the average number of cases associated with each long-term care outbreak fell by 60%, hospitalizations fell by 79%, and the average number of deaths per outbreak dropped by 77%, Miller said.

Without more federal cash, hospital staff and emergency workers will make fewer visits to the facilities, she said.

Staff writers Stacey Burling, Kristen A. Graham, Rob Tornoe, Laura McCrystal, and Jason Laughlin contributed to this article.