At least 40% of the doses have already been allocated to hospitals as they get ready to administer it to those on the front lines.
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The vaccines couldn't come soon enough as cases surge, and the near future looks grim.
"The number of deaths is accelerating...we know we're going to be reporting more in the days and weeks to come," Fresno County Public Health's Dr. Rais Vohra said.
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While cases trend upward, bed space is dangerously low.
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As of Tuesday, Fresno County health officials said just 16 ICU beds are available.
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County health officials are working with a contracted medical team to establish a 50-bed alternative care site at the North Plaza of Community Regional Medical Center to create more bed space.
"That site is being opened as we speak. It will be totally activated probably by Friday. Even though it's at CRMC, it's available for other hospitals," Fresno County emergency services director Dan Lynch said.
In the South Valley, staffing at Kaweah Delta is also critically low.
Employees are being stretched thin as hospital officials try to make space.
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"We're turning many areas of the hospital into patient care units. We've turned a 12 bed pediatric unit into a dedicated adult COVID unit," CEO Gary Herbst said
The Porterville Developmental Center is also back open and taking some patients while the Fresno Convention Center alternative care site could open in a couple of weeks.
Meanwhile, more vaccines are on the way.
Fresno County is expected to receive more doses in a little over a week, while Tulare County is expected to get their first shipment by on Wednesday.