About 1,000 people are scheduled to be the first in line when Hawaii’s first mass COVID-19 vaccination site opens at Honolulu’s Pier 2 cruise ship terminal on Monday.

Hawaii Pacific Health, which is operating the clinic, said it has assembled 20,000 doses to start vaccinating seniors 75 and older, first responders and front-line essential workers by appointment only. The health provider began contacting patients eligible for the shots randomly and has opened an appointment system on its website.

The parent company of Kapiolani Medical Center for Women & Children, Straub Medical Center, Pali Momi Medical Center and Wilcox Health on Kauai will begin vaccinating more than 1,000 people a day and ramp up in the next few weeks to between 3,000 and 4,000, Ray Vara, president and CEO of Hawaii Pacific Health, said at a news conference at Pier 2 on Wednesday. The site will have parking attendants and staff to manage the flow of people, and has additional overflow parking at Restaurant Row and Aloha Tower.

“We’re really excited about this,” he said. “We see it as a significant advancement as we look forward to restoring public health in our community.”

As of Wednesday, at least 40,386 individuals had started immunization by getting at least their first of two doses, and a total of 109,250 doses had been delivered in the islands.

“There’s a lot of people who will wonder why things haven’t gone faster and how they could’ve gone faster, but there are rate-limiting steps. There’s certainly a will to get it done,” Vara said, adding that some people not in the first priority groups could be vaccinated if there are extra doses at the end of the day. “There are a number of circumstances where people who are at the fringes of the phases may get vaccinated. If we finish a day and we’ve done everybody who has appointments and there’s nobody else around … within that phase and we have three doses left, we’re going to give that dose to whoever will bare their arm and allow us to vaccinate them. Rather than waste that vaccine we think it is consistent with the overarching goal, which is to get shots in arms.”

The Queen’s Medical Center will open a second large-scale vaccination clinic a week later at the Neal S. Blaisdell Center, starting with 2,000 inoculations a day, said Jill Hoggard Green, president and CEO of The Queens Health Systems, which is planning to set up a call center to help with vaccine registrations.

“We hope to be up to 3,000 to 4,000 (per day) within a week or two. Both of our goals is to be at least 5,000, but that’s a stretch and we need to work through that,” she said. “As health systems … we’ve seen the impact of this devastating disease and we know the root to getting in front of it is vaccination, so there’s nothing more important to us. We want to improve the health of all individuals in Hawaii by getting everyone vaccinated.”

Health officials reported three new coronavirus-related deaths — an Oahu woman and man in their 50s and a Maui man in his 60s, all with underlying health conditions — and 106 new infections, bringing the state’s totals since the start of the pandemic to 312 fatalities and 23,733 cases.

Honolulu Mayor Rick Blangiardi pledged to support widespread vaccination efforts and agreed to make city locations available as the rollout ramps up.

“The more efficiently we can distribute the vaccines, the faster we can get the City & County of Honolulu going again,” he said.

The state Health Department has not made a decision on whether it will follow new federal guidelines to begin vaccinating lower-priority individuals 65 and older and younger adults with certain health conditions.

A link to sign up for the vaccines will soon be posted at hawaiicovid19.com.