Urges to get a coronavirus vaccine are everywhere, but Brad Offutt has decided to reject them.
The 53-year-old is a pain therapist in Marble Falls, a town of about 6,000 people in Burnet County, and he said he wants the vaccines to get full approval — rather than the current emergency clearance — by the Food and Drug Administration before he goes there. one gets. But even then, Offutt said the chances of him doing so are slim because he “doesn’t feel personally threatened by COVID”.
Instead, he has made the decision to “take the risk of getting COVID”.
The coronavirus vaccines have been thoroughly tested and found to be safe and effective. More than 340 million doses have been given in the US, and side effects have been determined by the FDA and independent researchers to be extremely rare and far less than the dangers of contracting COVID-19, which has killed more than 52,000 Texans. Aug 2
Public health experts say getting as many people vaccinated as possible is the best and fastest way to end the pandemic, but Offutt’s hesitation is common. He is one of 14 million Texans on Aug. 1 who have remained unvaccinated, about eight months after the first batch of vaccines was first rolled out.
Many of those who have not been vaccinated are children who are not eligible for the injections; about 5 million Texans are under the age of 12. But still 83% of Texans, or 24 million residents, are eligible for the vaccine. With 15 million Texans who have received at least one shot as of August 1, there are 9 million eligible Texans who have not yet received their vaccine.
This places the state’s vaccination rate 36th in the country and has contributed to another worrying wave in the pandemic. The number of hospitalizations from COVID-19 in Texas quadrupled in July. Preliminary state data indicates that more than 99.5% of people who died from COVID-19 in Texas from Feb. 8 to July 14 had not been vaccinated. The percentage of fully vaccinated residents has increased from 3% to 42% in that time.
The Texas Tribune analyzed the demographic and geographic trends of Texans who haven’t had their chance yet. Here are some of our key findings:
- In Texas’ largest counties — Harris, Dallas, Tarrant, Bexar, and Travis — neighborhoods with the highest percentages of black and Hispanic populations are some of the least vaccinated areas.
- Neighborhoods with a median income that is lower than the province’s average income also have a lower vaccination rate than that of the province.
- Rural counties have consistently lagged behind the state’s fully vaccinated percentage.
Offutt lives along Lake Marble Falls with his wife, Dr. Amy Offutt, an integrative medicine physician who also chooses not to get vaccinated. He said they have enough space there not to worry about large crowds where the risk of exposure to the virus is high.
Marble Falls is a conservative stronghold; 76% of voters voted for Trump in 2020. The city is part of Burnet County, where 40% of residents are fully vaccinated — far behind neighboring Travis and Williamson counties, which are both about 56%.
“It matters if you live in a city that is more densely populated versus where we live that is not as populated and most of what we do is outdoor activities,” Brad Offutt said.
Data shows that is not necessarily true. Throughout Texas, the counties with the highest cases are outside urban centers.
Still, attitudes like Offutt’s are common among white conservative rural people, said Dr. David Lakey, the chief physician of the University of Texas System. According to the Tribune’s analysis, as of August 1, 33% of people in rural or non-metropolitan counties have been fully vaccinated, behind the state’s rate of 44%.
In the state’s largest cities, the story is different. Vaccination rates are higher in metropolitan areas, but poorer urban areas and those with more people of color generally have much lower vaccination rates. Overall, black and Hispanic Texans have the lowest vaccination coverage among racial groups statewide, at 28% and 35%, respectively.
“In an area like Houston or Dallas or Austin, the general rates may look good, but there can be significant differences and differences between one zip code and another,” Lakey said. “… one part of the city can be very different from another part of the city.”
For example, in Dallas County, 58% of people in predominantly white neighborhoods were fully vaccinated by July 26. Those rates are way ahead of predominantly black and Hispanic neighborhoods, which are 37% vaccinated.
Lakey added that vaccination coverage in East Texas has been lagging behind the rest of the state since “it tends to be older, and it’s a part of the state with a significant African American population and also a significant conservative white population, and is also a more rural area.”
Why aren’t they vaccinated?
Mistrust is the number one cause of vaccine hesitancy, Lakey said, and the root of the mistrust usually depends on a person’s culture.
Hesitancy for white conservatives, he said, hinges on “government distrust,” while for Hispanic and black residents it is often a “lack of trust in the health care system” because of generations of inequalities in the American system.
“For some individuals who don’t have a lot of experience in health care interaction — maybe they don’t have a primary care physician — this may raise more doubts when we start talking about a vaccine because these kinds of experiences are new,” said Dr. John Carlo, CEO of Prism Health North Texas.
He added that while he would like fewer people to hesitate about the vaccine, he understands the uncertainty.
“I think the most important thing I would say is that we just have to keep listening and see where people are about this, because a lot of the time people aren’t completely against it,” Carlo said. “There is an ongoing concern and perhaps questions can be answered.”
Alma Peña, a 40-year-old Austin resident, didn’t trust the coronavirus vaccine when it first came out and resisted getting it all spring.
“I was afraid something would happen to me if I got the vaccine,” she said in Spanish.
But the recent spate of cases and hospitalizations made being unvaccinated scarier than the possible side effects of the injection for Peńa. She is a cleaning lady and since she spends most of her days hopping from house to house, she put her fears aside and rolled up her sleeve in July.
“I’m scared,” Peña said.
She received her injection in early July through the University of Texas School of Nursing’s Vaccine Administration Mobile Operations, or VAMOS, which aims to vaccinate vulnerable populations in Austin. She attended one of their weekly clinics held in the parking lot of the First Spanish Seventh Day Adventist Church, just around the corner from her home.
She took her 13-year-old son Joseph to receive his first dose on July 21 at the same church, just before he enters seventh grade in August.
The way to convince more families like the Peñas to get vaccinated is to “make sure we have one message with many voices”.
Of the six zip codes in Travis County in which Hispanics make up more than half of the population, all but one zip codes have a fully vaccinated rate that is lower than the county’s 56%, according to the Tribune’s analysis.
The gap is also seen when comparing neighborhoods based on median income. Of the 14 zip codes with a median income lower than that of the province, 10 are also covered by the national fully vaccinated rate. Of the 20 Travis County zip codes with incomes above the county’s median income, only four are below the county’s rate.
Ana Todd is the director of the VAMOS clinic where Joseph received his injection, and said a lack of easy access to health care and transportation are also the main reasons why some black and Hispanic residents have not received a vaccine. But above all, “distrust is one of the biggest reasons” Texans are turning away from the shot, she said.
Todd said efforts that take the time to meet and talk to residents are critical to restoring the relationship between Austin’s Hispanic and black communities and the health care system. And that is why the organization organizes clinics in local churches.
“People trust the churches,” Todd said.
Every Wednesday since May, VAMOS has partnered with the Central Texas Food Bank to turn the weekly food campaign at First Spanish Church into a vaccination clinic. Some food bank regulars quit by not knowing about the vaccine clinic. While they wait in line to pick up food, a volunteer from VAMOS asks if they want to get vaccinated.
Sometimes, Todd said, hesitant residents refuse. But they’ll be back next week and she’ll ask them again if they’d consider getting the vaccine. That was the case a few months ago when a mother and daughter lined up for the food collection. Todd said she asked the duo if they wanted their vaccine and the mother immediately declined, but the daughter said, “Let me think about it.”
Todd continued to tell the daughter about the importance of the vaccine and she eventually agreed to have the shot. After watching her daughter get vaccinated, the mother told Todd she would take a week to think about getting hers.
“We’ve been working consistently to build trust,” Todd said. “And more importantly, we listened to why they don’t want to get the vaccine or why they didn’t.”
She added that being Venezuelan and treating a majority of the Latin American neighborhood helps her build trust with residents.
“I understand when someone says to me ‘Dios me va a proteger’ – ‘God is going to protect me,'” Todd said. “So when they tell me that, I know the context. I know how to lead the conversation and share how we got the tools to take care of ourselves. … And so it is about framing the conversation in such a way that it is person- and patient-oriented.”
dr. Lane Aiena, the director of Walker County’s COVID-19 medical response team, said he has a similar approach to convincing his rural community to get them vaccinated: having one-on-one conversations with his patients.
“I need to be well aware that I’m frustrated with the situation, but not with the person,” said Aiena, who is also a physician in Huntsville. “Nobody is anti-vaccine just because they woke up in the morning and decided, ‘I’m not going to take this shot.’ They’ve heard something somewhere. They have a reason to be hesitant and I’m asking them to put something in their bodies, and they have a right to want to know.”
A note on the methodology:
Higher and lower income zip codes are defined as zip codes with a median income above or below the county median, taking into account the margin of error. Postal codes were included in a demographic majority if more than half of the population belonged to that demographic group, taking into account the margin of error. Income and racial demographics are from the US Census Bureau’s 2019 American Community Survey.
Disclosure: University of Texas System is a financial supporter of The Texas Tribune, a nonprofit, unbiased news organization funded in part by donations from members, foundations, and corporate sponsors. Financial supporters play no part in the Tribune’s journalism. A full list of these can be found here.