Texas’ unvaccinated: who they are and where they live

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Admonitions to get a coronavirus vaccine are everywhere, but Brad Offutt has decided to turn them down.

The 53-year-old is a pain therapist in Marble Falls, a town of about 6,000 in Burnet County, and he wants the vaccines to be fully approved by the Food and Drug Administration – rather than the current emergency approval before he gets one. But even then, Offutt said the chances of this were slim, as he felt “not personally threatened by COVID”.

Instead, he 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 administered in the US, and side effects have been classified by the FDA and independent researchers as extremely rare and far less serious than the dangers of contracting COVID-19, which has killed more than 52,000 Texans to date 2. August

Public health experts say the best and fastest way to end the pandemic is to vaccinate as many people as possible – but Offut’s hesitation is widespread. He is one of 14 million Texans as of August 1 who went unvaccinated about eight months after the first batch of vaccine was introduced.

Many of the unvaccinated are children who cannot get vaccinations; around 5 million Texans are under 12 years old. But 83% of Texans, or 24 million residents, are still eligible for the vaccine. With 15 million Texans who had received at least one vaccination by August 1, that leaves 9 million eligible Texans who have not yet received their vaccine.

That puts the state’s vaccination rate in 36th place in the country and has helped fuel another worrying wave of the pandemic. COVID hospital stays in Texas quadrupled in July. Preliminary data from the state shows that more than 99.5% of people who died of COVID-19 in Texas February 8 through July 14 were unvaccinated. The proportion of fully vaccinated residents increased from 3% to 42% during this period.

The Texas Tribune analyzed the demographic and geographic trends of Texans who haven’t had their chance. Here are some of our key takeaways:

• In the largest counties in Texas – Harris, Dallas, Tarrant, Bexar, and Travis – neighborhoods with the highest proportions of black and Hispanic Americans are among the least vaccinated.
• Neighborhoods with a median income below the county’s median income also have lower vaccination rates than those in the county.
• Rural counties have consistently lagged behind the state’s full vaccination rate.

Offutt lives with his wife Dr. Amy Offutt, an integrative medicine doctor who also decides not to vaccinate, at Lake Marble Falls. He said they had enough space there so they didn’t have to worry about being in large crowds and having a high chance of being exposed to the virus.

Marble Falls is a conservative stronghold; 76% of voters cast their vote for Trump in 2020. The city is part of Burnet County, where 40% of the population is fully vaccinated – far below the rates of neighboring counties Travis and Williamson, which are both around 56%.

“It matters whether you live in a more populated city as opposed to a less populated city where most of what we do is outdoors,” said Brad Offutt.

Data shows that this is not necessarily true. Across Texas, the counties with the highest number of cases are outside of the urban centers.

Still, attitudes like Offutt’s are common among white, conservative rural dwellers, said Dr. David Lakey, the University of Texas System’s chief medical officer. According to the Tribune’s analysis, 33% of people in rural or non-urban counties are fully vaccinated as of Aug. 1, down from the state rate of 44%.

The story is different in the state’s largest cities. Vaccination rates are higher in metropolitan areas, but poorer urban areas and areas with more colored people tend to have much lower vaccination rates. Overall, Black and Hispanic Texans have the lowest vaccination rates among racial groups in the country at 28% and 35%, respectively.

“In an area like Houston or Dallas or Austin, the total prices may look good, but there can be significant differences and inequalities between one zip code and another,” said Lakey. “… a district can be very different from another district.”

For example, in Dallas County, on July 26, 58% of people in the white-majority neighborhood were fully vaccinated.

Lakey added that vaccination rates in east Texas have lagged behind the rest of the state because “it tends to be older and is an area of ​​the state that has, and is, a significant African American population as well as a significant conservative white population.” more rural area. “

Why are they not vaccinated?

Suspicion is the leading cause of vaccination reluctance, Lakey said, and the core of suspicion usually depends on a person’s culture.

Hesitation for white conservatives depends on “suspicion of the government” while for Hispanic and black residents it is often a “lack of trust in the health system” due to generations of inequalities in the American system.

“For some people who don’t have much experience with health system interactions – maybe they don’t have a family doctor – this could raise further doubts when we talk about a vaccine, as these types of experiences are new. “Said Dr. John Carlo, CEO of Prism Health North Texas.

He added that while he wishes fewer people were hesitant 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 think about it, because often people are not completely against it,” said Carlo. “There is ongoing concern and perhaps questions could be answered.”

Alma Peña, a 40-year-old Austin resident, didn’t trust the coronavirus vaccine when it first hit the market and refused to get it all spring.

“I was afraid something would happen to me if I got the vaccine,” she said in Spanish.

But the recent surge in cases and hospitalizations made it even more frightening to be unvaccinated than the possible side effects of vaccination for Peńa. She’s a cleaning lady, and since she spends most of her time hopping from house to house, she put her concerns aside and rolled up her sleeve in July.

“I’m afraid,” said Peña.

She received her vaccination in early July through the Mobile Operations of the University of Texas School of Nursing, or VAMOS, which aims to vaccinate vulnerable populations in Austin. She went to one of her weekly clinics in the parking lot of the First Spanish Seventh Day Adventist Church, which is just around the corner from her house.

She took her 13-year-old son Joseph to have his first dose in the same church on July 21, just before he started seventh grade in August.

The way to convince more families like the Peñas to get vaccinated, Carlo said, is to “make sure we have a multi-voice message”.

Of the six postcodes in Travis County, where Hispanics make up more than half of the population, all but one have a fully vaccinated rate that is lower than that of the 56% of the county, according to the Tribune’s analysis.

The gap is also evident when comparing the neighborhoods by median income. Of the 14 postcodes whose median income is lower than that of the district, 10 are also below the nationwide full vaccination rate. Of the 20 Travis County’s postcodes that have income above the county’s median income, only four are below the county’s median income.

Ana Todd is the director of the VAMOS clinic where Joseph received his injection, and said the lack of easy access to health care and transportation are also the main reasons some Black and Hispanic residents have not received the vaccine. But most of all, “Mistrust 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 vital to improving the relationship between Austin’s Hispanic and black communities and the health system. And that’s why the organization runs clinics in the local churches.

“People trust the churches,” said Todd.

Since May, VAMOS has been working with the Central Texas Food Bank every Wednesday to turn their weekly food drive at First Spanish Church into a vaccination clinic. Some of the regulars at the table stop, not knowing anything about the vaccination clinic. While they are waiting in line to pick up food, a VAMOS volunteer asks them if they would like to be vaccinated.

Sometimes, Todd said, hesitant residents refuse. But they’ll be back in the next week and she’ll ask them again if they’d like to consider the vaccine. That was the case a few months ago when a mother and daughter were lining up for the meal drive. Todd said she asked the duo if they wanted to get their vaccine and the mother immediately declined, but the daughter said, “Let me think about it.”

Todd kept telling the daughter about the importance of the vaccine, and she eventually agreed to get the vaccine. After watching her daughter get the vaccine, the mother told Todd she would take the week to think about getting hers too.

“We’ve worked hard to build trust,” said Todd. “And more importantly, we heard why they didn’t or don’t want to get the vaccine.”

She added that as a Venezuelan and treating a Hispanic majority neighborhood, she can build her trust with residents.

“I understand when someone says to me, ‘Dios me va a proteger’ – ‘God will protect me,'” said Todd. “So when you tell me that, I know the context. I know how to have the conversation and talk about how we got the tools to take care of ourselves. … And so the point is to structure the conversation in such a way that it is person- and patient-centered. “

Dr. Lane Aiena, the director of Walker County’s COVID-19 medical team, said he had a similar approach to convincing his rural community to get them vaccinated: one-on-one with his patients.

“I have to be very careful not to get frustrated with the situation but not with the person,” said Aiena, who is also a doctor in Huntsville. “Nobody is against the vaccine just because they woke up one morning and decided I wasn’t going to have this vaccine. You heard something somewhere. You have a reason to hesitate and I am asking you to put something in your body and you have a right to know about it. “

Methodological note:

Postcodes with higher and lower incomes are defined as postcodes with median income above or below the median of the district after taking into account the margin of error. Postal codes were included in a demographic majority if more than half of the population belong to this demographic group after taking into account the error rate. Income and race demographic data were taken from the US Census Bureau’s 2019 American Community Survey.

Disclosure: The University of Texas System is a financial supporter of The Texas Tribune, a nonprofit, non-partisan news organization funded in part by donations from members, foundations, and corporate sponsors. Financial supporters play no role in the journalism of the Tribune. You can find a full list of them here.

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