A hitch in path to herd immunity
Vaccine skepticism in whiter, more conservative counties slows efforts
Low vaccination rates in counties that are whiter and more conservative could be impairing Texas’ ability to quickly reach herd immunity for COVID-19.
Texas counties that are poorer, whiter, less-educated and where former President Donald Trump won a larger than average share of the vote have vaccinated a smaller share of their population than the state average, a Houston Chronicle analysis found.
In the 144 Texas counties that meet these criteria, about 29.4 percent of people aged 16 and older have received at least one dose of the COVID-19 vaccine. Statewide, the average is 33 percent.
If residents in those counties were vaccinated at the same rate as the state average, more than 100,000 additional Texans would’ve received at least one dose.
In Liberty County, just a shade over 20 percent of residents have received at least one dose of the vaccine, one of the lowest rates in the state.
What’s more, as Harris County residents have begun flocking to rural counties for easier access to vaccines, state data shows that providers in Liberty County — a rural patch between Houston and Beaumont — have put 27 percent more shots in the arms of Harris County residents than they have in residents of their own county.
Meanwhile, in the 22 counties where Joe Biden won a majority of the vote — places that tend to be both more diverse and educated — an average of about 45.6 percent of eligible Texans have received at least one dose of the vaccine.
The vaccination gap between whiter, more conservative counties and the state average may not be cause for concern for the state’s vaccination efforts yet, said Rice University health economist Vivian Ho, but there is a potential for it to widen over the next two to three months.
“As more vaccines become available, that gap is going to widen, because there’s still excess demand for vaccines in our cities, where the majority of the population lives,” she said. “If, for instance, only 50 percent of people in these outlier counties are vaccinated, they will continually be subject to superspreader events that will overwhelm the weakest components of the state’s health care infrastructure.”
While polls have consistently shown that white Republicans are more hesitant about the vaccine, the Chronicle’s analysis used voting and demographics data, as well as the state’s own vaccine data, to show that race and political affiliation are tied to lower vaccination rates.
The Kaiser Family Foundation’s COVID-19 Vaccine Monitor found that nationwide, white, rural Republicans were the groups most likely to say they weren’t getting the vaccine at all. More locally, a University of Texas/Texas Tribune poll in February found that 59 percent of Texas Republicans either were reluctant to get a shot or would refuse one.
Doubt among evangelicals
While attention has been focused on Trump supporters, there’s also been worry among some that white evangelicals, a massive demographic that largely overlaps with the counties in the Chronicle analysis, will slow the nation’s path to herd immunity.
In Montgomery County, where only 27.6 percent of adults have received at least one dose of the vaccine, one religious leader said he’s heard many people voice skepticism.
“I know that exists here in Montgomery County because I see it on my social media,” said Jeff Berger, pastor of First Baptist Church in Conroe. “That’s part of
the curse of living in this age. Social media, the 24-hour news cycle, the different echo chambers — it gives free rein to voices that push out this conspiracy-type rhetoric, and there are certain people who just get addicted to that content.”
Berger said that his congregation included a few vocal skeptics of the pandemic early on but that churchgoers have been generally receptive to safety precautions. The virus killed two First Baptist members, which Berger said made the reality of the pandemic hit home at his church.
“The fact that everybody now knows somebody who’s had it has helped them see that this is real,” he said of his congregation.
White evangelicals have a history of vaccine skepticism dating back decades, said Kira Ganga Kieffer, who researches vaccines and religious movements at Boston University.
But COVID-19 has been particularly worrisome because of how politicized it’s become, she said. Whereas hesitancy toward other vaccines, such as the one for HPV, have often been rooted in moral concerns, today’s skeptics have been fueled by a mix of “culture war” rhetoric and the proliferation of online conspiracies.
She also noted that, historically, the idea of government-mandated vaccinations has fueled hesitancy in a variety of communities, including those that are predominantly white and evangelical.
Such concerns have been bubbling in recent weeks, as some conservative politicians have said Biden planned to institute “vaccine passports.” A White House spokesperson denied that was the case on Tuesday, the same day Gov. Greg Abbott announced a statewide ban of vaccination passports.
“A lot of (skepticism) is coming from a distinct and real strong distrust of authority and of the government in general, and a goat-it-alone, individualistic worldview,” Kieffer said. “That’s not new, but I’d say it’s been really hyped up, and Trump really tapped into that anti-establishment, anti-authority mentality.”
Craig Matson is among those who say they will likely not take the vaccine. The 70-year-old Boerne resident questioned the severity of the virus, comparing it to the flu. He was suspicious of numbers reported by the Centers for Disease Control and Prevention, as well as the major vaccines.
“If people choose to take a COVID-19 vaccine because they believe that is their best protective option, they ought to have the freedom to do so,” he added. “Medical freedom is important on both sides of this issue.”
Kendall County, where Boerne is located, voted for Trump at a greater rate than the state as a whole and has a higher share of white residents than the state.
On average, support of Trump, coupled with higher shares of the white population, regardless of other factors, is the strongest link to lower vaccination rates, the Chronicle’s data analysis found. In whiter counties where support for Trump was stronger, an average of 30.2 percent of residents have gotten at least one shot, lower than the state’s average.
The ‘last mile’
There’s also a positive correlation between education and vaccination rates, regardless of political affiliation. This can be seen in Kendall County, which is wealthier and more educated than the state averages, and where more than 40 percent of residents have received at least one dose of the COVID vaccine.
Across the state, health officials are searching for ways to reach and vaccinate people who are reluctant to do so.
State health officials are trying to think through the “last mile,” said Dr. David Lakey, a member of the Texas COVID-19 Expert Vaccine Allocation Panel. People who are hesitant to get vaccinated may not go to mass vaccination sites or hubs but may go to providers they trust.
In Public Health Region 4/5 North — a group of counties in the northeastern part of the state, around Tyler — officials are working with faith-based communities and hosting vaccine fairs to vaccinate more people in the region with the state’s lowest average rate. They have also been conducting home visits as part of these efforts to bring vaccines to homebound people.
Ron Nichols, emergency coordinator for Chambers County, said having well-known, local paramedics dole out doses has helped assuage some residents’ concerns. Nichols said demand for vaccines was initially high but has begun to plateau in recent months because people either are waiting on the single-shot vaccine from Johnson & Johnson or have distrust rooted in misinformation.
“There are a lot of people who just don’t understand, don’t know or don’t trust the process,” he said. “The Facebook misinformation machine has been running rampant.”
Hesitancy has also affected the state’s allocations of vaccine doses. The counties that are whiter, more Trump-friendly, poorer and less educated have been allocated proportionally fewer vaccine doses, according to the Chronicle’s analysis.
“I think hesitancy plays into demand and then demand plays into the allocation,” Lakey said. “If there is a community that is more hesitant, they go through vaccines slower and therefore they would be shipped less vaccine.”
Lakey said he believes that shifting away from allocating vaccine doses to larger providers and sending more to smaller providers will dispel some of the hesitancy.
Leighanne Cobb, 67, was among the skeptics in Chambers County. The retired, Trump-voting Southern Baptist said she had read conspiracies about people being microchipped through the vaccine. More than anything, she was concerned by what she felt was a rushed rollout of the vaccines.
“I felt like it got pushed along too fast,” she said. Eventually, she and other family members sought out the opinions of medical professionals.
Cobb received her second dose on Tuesday, as did her elderly father.
“I feel perfectly fine,” she said.
“There are a lot of people who just don’t understand, don’t know or don’t trust the process. The Facebook misinformation machine has been running rampant.”
Ron Nichols, emergency coordinator for Chambers County