Fort Worth is trying to close its COVID vaccine gap. What’s working elsewhere in Texas?
White and Asian Tarrant County residents remain more likely than their Black and Hispanic peers to be vaccinated against COVID-19, according to state data, as the virus death toll surpassed 700,000 people in the U.S.
From the first days of the COVID-19 vaccine rollout in the U.S., national and local leaders have been dogged by questions of how to distribute the life-saving vaccines equitably, and how to avoid further exacerbating the unequal death rates the virus has wrought.
There is some evidence that, nationwide, the racial and ethnic COVID-19 vaccination gaps are narrowing, according to the Kaiser Family Foundation. But in Tarrant County, gaps persist: Just 32% of Black residents and 34% of Latino residents of all ages are vaccinated against COVID-19, compared to 49% of white residents and 55% of Asian residents, according to data from the state and the U.S. Census Bureau.
Public health officials and community groups continue to try and make in-roads among hard-to-reach populations in the county, especially in Black and Latino communities.
The majority Latino neighborhood Diamond Hill continues to have one of the lowest vaccination rates in the county, with just 38% of all residents fully vaccinated again COVID-19.
Although there are still thousands more Diamond Hill residents to be vaccinated, that number has improved by about 3 percentage points in the month of September, according to state data. That’s thanks in part to efforts like a partnership between the neighborhood’s historic lowrider community and hospital systems like Texas Health Resources. The two groups planned to host Saturday (Oct. 2) their second COVID-19 vaccine clinic in the neighborhood along with other community partners.
Gino Ayala, a spokesman for the United Lowrider Council and longtime Diamond Hill resident, said trust was the most important step in getting his neighbors to take the vaccine.
“It’s a trust factor, and I just don’t believe that the trust factor has been out there in the communities,” Ayala said. “Not just our communities, but other communities.”
As communities and the nation continue to try and figure out how to close the vaccination gap to protect more lives and prevent dangerous future variants of the virus from developing, other cities in the state offer lessons on building trust, sharing accurate information about the vaccine, and getting shots in arms.
Houston: Texts, field trips, and support from friends
The target group: The kids, teenagers, and young men who are part of the Houston reVision, a nonprofit that supports young people in Houston who have gone through the juvenile justice, foster care, or immigration systems.
The numbers: At least 80% of reVision’s 225-person community was vaccinated over the summer, according to Chief Executive Director Charles Rotramel. In 77076, the ZIP code where reVision is based, 46% of the total population is vaccinated, according to state data.
The approach: When reVision Houston began considering in spring 2021 whether to reopen its offices, where kids, teens and young adults can come for snacks, watch TV, or spend time with each other and their mentors, Rotramel realized he and his staff had a problem: Almost none of the young people in reVision’s community were vaccinated against COVID-19. The organization decided to focus on getting its community vaccinated as its first priority.
As with many hard-to-vaccinate populations, trust was the most important part of helping the young people decide to take the shot, Rotramel said.
“All of our kids have been through some kind of institutions, whether that’s the immigration system, the justice system, the foster care system,” Rotramel said. “Most of their experience with all of those systems has been negative, and so it makes them even more skeptical about receiving information from say, governments or schools or other institutions.”
After adult staff members made little progress in talking with the teenagers and young men in reVision’s community, the nonprofit’s leaders switched gears: They decided to hire two student ambassadors to work for $15 an hour, to convince their peers to get vaccinated. As a condition of employment, the ambassadors were themselves required to be vaccinated and were trained by Houston Methodist Hospital to learn about the science and technology behind the vaccines, Rotramel said.
Once the ambassadors got the job, their workdays were theirs to structure, Rotramel said.
“We set no parameters,” he said. “We let them determine what they would do because our philosophy was: They know how to reach our guys better than we do.”
Through one-on-one meet-ups and long text message conversations, the student ambassadors began to convince their peers one by one to get vaccinated. reVision eventually hired two more ambassadors for a total of four young people working to get their peers vaccinated over the summer.
In addition to the one-on-one incentives with student ambassadors, reVision also offered incentives via gift cards and four vacation trips that they could attend if they were vaccinated. The final incentive was the reopening of the reVision space, where teenagers could spend after school, but would only be open to those who were fully vaccinated.
After starting with almost none of their young people vaccinated in June, Rotramel estimated about 80% of their community was vaccinated by the end of September.
“I think the equation really starts with supporting community-based organizations in standing up vaccination efforts that they designed that are tailored specifically to their communities,” Rotramel said.
Waco: Door knocking in public housing units
The target group: Residents of Waco Housing Authority, which has 902 public housing units.
The numbers: In the two ZIP codes where the Waco public housing units are located, 30.2% and 40.4% of all residents were vaccinated as of Sept. 27, according to state data.
The approach: Waco Public Housing authority hired an outreach coordinator in June to go door-to-door in Waco’s three public housing complexes to talk to residents about the vaccine. In that time, coordinator Leonard Buffin has made 260 contacts, and at least 35 people have been vaccinated directly because of his efforts, said Melissa Johnson, the director of community services at the Housing Authority. Johnson added that she and Buffin have anecdotally heard of a ripple effect in which other family members and friends that don’t live in public housing have gotten the shot after their loved one has.
Buffin, 60, spends 20 hours a week going door to door and talking to people. The most important part of his approach is just being a constant in the community, and always being visible, he said. Buffin draws on decades of working at the state supported living center in Mexia in his work doing vaccine outreach. Buffin said whether someone has been diagnosed with a disability or is experiencing poverty or other hardship, they often experience the same reaction from political leadership.
“They’re not humanized,” he said. “When you make them feel very human, they seem to react and respond a lot differently.”
To do that, Buffin does a lot of what he calls “retalking.” When he talks to someone who isn’t vaccinated, he listens to their concerns and tries to avoid making them defensive, and he shares his own personal dislike of getting shots.
Buffin’s regular presence in the community also helps with following through on people getting their second dose of the Pfizer or Moderna vaccine, which require two doses.
“I go back and check on them a lot, especially through the second shot,” he said. “Sometimes if I leave them hanging they won’t get the second one.”
The Housing Authority is using a grant to add $40 incentives for each shot received, as well as to support Buffin’s salary and other educational events, Johnson said. Ultimately, the housing authority hopes to get at least 250 people vaccinated.
Beaumont: Face-to-face conversations
The target group: Residents of the 77703, 77705, and 77701 ZIP codes, where more than half of all residents are Black and one in three residents live below the poverty line.
The numbers: 34.5% of the 77703 ZIP code in Beaumont was vaccinated as of Sept. 27, according to state data.
The approach: Mary Scott started with the churches.
Scott, a longtime Beaumont nurse, knew that getting as many churches and religious institutions as possible involved in the vaccination effort would be the quickest and easiest way to reach a regular and recurring audience every Sunday. Once Scott and her fellow vaccination volunteers had a coalition of churches and businesses interested in getting people vaccinated, they started going door-to-door.
Scott’s team knocked on more than 1,000 doors, and distributed fliers and giftbags to more than 1,200 people. The door knockers included Scott’s pastor, who could address rumors that residents had heard about the vaccines or that they weren’t ethically or morally made, as well as Scott and her physician husband, who could respond to any medical questions or misinformation that residents had heard about the shot.
Over the summer, Scott’s team has directly vaccinated more than 347 through their sponsored events, and gotten accurate information about the vaccine to almost 1,500 people through door knocking and other community events.
For the remaining vaccine holdouts, Scott said convincing them would take time, and a lot of work.
“It’s going to take face-to-face conversations,” she said.
More information
If you haven’t yet received a COVID-19 vaccine, you can find locations and more information at vaccines.gov or call 1-800-232-0233.
Is someone in your neighborhood doing something creative to help people access the COVID-19 vaccine or information about it? We want to hear from you. You can email reporter Ciara McCarthy at cmccarthy@star-telegram.com.
