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By the numbers: How vaccine skepticism in Texas’ Trump country threatens herd immunity



TX – 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 less-educated and whiter and in which 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 Hearst Newspapers analysis found.

In the 144 Texas counties that meet these criteria, about 29.4 percent of people age 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 have 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 more diverse and more 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 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 group most likely to say they weren’t getting the vaccine. More locally, a February University of Texas/Texas Tribune poll found that 59 percent of Texas Republicans were either reluctant to get a shot or would refuse one.

On average, support of Trump, coupled with higher shares of the white population, regardless of other factors, are the strongest links to lower vaccination rates, the 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.

While income levels do not correspond with a variation in rates, there is a correlation with education levels: Trump-friendly counties that are more educated tend to have a higher share of people with at least one shot than the state average. The data shows that more educated counties have vaccinated a larger share of residents than the state average, regardless of political affiliation.

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 coronavirus, 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. But the county is also wealthier and more educated than the state averages, and as of Friday, 41 percent of its residents 16 and older had been vaccinated with at least one dose.

That’s a higher vaccination percentage than in Bexar County, which Biden carried and where 37 percent of residents 16 and older had received at least one dose of the vaccine.

Bexar County’s rate was identical to that of nearby Comal County, which went with Trump, and was higher than the state average. But in Atascosa County, which also supported Trump, only 28 percent of residents 16 and older had received at least one dose of the vaccine, lower than the state average.

While attention has been focused on Trump supporters, there’s also been worry that white evangelicals, a massive demographic that largely overlaps with the counties in the 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 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 among his church.

“The fact that everybody now knows somebody who’s had it has helped them see that this is real,” he said.

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. Hesitancy toward other vaccines, such as the one for HPV, have often been rooted in moral concerns, but today’s skeptics have been fueled by a mix of “culture war” rhetoric and the proliferation of online conspiracies.

In recent weeks, some conservative politicians have said President Joe Biden planned to institute “vaccine passports.” A White House spokesperson Tuesday denied that was the case, the same day Gov. Greg Abbott announced a statewide ban on 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 go-at-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.”

Across the state, health officials are searching for ways to reach and vaccinate people who are reluctant to do get shots.

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, with the state’s lowest average vaccination rate — officials are working with faith-based communities and hosting vaccine fairs.

Ron Nichols, emergency coordinator for Chambers County, said having well-known local paramedics dole out doses has helped soothe some residents’ concerns.

“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 also has 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 analysis.

“If there is a community that is more hesitant, they go through vaccines slower, and therefore they would be shipped less vaccine,” Lakey said.

Lakey said he believes that 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 Tuesday, as did her elderly father.

“I feel perfectly fine,” she said.