Oh, Texas!

Last week, the governor of Texas lifted all COVID restrictions, to be effective March 10, in the middle of Spring Break for most of Texas. He acknowledged COVID hasn’t disappeared, but is confident we have enough vaccine to get ahead of this pandemic.

The current 7-day average is between 4000–5000 new cases per day across the state.

Eric Gay/AP Riverwalk, San Antonio.

So do we have enough people vaccinated?

There are 26.2 million people over the age of 16 (the youngest age for the Pfizer vaccine). As of March 5, 2021, 8.56% of people over 16 have been fully vaccinated and 15.5% have received at least one dose. In the past few days, educators have been put on the list and the Johnson and Johnson vaccine is on its way. Hopefully, the next few weeks will see an exponential increase in vaccination.

About 8% of people in Texas have had COVID. If we take suspected cases, estimate undetected cases, all those vaccinated, and assume all infected are now immune, we have maybe 20% immune already with another 15% getting there.

More importantly, who is most at risk and who is getting vaccinated?

We know people over 65 are more likely to have severe COVID and more likely to die (grey bar, below). So they were first on the priority list (along with health care workers), 26% of Texans over the age of 65 have been vaccinated (yellow bar).

Vaccine data are listed as 16–49 years old, Case and Fatality dated are recorded as 17–64.

We also know that people of color are more likely to be infected with COVID and to die from it, or to experience serious illness. Are BIPOC being vaccinated in Texas?

It comes as no surprise to anyone that the answer is No, not really. Hispanic/Latinos are just under 40% of the population of Texas and make up 46% of the fatalities, and 25% of those vaccinated. If you’re white it Texas, you’re less likely to die from COVID, but more likely to be vaccinated (58% of all vaccinated). While Black/African-American people are disproportionately infected, fatality rates have declined slightly since the early days of the pandemic, but vaccination also lags in this population (7.9%).

Vaccines are also available to people ages 16–64 who are healthcare workers or have risk factors associated with severe COVID.

If vaccination was equitable, the blue and orange bars (and grey and yellow) would be the same height for each group.

Once again, if you’re Black or Latino, you’re less likely to be vaccinated in either age group, although in both groups, if you’re under 65 you’re more likely to be vaccinated than the elders of these communities.

Latino and non-Hispanic white Texans make up about the same proportion of the population under 65 years old. Pre-COVID we knew that if you are Black or Latino you have a lower life expectancy: 62% of Texans over 65 are white, compared to 24% Latino. Of those vaccinated, 68% are white and 17% are Latino. The disparities continue if you are Black. Interestingly, the Asian population is more likely to be vaccinated as well.

The data for Bexar County follow the same pattern.

We can propose theories as to why Black and Latino Texans are less likely to be vaccinated. What we do know is that those most at risk are not getting vaccinated.

We can guess what that’ll mean for COVID in Texas, with no restrictions, and mask wearing left up to “freedom to choose.”

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Cherise Rohr-Allegrini, PhD, MPH

Dr. Rohr-Allegrini is an epidemiologist and tropical disease scientist currently working to prevent diseases through immunizations.