A nurse administers a COVID-19 vaccine at University Medical Center's vaccination hub at the El Paso County Coliseum. (Photo courtesy of University Medical Center)

Close to 113,000 El Pasoans have received their first shot in the 10 weeks since COVID-19 vaccines arrived in Texas, something El Paso leaders have celebrated.

“While we’re still a long way from herd immunity, we continue to make progress with the vaccines we are allocated,” El Paso City Manager Tommy Gonzalez said at City Council’s Feb. 15 work session. One in six people aged 16 and older have gotten the first dose, he said.

Though efficient, particularly compared to other large Texas counties, limited data makes it difficult to know whether El Paso’s vaccination effort is reaching those who need the vaccine the most. Neither of the county’s hubs, which inoculate thousands of patients weekly, are releasing patient demographic data, and the state’s records are incomplete.

Eric Jones

“In terms of equity issues, without data, it’s hard to say” whether vaccines are going to those most at risk of COVID-19, said Eric Jones, an assistant professor at University of Texas Health Science Center at Houston School of Public Health’s El Paso campus.

While incomplete, state data suggest that two groups are under-represented in vaccinations compared to their proportion of the population: Black El Pasoans and men.

The Texas Department of State Health Services requires providers to report patients’ age, gender and race and ethnicity, but not which priority group they fall under.

Though race and ethnicity reporting has improved since DSHS made it a requirement last month, it remains unknown for about two-thirds of El Pasoans.

The state will soon provide weekly breakdowns of patients’ ZIP code of residence. Those datasets were set to launch Monday, but “may be moved back” due to the winter storm, DSHS spokesperson Douglas Loveday said in an email Friday.

Providers aren’t required to report ZIP code, so it’s likely this may be unknown for many patients.

Though broad, since a single ZIP code can cover a range of neighborhoods, it’s useful information when thinking about vaccine equity, Jones said. That’s because ZIP codes capture income “extremes.” 

“We know which ZIP codes are the most wealthy and we know which ones experience the most poverty,” he said.

Low-income residents face more barriers to health care access than wealthier residents, particularly lack of internet connectivity to sign up for the vaccine and limited access to digital vaccine information.

Vaccine equity is important because the pandemic’s toll in the United States has disproportionately impacted low-income people of color, Jones said.

“The most extreme consequence of public health is death,” Jones said. “Since public health is largely taxpayer funded and is supposed to benefit everyone, then it’s our job to make sure that everybody gets the chance to get care.”

Here’s what the state data reveals about El Paso’s vaccine distribution:

Race and ethnicity

Race and ethnicity is only known for about 45,000 of the approximately 112,600 El Pasoans who had received at least one shot as of Friday.

Of those for whom this data was known, the demographic breakdown is fairly similar to that of the county’s population, Jones noted. Fewer Black El Pasoans, however, have been vaccinated compared to their share of the county’s population. Blacks make up about 4% of El Paso’s population but less than 1% of El Pasoans vaccinated for whom race and ethnicity is known.

Vaccines given by Fort Bliss and the Department of Veterans Affairs generally aren’t reported to the state’s immunization registry, Loveday said. Many Black El Pasoans are soldiers and their dependents, or military veterans.

Outreach to African-Americans is needed given “historic distrust and low rates of vaccination,” Jones said.

Several regional Black organizations have organized a March 13 virtual event to discuss the vaccine and other COVID-19 issues, with a focus on the Black community. Featured speakers include Dr. Ogechika Alozie, an El Paso infectious disease expert, and Dr. Ian Moore, a researcher who was involved in testing of the Moderna vaccine. Register for the event here.

In a majority Hispanic county like El Paso, race and ethnicity alone won’t provide much insight about vaccine equity, Jones cautioned. Rather, the patient’s ZIP code, income level or occupation would give more information about their risk of death from COVID-19, he said. 

People who work low-wage jobs as line cooks or in the warehouse, agriculture and construction industries have the highest risk of dying from the virus, a new study from the University of California, San Francisco found. Black, Latino and Native American workers tend to have to work in closer distances than white workers, Jones said.

Age

Approximately 65% of El Paso County residents who had gotten at least the first dose have been younger than age 65. Because the state does not report which priority group patients fall under, it’s impossible to know whether most of these people are front-line health care workers, who are in the first priority group.

El Paso has one of the youngest populations in the state, with 17% of its population over the age of 65, Jones said. About 35% of the county’s vaccine recipients have been 65 or older.

Gender

Higher numbers of women in El Paso have been vaccinated than men compared to their share of the county’s population, which is nearly evenly split. It’s impossible to know if this is because many of these women are health care workers.

Because males worldwide have a higher risk for COVID-19 complications and death, their lower vaccine risk may be cause for concern, Jones said.

Cover photo: A nurse administers a COVID-19 vaccine at University Medical Center’s vaccination hub at the El Paso County Coliseum. Far more women than men have been vaccinated so far in El Paso. (Photo courtesy of University Medical Center)

Molly Smith has been a reporter for the El Paso Times and The (McAllen) Monitor. She’s covered education, criminal justice and local government. A Seattle native, she’s lived in Texas since 2014.