COVID-19 ravaged the state’s border counties. Now they’re leading Texas in vaccinations.

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When Rio Grande Valley retiree Robert Chapa finally got his COVID-19 vaccine in March after months of trying to secure an appointment, it was a nearby school district that came through for him.

After a year of living in a national hot spot for the virus, where death rates at one point were among the highest in the nation, Chapa, 59, was anxious to get the shot.

“I was at high risk, with one kidney,” said Chapa, who lost the organ in a car accident decades ago. “I stood in line for three hours, I think. But if you gotta get it, you gotta get it.”

A friend who worked at the Mission Independent School District helped him secure an appointment at Doctors Hospital at Renaissance in Edinburg as part of a drive to vaccinate district employees and their families, when demand was still high and vaccine supplies were low.

Counties on the Texas-Mexico border that were among the hardest-hit by COVID-19 are now seeing some of the highest vaccination rates in the state. From El Paso to Brownsville, every county along the border is outpacing the state average for the percentage of residents fully vaccinated against COVID-19. Of the 39 Texas counties currently above the state average, more than a third of them are border counties, according to state numbers.

Statewide, 35% of the total population has been fully vaccinated, including 42% of eligible Texans 12 and older. In the Rio Grande Valley, three of the four counties have already surpassed 40% of their total population fully vaccinated, including Hidalgo County with 43%, Cameron at 45% and Starr County with nearly 50%. In Webb County, which includes Laredo, 47% of residents are fully vaccinated, and El Paso County has fully vaccinated about 45% of its population.

The biggest motivator for residents to show up in such large numbers for the shot, locals say, is the fact that the region suffered so much death during COVID-19 surges. In El Paso County, more than 2,700 residents were reported to have died from the virus, and COVID-19 deaths were so frequent in the fall that inmates were used as labor to help deal with the bodies. Hidalgo County reported more than 2,800 deaths — at one point last summer, one in 10 COVID-19 deaths in Texas had happened in the county of nearly 900,000 people.

“Everybody knew someone that had died from COVID here in this region,” said Dr. Michael Dobbs, vice dean of clinical affairs at the University of Texas Rio Grande Valley School of Medicine. “I think there were very few people who were COVID skeptics or deniers.”

Strong family ties help vaccine acceptance

Some say the trend was unexpected, mainly because most border counties are 85% or more Hispanic, and in the early days of the vaccination effort, Hispanics were being vaccinated at lower rates than whites. Border counties also are home to some of the poorest communities in the country; lower-income Texans tend to have less access to vaccines.

“I’m proud, but more than anything else, I’m grateful,” said Dr. Ivan Melendez, Hidalgo County Health Authority and a COVID survivor. “All the pre-vaccine hype about how minorities were more hesitant to get the vaccine than the rest of the population hasn’t really panned out.”

Another factor that has contributed to a high rate of vaccine acceptance along the border, locals residents and officials said, is the strong family ties among Hispanics in the region.

In Hidalgo County, for example, one in 10 families has at least three generations living in the home.

The same culture that made distancing and isolation from families particularly difficult to bear as the virus was hammering border counties now is leading families to get vaccinated so they can safely see each other again, and adult children to push their parents and relatives to get vaccinated to avoid more deaths, said Frank Arredondo, a pharmacist at a CVS Pharmacy in Pharr and a COVID-19 survivor.

“I think that’s probably kind of the secret sauce — the strong familial bonds,” said Arredondo, who estimates that he has administered up to 4,000 COVID-19 vaccines since February.

When Arredondo caught the virus last year, doctors twice told his wife that he was about to die, he said. Now that he’s recovered, he tells that story to his patients — who pass that on to their families.

One man heard the story from his wife and told Arredondo: “I would hate for my family members to get that phone call.”

Leveraging that bond in public health messages about the vaccine to younger generations — health officials modeled their “Starr County Strong” campaign after the anti-smoking ads of the 1980s that urged kids to push their parents to quit smoking — was a vital part of the effort to convince the area’s most vulnerable elderly residents to get the shot, said Dr. Antonio Falcón, a local doctor for more than 40 years whose final day as Starr County Health Authority was Monday.

In Starr County alone, about 97% of residents 65 and older have gotten at least one shot.

“It was for the love of grandkids that the grandparents wanted to get vaccinated,” Falcón said. “I think that was very effective, priming grandma and grandpa to get the vaccine when it came out. It helped to get the word out through the kids.”

“This is what we really do well”

As demand for vaccines soared, state health officials also tapped into existing relationships locals already had with state health department field offices, schools, community clinics, civic leaders and state and local health programs, including long-standing efforts to boost health care along the border, said Elizabeth Cuevas, the preparedness, response and epidemiology manager for the Texas Department of State Health Services in South Texas.

For example, Operation Lone Star has run an annual disaster preparedness exercise in the Rio Grande Valley for more than 20 years that lets emergency responders practice setting up and operating clinics that could be used during a public health emergency.

The participants — health workers for the state health department, Valley counties, the city of Laredo, the Texas Military Department, Texas A&M University and community volunteer organizations — provide free child immunizations, hearing and vision screenings, diabetes and blood pressure screenings, and physicals that draw nearly 10,000 people each year.

“We really have built deep roots and relationships, so now that there is an emergency where we need to get vaccines and do health assessments or make referrals, the community knows my team,” Cuevas said.

Locals picked up the effort themselves and have run with it, Cuevas said. In the Starr County city of Roma, the fire department opened its bay doors and offered a drive-thru vaccination clinic.

“We have not done a large number of clinics that are DSHS-run,” Cuevas said. “We’ve partnered with people, but mostly it’s local physicians, it’s local school districts, the county judge, the local hospital. They’re all working together.”

In McAllen, Arredondo has spent hundreds of hours fulfilling what he calls “my personal mission” to vaccinate residents at El Milagro Clinic, a community health center serving the indigent for the past 25 years, which has partnered with CVS as one of the chain’s strategies for “working to increase access for vulnerable populations and go deeper into communities,” said CVS spokesperson Monica Prinzing.

Over the past six years, the University of Texas Rio Grande Valley’s new School of Medicine has also become a trusted source of health information and services for the community, making it a key player in the vaccination effort for area residents, said Dobbs, the school’s chief medical officer.

About 80,000 shots have been administered through the medical school, he said, but another important role has been in communicating the safety and effectiveness of the vaccines to the public.

“We’re used to teaching and doing community advocacy,” Dobbs said. “This is what we really do well.”

School districts have also been “phenomenal” partners in encouraging vaccination and distributing the shots, Cuevas said.

With an average of one-third of residents under 18 years old, border communities have a much higher share of children than the state as a whole — and the school districts maintain a stature in these communities that became instrumental in boosting vaccination rates, local officials said.

Melendez said that’s because people stay in the Valley for generations and are still strongly connected to their high school alma maters. In Hidalgo County, more than one-third of them are connected to the schools through students, volunteerism, alumni groups and employment, he said.

El Paso Independent School District began offering vaccines to its staff in January and, in early May, launched a program called “Vaccinate Before You Graduate” that drew hundreds of students on its first day.

The La Joya school district in Hidalgo County sent school nurses to clinics, offered vaccinations to students and staff and partnered with police and other civil service groups to get locals vaccinated, spokesperson Blanca Cantú said.

The success of the various vaccination efforts comes as a relief to Melendez, who recalls getting teary-eyed in the waiting area of a mass vaccination clinic in Hidalgo County in January while watching older people lining up for the shot.

“For the first time in a year,” he said, “I left with some hope.”

Disclosure: Texas A&M University and CVS Pharmacy have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.