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EL PASO — Hospitals in some of Texas' hardest-hit border counties began vaccinating health care workers against COVID-19 on Tuesday, bringing what one health authority called "cautious hope" to a heavily Hispanic, economically distressed region whose communities have been traumatized by infections and deaths at disproportionately high rates throughout the pandemic.
Some 15,600 doses of Pfizer's COVID-19 vaccine arrived at hospitals on Tuesday in El Paso and Edinburg, and more will land in Laredo, McAllen, Brownsville and El Paso later this week.
At UT Health RGV in Edinburg, in the Rio Grande Valley, the first doses were administered Tuesday afternoon and a vaccination center in the medical school's lobby will usher through 400-500 people per day for the next several days, said Dr. John H. Krouse, dean of the University of Texas Rio Grande Valley School of Medicine.
In El Paso, vaccinations began within hours of the doses arriving.
For a population that is especially susceptible to COVID-19, the beginning of the end could not come soon enough.
“People who have seen so much tragedy are going to be protected, and it’s the beginning, for the rest of our community, to have the protection that they need," said Ryan Mielke, director of public affairs for the University Medical Center of El Paso, which received 2,925 doses Tuesday.
Among the first recipients in the Rio Grande Valley on Tuesday was Dr. Chelsea Chang, an internal medicine physician at UT Health RGV, who called the vaccine "a blessing."
"I was so thrilled to be able to receive the vaccine and be a part of this movement that is, hopefully, going to be the beginning of the end of the pandemic," Chang said. "It's been a challenge that none of us has ever seen before, both in the medical field and in our personal life."
But while the vaccine can protect the health care workers from dying from the disease — COVID-19 has claimed 1,000 healthcare workers across the country, including at least five doctors and 20 nurses in the Rio Grande Valley alone — authorities are warning that those around them may not be protected yet.
Vaccinated people could still carry and spread the virus and should continue to wear masks, practice frequent hand washing and socially distance until a majority of the population is inoculated, Krouse said.
It's an especially important point to be making in places like Hidalgo County, where one in nine households has three generations living together and where one in three bedrooms sleeps multiple people, said Hidalgo County Health Authority Dr. Ivan Melendez, a COVID-19 survivor who also treats patients at Mission Regional Medical Center in the Valley.
For a culture that strongly values family ties and where convincing the population to socially distance has been a challenge, Melendez said, the danger of transmission is still real — even after the "miracle" vaccine brings "cautious hope" to the wracked region.
"The question is whether people who have been vaccinated can still be vectors of this disease, and the answer is absolutely," Melendez said. "I believe that with the great news of the vaccine, people who get vaccinated are also going to have a false sense of security. Therefore I think it's important for people to know: Because even though you have the vaccine, you can still infect people."
El Paso County Judge Ricardo Samaniego said he’s concerned about community spread continuing as the vaccine begins to be administered. The first dose is only one step, he said, and he’s worried that the community will assume the worst is over.
“I’m very worried, very concerned because ... people drop their guard,” he said. “We have to be extremely careful, it’s not a cure and it’s part of a long process.”
One of his main concerns has been that younger El Pasoans will pass on the virus to more susceptible, older members of their families.
“We have a lot of multi-generational households in El Paso,” he said.
Border counties hit harder by COVID-19
Tuesday's vaccinations on the border are part of the first phase of a rollout that will deliver a quarter-million doses to 110 sites from the Panhandle to the Valley to the Gulf of Mexico this week — with more on the way next week, said Chris Van Deusen, spokesman for the Texas Department of State Health Services. Texas has 1.4 million doses allocated through the end of the year.
Four hospitals in the state's largest cities received the doses on Monday. Doses landed at another 19 sites on Tuesday. And the remainder will get them later this week.
The Centers for Disease Control and Prevention said in a late July report that Hispanics are disproportionately affected by COVID-19 for a number of reasons: systemic discrimination, lack of access to and use of health care services, a higher proportion of front-line jobs and a cultural predisposition toward living in multigenerational households, which increases exposure risk for vulnerable elderly people.
The pandemic has disproportionately affected El Paso and Hidalgo counties compared to areas of similar or larger sizes in Texas.
As of Wednesday, there had been more than 91,000 cases recorded in El Paso County, the fourth-highest total in the state. El Paso's COVID-19-related deaths are higher than larger counties like Travis and Tarrant; out of desperation, the county last month enlisted inmates from the jail to help move bodies at the morgue because staff couldn’t keep up with demand.
“Some of the stories would rip your heart out, they really would,” said Mielke, adding that he “almost got misty-eyed” during interviews about the vaccine this week.
The death toll has been even higher in Hidalgo County, which has about the same population as El Paso County at over 800,000 residents but its 1,876 coronavirus-related deaths rank second in the state. Only Harris County, the state’s most populous, has more.
If anywhere needed a break from the pandemic, it is the Texas border, officials there said.
“It’s really thrilling,” Krouse said, “that we’re finally able to begin to see the light at the end of the tunnel.”
Vaccinations don't eliminate risk
The Centers for Disease Control is advising that people who take the vaccine continue to practice social distancing and other precautions they’ve been taking for the past nine months.
The Pfizer vaccine protects the recipient from the ravages of the disease because it prevents the virus from entering a person’s cells and reproducing, but less is known about how long the virus can survive in places like the nostrils, Krouse said.
That brings uncertainty about how contagious a person can be after receiving the vaccine, said Dr. Paul Offit, a member of the U.S. Food and Drug Vaccines and Related Biological Products Advisory Committee and director of The Vaccine Education Center at Children’s Hospital of Philadelphia.
Studies on college campuses are being planned soon "that will look at exactly that, to see whether or not the vaccine ... also prevents asymptomatic infection where you could still be contagious," said Offit, who met with the National Institutes of Health on the idea of post-vaccine transmission on Tuesday and said the studies will likely be funded soon.
The Moderna vaccine, expected to win emergency use approval from the FDA on Friday, has generated some data that suggest it could prevent spread of the virus as well as infection by reducing asymptomatic infection, according to a Tuesday report in the Wall Street Journal. That vaccine is expected to join the Pfizer vaccine in the second wave of rollouts next week.
But people shouldn't assume that the virus is any less transmissible until more is known or the general population is inoculated, Offit said.
"I think we'll know this answer fairly early next year," he said. "You could argue, not knowing in the meantime, that if you've gotten the vaccine it would probably still be prudent to wear a mask, and social distance for those you could come in contact with, because you could still infect them."
In the Rio Grande Valley, Krouse said his university is following CDC guidelines on advising people who receive the vaccine to remain cautious until more is known and enough of the overall population is inoculated, which he said is likely to be “well into 2021.”
Chang, who grew up in the Rio Grande Valley, said socially distancing from her family has been difficult and had a "very profound" impact on personal relationships in her family-oriented community.
"It's important that we be patient," she said. "Even without the vaccine, everyone is guilty of experiencing COVID fatigue and following the guidelines is challenging, but it's the best way to recover as a community and a nation."
But even with the end still months away, the relief in parts of the state that have been shredded economically, emotionally and physically by the coronavirus is unmistakable.
“I kid you not. This is an exciting time,” said Mielke, the University Medical Center of El Paso spokesperson. “It’s Christmas before Christmas.”
Disclosure: UT Health has been a financial supporter 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.