Spring resident Linda Higgins said when the COVID-19 vaccine was made available to the public earlier this year, she was hesitant to get it.

“It was developed so quickly, and the public didn’t have as much information as we have now,” Higgins said. “I am a senior citizen with diabetes and two immune diseases, and if I got COVID, it could very well kill me. Then I learned that a much younger friend had died from it. So, my mindset about the vaccine quickly changed, and I got the first one a month ago and the second one last week.”

Higgins is one of more than 197,500 Spring- and Klein-area residents who had been fully vaccinated as of Sept. 13, according to the Texas Department of State Health Services—just over half of the area’s total population.

Jennifer Kiger, who was recently named director of Harris County’s new COVID-19 response division, said the Spring and Klein area is among those with the lowest vaccination rates countywide. The new 69-position division was created Aug. 24 and will be taking over COVID-19 testing, vaccination and outreach countywide for the next two years. The $17 million division is being funded through the Public Improvement Contingency Fund and federal COVID-19 relief grants.

“When we look at vaccination rates across the county, ... we do see lower vaccination rates in the north, central and east parts of the county,” Kiger said. “But in general, we’re not at the point where we need to be across most [Harris County] ZIP codes.”

While Harris County Public Health rolled out initiatives this summer to incentivize vaccines, Kiger said reaching herd immunity—when a sufficient proportion of a population is immune to an infectious disease through vaccination and/or prior illness—is becoming increasingly unattainable.

“[Herd immunity is] getting harder and harder to achieve because of the variants and low vaccination rates,” Kiger said. “What we’re trying to achieve now is ... a lower hospitalization rate, low morbidity/mortality rates and ... less community spread.”

Summer slowdown

Since Texas expanded COVID-19 vaccine eligibility in mid-May to include everyone age 12 and older, HCPH has been making vaccines more accessible to its more than 4.7 million residents by establishing mass vaccination sites, mobile vaccination sites through community partnerships and a COVID-19 vaccine hotline.

“As we’ve seen more providers come online, we were able to shift our focus to ... ‘vaccine deserts’ where we didn’t have a lot of accessibility to vaccines,” Kiger said.

One of those providers was Houston Methodist Willowbrook Hospital, which launched a vaccine clinic Jan. 18 and has since administered more than 82,000 COVID-19 vaccine doses, according to Andy Cole, the hospital’s regional administrator who is overseeing the vaccine clinic.

At its peak, the clinic had the capacity to administer 800-900 doses per day; however, Cole said that has since been cut to about 400 doses per day in response to the current demand.

“Mid-June is when [vaccine demand] started dropping significantly, and we’ve been pretty slow through the summer,” Cole said.

Simultaneously, the delta variant began spreading throughout the Greater Houston area over the summer, causing Harris County to raise its COVID-19 threat level Aug. 5 back to red, signifying a severe and uncontrolled level of the virus. At the time, Harris County had over 20,000 active COVID-19 cases and a testing positivity rate of over 15%.

While the U.S. Food and Drug Administration issued formal approval of Pfizer’s COVID-19 vaccine Aug. 23, Cole said the change in demand for vaccines has been minuscule.

Incentivizing vaccines

In hopes of driving up vaccination rates, HCPH launched a pair of incentive programs this summer.

In May, county officials launched a 10-week scholarship program during which a $5,000 scholarship was awarded each week to a student who received his or her vaccine from a HCPH site. To date, Kiger said HCPH has vaccinated more than 25,000 residents under the age of 18, which she said can be partially attributed to the scholarship program.

In the same spirit, HCPH launched a second incentive program Aug. 17 in which anyone who received a COVID-19 vaccine at a HCPH site through Aug. 31 would receive $100. Citing a 706% increase in daily vaccinations, county officials expanded the program to include all medical providers in Harris County. The program was later extended to run through Sept. 14.

Similarly, local physicians are hoping to encourage their patients to get vaccinated. Dr. Rakhi Dimino, an OB-GYN hospitalist who practices in the Willowbrook area, said pregnant women are among the most undervaccinated populations while also being at a higher risk for developing COVID-19 complications.

“Primarily, what we’re seeing is women who want to wait to get vaccinated until after the pregnancy is over,” Dimino said. “But unfortunately, pregnant women are at greater risk for COVID complications.”

While Dimino said she does not pressure patients into getting the vaccine, she does ask all of her patients if they have been vaccinated. If not, she provides the patient with vaccine information and how it relates to pregnancies.

Looking ahead

With Pfizer’s third dose—a vaccine booster shot available to some patients eight months after full vaccination—coming down the pipeline, county officials and local health care providers are gearing up for another spike in demand this fall.

While the third dose is only available for those age 16 and older who are immunocompromised, Cole said he expects eligibility to be expanded in the coming weeks. In preparation, the Willowbrook vaccination site will expand its capacity back to 800-900 doses per day.

Similarly, Kiger said the COVID-19 division is ramping up its efforts as many fully vaccinated residents will soon hit their eight-month booster shot milestone.

“We’re able to see within our database which patients who got their first and second dose from us will be due for their dose, and so we’re planning appropriately for that,” Kiger said.

Cole said Houston Methodist will continue to host vaccine clinics until the demand runs dry. Additionally, the hospital system plans to make COVID-19 vaccines available in all primary care clinics this fall.

“The more folks we can get vaccinated, the better off we’ll be in this fight against COVID,” Cole said.