Texans getting COVID-19 vaccine boosters outpace those getting first shots as omicron bears down

Syringes sit on a table at a COVID-19 vaccine clinic in Austin. (Sophie Park/The Texas Tribune, Sophie Park/The Texas Tribune)

Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news.

As the omicron variant of COVID-19 threatens to fuel another surge of infections this winter, the state’s vaccination data shows demand for booster shots has outpaced the demand for first doses of the vaccine in the last few months — even as millions of Texans remain unvaccinated.

The average number of people getting boosters in Texas every day has surpassed those getting their first shots since late September, according to the state’s data. As of Dec. 21, the daily average of Texans who received their booster shots over the last week was about 52,000 — compared with the approximately 20,000 who received their first doses.

So far this month, at least 1.2 million Texans have gotten booster shots — nearly triple the number of people who received their first doses of the vaccine during the same time.

Meanwhile, the number of people getting their first shot of the vaccine over the last few months has remained far below people getting boosters, though the rate of first shots slightly increased in November and December.

The rush for the fully vaccinated to get boosted comes at a time when hospitals and medical experts are bracing for a surge in cases amid the rapid spread of the omicron variant and Texans are having to alter their plans as COVID-19 looms large over the holiday season for a second year in a row. More than 50% of Texans are fully vaccinated, and nearly 15% have received their booster shots. Booster rates remain low across the country, but even so, Texas ranks in the bottom 10 states.

In Texas, counties along the border and major metro areas have higher vaccination and booster rates compared with other parts of the state.

Getting a booster shot helps to combat the virus’ tendency to evolve and variants that evade immune response, said Dr. Jason Bowling, an infectious disease specialist at University of Texas Health San Antonio. It also can help reduce the risk of having severe symptoms or being hospitalized.

“The idea with this booster is really to bump up your protection better to account for the mutations that allow this variant to get around it,” Bowling said.

Booster rates have gone up as the Food and Drug Administration has gradually authorized their use among different age groups. Adults 18 and older are allowed to get booster shots, and this month, the FDA authorized emergency use for 16- and 17-year-olds who had the Pfizer vaccine as their initial two-dose treatment, making them eligible to receive the same vaccine as a booster.

Meanwhile, the amount of people getting their first vaccine doses has waned in the last few months as vaccines have become more widely available and more people take the next steps in their vaccination regime. The state’s data shows a slight bump in first doses in November as Thanksgiving approached.

Even so, 10 million Texans remain unvaccinated.

And while there isn’t one specific reason why first-dose rates lag behind booster shots, Dr. Emily Briggs, who specializes in family medicine and has seen the split in the demand for the vaccine from a private practice in New Braunfels, largely credits ideology.

“We are at that point of anybody who believes in science acknowledges that we have had benefit from this vaccine. Those who are politically motivated or have been given fear and are focused on that fear are not vaccinated,” she said.

Raising vaccination rates

Briggs said many in her community are highly motivated to get the booster — including people over 65 years old, schoolteachers or residents who work in crowded places where exposure is high — but others are still hesitant to do so.

Bowling said although he feels messages are reaching residents about getting vaccinated, he’s unsure if people are heeding the call about boosters like they did when vaccines first became available — partially due to pandemic fatigue and the frequency in which vaccine guidance seems to change.

“Initially it was no vaccine versus getting a vaccine. So obviously that drew a lot of interest. ... There were a lot of initial people going to get vaccinated at first,” Bowling said. “It’s harder to get excited about the boosters, although they’re also extremely important.”

Among the unvaccinated, Briggs said, some have been motivated by the predicted holiday surge in infections to get their first shots, but she lamented that for some the motivation has already come too late.

“The motivation comes once the person’s in the hospital or they have a family member who’s in the ICU, and that’s well past the time,” Briggs said. “We wanted them to be able to protect themselves and their family long before it came to that.”

Local government and public health officials across the state have been asking residents to take precautionary measures as they travel and gather ahead of the Christmas holiday, calling on them to get tested and vaccinated. Gov. Greg Abbott has continued to take on an approach of “personal responsibility” toward vaccination while promoting therapeutic infusion centers and vaccines as the best defense against COVID-19. He has staunchly opposed vaccine mandates.

In Dallas County, the health and human services department is “doubling down” its efforts to get the message out about vaccines, spokesperson Christian Grisales said. Strategies like going door to door and conducting block walks have enabled officials to engage in dialogue with residents and counter distrust and misinformation about vaccines, he said. Vaccination and booster rates in Dallas County closely mirror state-level numbers.

Although residents continue to get vaccinated, one problem that has emerged is that residents are getting their first shots of either the Moderna or Pfizer vaccine but not returning for the second ones, Grisales said.

Dr. Anita Kurian, assistant director of the San Antonio Metropolitan Health District, said the city has engaged with residents about vaccination rates by deploying an “army of community health workers” who spend almost every day doing outreach, particularly in areas that have been heavily impacted by COVID-19. The health district also organizes town hall discussions about COVID-19 and tries to reach out to residents virtually through social media and influencers, Kurian said. In Bexar County, about 60% of residents are fully vaccinated, and nearly 17% have received their boosters.

With the onset of the omicron variant, Kurian said, now is the time to get boosted and mitigate exposure by masking, social distancing and asking about the vaccination status of others in your immediate environment.

“It is going to surge here, so it’s inevitable,” Kurian said of the new variant.

Correction, Dec. 27, 2021: The chart comparing booster shots and first doses incorrectly stated that more people were getting boosters than first doses each day on average starting in October. The trend began in late September.