San Antonio residents walked past a small band of mariachis playing Wednesday as they headed inside the Zarzamora Clinic on the Southwest Side for doctors’ appointments. 

Inside, rows of papel picado decked the ceiling, and a small table with a plastic yellow tablecloth showed off a festive cake. A woman passing out tamales from a slow cooker manned another table nearby, and across the waiting room stood four more tables where several San Antonians sat as they received the one-shot Johnson & Johnson COVID-19 vaccination. 

With numbers showing more residents in northern Bexar County have been vaccinated than those in southwestern Bexar County, County Commissioner Rebeca Clay-Flores (Pct. 1) worked with the University Health system to plan a Cinco de Mayo vaccination event in her precinct for Wednesday.

More than five dozen people at the clinic Wednesday received vaccinations, which were free to preregistered residents and walk-ins.

County vaccination data through the end of March shows southwestern Bexar County has experienced higher COVID-19 case rates and lower vaccination rates than northern Bexar County.

The commissioner, who was celebrating her birthday Wednesday, said she wanted to plan an event that would encourage residents in her area both to get vaccinated and emphasize that the recently resumed Johnson & Johnson vaccine is safe. Johnson & Johnson vaccines were temporarily halted across the country last month after six women who received the vaccine experienced rare blood clots. One died. The Centers for Disease Control and Prevention (CDC) and the Food & Drug Administration (FDA) have since lifted the pause. 

Bexar County Precinct 1 Commissioner Rebeca Clay-Flores speaks to a woman who was vaccinated Wednesday at the Zarzamora Clinic. Credit: Nick Wagner / San Antonio Report

“This part of town is lagging behind in terms of percentages for numbers of vaccinations compared to the northern sector of our county,” Clay-Flores said. “And with all the controversy about the Johnson & Johnson shot, I thought I’d make a public announcement and encourage people to go ahead and move forward.”

One reason for these differences is a disparity in access, said Cherise Rohr-Allegrini, CEO of San Antonio AIDS Foundation and former San Antonio program director of the nonprofit Immunization Partnership.

Barriers to access include lack of transportation and an inability to take time off work, Rohr-Allegrini said. 

The most recent data from the The Health Collaborative show residents of southwestern Bexar County also had less access to healthy food, health education, and health care facilities than residents of northern Bexar County.

“When it comes to access, we need the ice cream truck model – I bring it to you,” she said. “Access doesn’t just mean having the vaccine readily available, it means a lot more than that.”

San Antonio resident Diana Fernandez, 53, said transportation was the major issue that kept her from getting vaccinated before Wednesday.

“This is right down the street from me,” Fernandez said. “I don’t drive, so I was able to ride the bus over here.”

To get downtown to the Alamodome vaccination hub by bus would likely have taken over an hour, Fernandez said. 

The Zarzamora Clinic does not usually carry doses of the vaccine, said Bill Phillips, senior vice president and chief information officer at University Health. The event was University Health’s first to administer Johnson & Johnson, which doesn’t require the cold storage needed by the Pfizer and Moderna vaccines.

“If you look geographically where all the vaccine hubs are, they aren’t really in this area of San Antonio,” Phillips said. “So we thought it was a great opportunity to partner [with the county] and try to get some shots [into] arms.”

The fact that the Johnson & Johnson vaccine requires only one poke rather than two like the Moderna and Pfizer vaccines also makes it more beneficial to residents who regularly lack access, Rohr-Allegrini said. With a second appointment unnecessary, more residents are likely to want to get vaccinated, she said.

This was definitely a factor considered by Mac Shelton, 58. She said she’d been waiting for a chance to get the Johnson & Johnson vaccine since it would be just one dose rather than two.

Mariachis perform during Wednesday’s event at the Zarzamora Clinic. Credit: Nick Wagner / San Antonio Report

“Plus the tamales and mariachis coming out here were a plus,” Shelton said.

Another reason for the differences in vaccine rates across the county could be culturally driven vaccine hesitancy, Rohr-Allegrini speculated.

“Institutional biases can make it difficult to get people to come to you,” Rohr-Allegrini said. “Those who may have chronic conditions but have less access to health care may not like going into the doctor where they’re made to feel bad for being overweight or having diabetes or other concerns. Those who are low income may expect to be asked questions about income or other personal questions they don’t want to answer.”

Those working at Wednesday’s event recorded only residents’ names and birth dates so health officials could record data for the city and state.

Vaccine advocates need to have more one-on-one conversations with hesitant residents, Rohr-Allegrini said – even if that means door-knocking and speaking with residents at their homes.

“We need one-on-one conversations, listening to concerns and answering questions,” she said. “Most truly hesitant come around. It helps dramatically if the vaccine is available – for example, ‘I can give you the vaccine right now,’ rather than expecting them to make an appointment and drive across town.”

The Metropolitan Health District will be offering several free pop-up clinics on the South Side in the coming weeks. For more information, click here.

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Lindsey Carnett

Lindsey Carnett covers the environment, science and utilities for the San Antonio Report.