It was 1977. Twelve Texas women began meeting regularly in an empty Baptist parsonage to play games, socialize, and share good food. They named their group Silver Sage, and over time, its membership and activities flourished. In 1984, Silver Sage was officially reborn as the Bandera County Committee on Aging—and the rest is history.

After 40 years of serving older adults in the "Cowboy Capital of the World," the Bandera County Committee on Aging (DBA Silver Sage) has become a trusted and beloved name in the community. During the COVID-19 crisis, this Vaccine Uptake Initiative grantee leaned into their reputation to improve vaccine access and protect the health and well-being of older residents.

What challenges did Silver Sage face in promoting vaccine acceptance among older adults?

At the peak of the pandemic, Texas was a hotbed for COVID misinformation. This led to conflicting vaccine mandates and high rates of vaccine hesitancy that still linger today.

"Older adults in Bandera County have been exposed to tremendous amounts of false or misleading information about the vaccines' safety, efficacy, and necessity," explained Silver Sage CEO Art Crawford. "This has required proactive efforts to provide accurate information from trusted sources, debunk myths, and educate older people about the critical importance of vaccination."

While misinformation has had a major impact on vaccine access in the county, it isn't the only factor at play. Other ongoing barriers include:
 

• Transportation: Bandera County is rural, with fewer than 21,000 residents. Many older adults live far from vaccination sites and/or lack a way to get to and from vaccination appointments.
• Medical mistrust: Systemic issues and past negative experiences have led to a sense of distrust in the health care system.
• Language: "For older adults from non-English-speaking backgrounds, language barriers or difficulties in accessing information in a preferred language was a big obstacle early on," explained Crawford.
• Technology: Lack of digital literacy and internet services have made it challenging for many older Texans to use online appointment systems and vaccine registration processes.

What strategies did Silver Sage use to overcome these barriers?

Combating myths and falsehoods

Crawford explained that a proactive, multi-pronged approach was key to offsetting the influence of local, state, and national misinformation about vaccines. “We engaged local leaders, health care professionals, and other trusted figures to actively deliver accurate information about vaccines through community conversations, social media platforms, and food distributions,” he said.

During the pandemic, Silver Sage ran VaccinateBandera.org, a dedicated website that provided science-backed COVID information, updates on vaccine clinics, and general community resources for older adults. They also promoted the latest COVID guidelines and vaccination opportunities through their website and highly active Facebook page.

Additionally, Silver Sage staff took advantage of opportunities to talk face-to-face with residents at monthly food distributions, health fairs, and other community events where vaccines were being offered. For many older adults, these casual chats were enough to give them a fresh perspective on vaccination.

Making vaccinations easier to obtain

To help bridge gaps in access to vaccines, Silver Sage set up mobile and pop-up COVID and flu vaccination clinics across Bandera County. These events offered flexible hours and a culturally sensitive staff to encourage people to roll up their sleeves. Staff worked closely with community partners and area churches to help build trust among residents and amplify outreach efforts. Complimentary transportation was provided to and from vaccine clinics and other vaccination provider sites.

What about homebound residents? Crawford said that by partnering with various providers and the National Guard, Silver Sage brought vaccines directly to many Meals on Wheels participants and other older adults who could not be safely transported to clinics.

Overcoming language and technology barriers

Silver Sage has been successful in removing many of the barriers facing the older Hispanic community in Bandera County. They’ve achieved this by incorporating bilingual staff into outreach efforts and using Spanish-language resources provided by NCOA and the Centers for Disease Control and Prevention (CDC).

To assist older adults without internet access, the organization conducted robust outreach in the community and set up a dedicated 1-800 hotline for COVID-related information. In addition, staff was made available to schedule online vaccination appointments on behalf of residents.

The mission continues

COVID has not gone away; it still poses a serious health threat to older adults nationwide. That’s why Silver Sage continues their efforts to ensure residents stay up to date on COVID and other vital immunizations.

Most recently, they collaborated with the local area agency on aging (AAA) to hold the Bandera Road Show. In addition to a vaccination clinic, the Silver Sage Benefits Enrollment Center (BEC) team was on hand to help older adults find and enroll in various money-saving benefits programs. “By collaborating with our AAA and BEC, we orchestrated not merely a routine vaccine clinic, but an engaging event that reached a much broader audience,” said Crawford.

The Road Show was advertised in local newspapers, and flyers were distributed to older residents throughout Bandera County, including Meals on Wheels recipients, congregate clients, and active senior center participants. Gift cards from the local grocery store were offered as an incentive for getting vaccinated.

In the end, 71 COVID, flu, RSV, and shingles vaccines were administered—and the response was profoundly positive. “So many people were grateful for our efforts in organizing the event, and they were particularly impressed by the coordination and efficiency of the clinic,” explained Crawford. “The gift cards were received with enthusiasm and really enhanced the overall experience.”

At the heart of Silver Sage’s pro-vaccine campaigns is the strong sense of community Bandera County is known for. It emphasizes that vaccination is not just a personal choice, but a collective responsibility.

“Seeing friends and community members being hospitalized or losing their lives—while others remained unvaccinated and continued to gather in groups—has been a heart-wrenching experience,” Crawford remarked. “So if you're hesitant to get vaccinated for yourself, I urge you to consider the profound impact it can have on those you hold dear. Let's come together to protect each other.”

For more information

To stay up to date with Silver Sage vaccination clinics and other events for older adults in Bandera County, you can call them directly at 1-830-796-4969, visit the Silver Sage website, or follow them on Facebook.

Get the latest information on COVID-19 vaccines and treatment by browsing NCOA’s COVID-19 for Older Adults resource library.