Nestled deep within south-central Texas, the city of San Antonio shines with warm hospitality, a vibrant history, and a diverse culinary scene. This popular travel destination is one of the fastest-growing and most highly populated cities in America. It’s also one of the poorest, with a poverty rate that ranks second among Texas' five larger cities.¹

Much of the poverty in San Antonio is concentrated in the West Side district, an area central to the city’s identity as a hub for Hispanic culture.

This is where the Young Women’s Christian Association of America (better known as YWCA) makes its home. The multi-purpose YWCA Olga Madrid Center is the heart of the West Side community, serving roughly 10,000 people across all generations.

The YWCA’s mission is an ambitious one, built on “eliminating racism, empowering women, and promoting peace, justice, freedom, and dignity for all.” In addition to child care, career planning, literacy classes, and senior programs, the organization offers a range of preventive health services. As a Vaccine Uptake Initiative grantee, they’re committed to reducing health disparities by getting the word out about COVID and flu vaccines—and making these vaccines more accessible through pop-up and mobile clinics.

COVID’s impact on women

The need to improve vaccine access to women in marginalized communities is dire. Research shows COVID has had a disproportionate impact on women, who often serve in caregiving roles that increase their exposure to the virus. Throughout the pandemic, while women were overall less likely to develop severe disease from COVID compared to men, they were more likely to be diagnosed later. They also died earlier after diagnosis, which suggest many did not receive the care they needed. Women are also more likely to be affected by long COVID (17%) compared to men (11%).

Women in poorer communities face even greater risks: A recent study found that people with low income were 55% less likely to be vaccinated against COVID. It also showed that women in this group faced greater disparities in vaccine access than male subjects.²

Barriers to vaccine access

In urban communities—especially one like San Antonio where Hispanic and Latino people make up nearly 66% of the population³—the language and cultural barrier can be one obstacle to getting vaccinated. Others include limited access to health care facilities, lack of transportation to vaccination sites, and low digital literacy that can make it hard to get up-to-date information about COVID and vaccination opportunities.

But the biggest barrier, said Alexis Mata, a Vaccine Outreach Assistant at the YWCA, is misinformation that continues to fuel vaccine hesitancy among older adults. Research has shown that women, in particular, are more likely to want to delay or refuse the COVID vaccine than men. They also have a greater tendency to worry about side effects from the shots. Concerns about vaccine safety are often coupled with a general mistrust of the health care system and the government.

Mata and her team actively combat misconceptions by distributing educational flyers at their various community outreach events and pop-up vaccine clinics. The YWCA San Antonio also has an active and widespread social media presence, where it shares videos and infographics that emphasize COVID and flu risks as well as the proven safety and efficacy of the vaccines.

Face-to-face conversations play a big role as well. Vaccine clinics give YWCA staff and community health workers the chance to talk personally to people and dispel their doubts about vaccines. Many of the community health workers the YWCA trains and works with speak Spanish or are bilingual. Their culturally sensitive interactions with the public have helped the organization become a trusted messenger in the community.  

“Initially, some are reluctant to get vaccinated due to concerns about potential illness from the vaccine,” Mata explained. “But after educating them on vaccines, they will, most of the time, receive both vaccines.”

Improving COVID and flu vaccine equity

If there’s one word to sum up the YWCA’s vaccination efforts throughout San Antonio, it’s “proactive.” Their work isn’t simply about setting up clinics and hoping people show up. Instead, they reach out deep into the community to find out where the need is greatest—and meet people where they are.

Speaking to News 4 San Antonio in November, Corin Reyes, the YWCA San Antonio’s Director of Health Equity, said the organization collects regional data to identify areas where vaccine access is limited. They then use this data to inform their outreach strategies. “We go in those places, we contact local partners, even restaurants, it doesn't matter who it is. We say, can we set up a vaccine clinic? And that's how we go about it,” she explained.

One such clinic was held at Artisan at Willow Springs, a 248-unit housing community for people with low income. Vaccines were administered to most residents in the facility’s main lobby. For older residents unable to get there, a team was dispatched to vaccinate them in their apartment. The clinic even received a visit from Mandy Cohen, MD, MPH, Director of the Centers for Disease Control and Prevention (CDC). Her message echoed that of YWCA staff: Residents should take steps to protect themselves as holiday celebrations drew near and their risk for infection increased.

During the fall and winter months, Mata and her team regularly attended weekly events at Haven for Hope, a shelter for the unhoused in San Antonio.

We brought vaccines directly to them, eliminating the need for travel expenses,” she said. “We also distributed information about upcoming clinics.”

This past October, the YWCA San Antonio organized an event called “Think Pink” to honor breast cancer survivors and celebrate Breast Cancer Awareness Month. Alongside a health fair that included mammograms and other cancer screenings, staff set up a flu vaccine clinic. The clinic was promoted far and wide to local communities. "We used flyers distributed at various events, placed flyers in local restaurants near the event location, and utilized social media platforms to spread the word,” said Mata.

Forty vaccines in total were given during Think Pink, with women making up more than half of recipients. Every shot represents one less person who could suffer a life-threatening infection from the flu or COVID.

What’s one thing Mata wants older adults to understand about preventing COVID and the flu? It’s simple: Getting vaccinated can save your life. “Strains of these viruses are constantly changing,” she said. “That’s why it’s critical to get your vaccines every year. People who stay current with their shots are at a much lower risk of severe illness, hospitalization, and death compared to those who are unvaccinated or incompletely vaccinated.”

Mata added that boosters are important, too: “Especially if they're immunocompromised, women age 65 and older should get an additional COVID booster shot at least four months after their previous dose.”

For more information

Those seeking information on upcoming vaccine clinics or other health-related events can call the YWCA San Antonio at 1-210-433-9922, check their Events page, or follow them on Facebook or Instagram for updates. The Metropolitan Health District website also provides details on local clinics as well as resources on COVID-19 and other vaccine-preventable illnesses.

Sources

1. City of San Antonio Human Services. Status of Poverty 2024. Found on the internet at: https://www.sa.gov/files/assets/main/v/1/dhs/documents/shared/2024-poverty-report.pdf

2. Kenechukwu C. Ben-Umeh, et al. Income disparities in COVID-19 vaccine and booster uptake in the United States: An analysis of cross-sectional data from the Medical Expenditure Panel Survey. PLOS One. February 20, 2024. Found on the internet at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0298825

3. U.S. Census Bureau. Quick Facts: San Antonio, Texas. Found on the internet at: https://www.census.gov/quickfacts/fact/table/sanantoniocitytexas