NUEVO LAREDO, Mexico — The COVID-19 vaccine shot that went into Nohemi Lima Eusebio’s arm as she sat on a dusty yellow school bus at the U.S. border checkpoint in Laredo was just days away from going in the trash in Dallas.
The dose had been in a batch earmarked for Texas residents, but it was about to expire at a clinic nearly 500 miles away because nobody used it.
Instead, it turned out to be a potential lifesaver for Lima Eusebio, a 44-year-old single mom whose job in the close quarters of a factory across the border in Nuevo Laredo put her at risk for the virus and made her fear for the safety of her loved ones.
“I was worried a lot because my elderly mom lived with me, and I was worried that going to work was a risk of contracting the virus, and I would infect my mom and my [15-year-old] daughter,” she said.
Getting a shot in her hometown — where persistently high demand and low supply meant long lines at places that had vaccines — took hours and made her miss too much work.
That’s how Lima Eusebio wound up in a secure area of the Gateway to the Americas International Bridge on a cloudy weekday morning earlier this month, sitting on the bus with her sleeve rolled up, surrounded by her factory coworkers.
As the bus idled on the Laredo side of the bridge, Mexican and U.S. health care workers traipsed down the aisle carrying vaccine doses stacked in buckets hanging around their necks — the kind that children use to sell gum to tourists on the corners near the mercado in downtown Nuevo Laredo.
They injected Lima Eusebio, signed her vaccine card and then the bus turned around and took them all back into Mexico.
The dose Lima Eusebio received, flown down on a private plane piloted by the attorney son of Laredo’s local top health official, was among nearly 200,000 that have been administered to Nuevo Laredo residents since last summer — part of a unique binational vaccination program that’s credited with bringing up vaccine rates and fighting the virus on both sides of the Rio Grande.
“This is a very essential humanitarian effort because, in order to get herd immunity in our area, we need to make sure everybody's vaccinated to avoid variants and to avoid cross-border transmission,” said Victor Treviño Jr., who oversees the program and whose father, Dr. Victor D. Treviño, is the Laredo Health Authority.
Launched last June as the state grappled with both a rising wave of deaths related to the delta variant and a sharp drop in demand for the vaccine in Texas and nationally, the cross-border vaccination program aimed to address a dismally low vaccine rate — an estimated 7% at the time — in Nuevo Laredo that was creating problems in highly vaccinated Laredo, which was reporting 10 times that vaccination rate, among the highest in the state.
It was also a good way, organizers said, to use up doses that had suddenly become a surplus in the U.S., where nearly 50% of the population were fully vaccinated by the time the Laredo program was up and running.
Meanwhile, Mexico’s early vaccine rollout was painfully slow because the country’s government had prioritized people in rural areas where social distancing was easier. The rollout was also hampered by logistical issues, with some people reportedly waiting in line for up to 12 hours for their first dose. By the time the cross-border vaccination program launched in June, Mexico was reporting only a 10% vaccination rate.
About 10 months after its launch, the program is still giving about 2,000 doses per day, Treviño Jr. said — which means the buses going back and forth across the bridge represent roughly 10% of the total doses being administered across Texas on a daily basis.
Nuevo Laredo, which has nearly half a million residents, has seen its vaccination rate soar to about 50% now, by most estimates — still far below Laredo’s 96.5% rate but seven times more than when the program began.
“It’s now one of the most highly vaccinated cities in Mexico,” Treviño Jr. said.
Shots arrive by car, plane and 18-wheeler. The doses used by the Laredo program are donated by providers like doctors, hospitals and pharmacies who would rather give away their excess supplies than throw them out, the senior Treviño said.
They’re picked up by car, plane and truck — any secure way they can find, organizers said.
“Sometimes there are 18-wheelers that are coming from other states passing through Dallas or San Antonio or somewhere, and we coordinate with trucking companies and if they can pick them up, they do that,” Treviño Sr. said. “So it’s quite a show. But it’s worth the effort.”
A provider that donated nearly 20,000 doses this week had initially “tried to give them back to the state because they said demand completely stopped,” said Treviño Jr., who frequently picks up the doses in his plane or car. “But they said to use them or transfer them.”
The state stopped warehousing doses months ago after supplies exceeded the demand, so providers now order them directly from the federal government, which purchases them and allocates them at no cost to the providers.
“It’s a bedrock public health principle that reducing an infectious disease on one side of a border will help reduce that disease on the other side, especially when there is a lot of cross-border traffic,” said Chris Van Deusen, spokesperson for the Texas Department of State Health Services.
Texas health officials say the state is not directly involved in the program, other than to track the doses donated by Texas providers to the binational effort. But they say that addressing the virus on both sides of the border is an effective approach for this vibrant and close-knit border community.
The program is slated to continue at least through April, when it will be reevaluated to see if it’s still needed.
A look at the numbers shows that there’s still very much a demand: Last week, Treviño Jr. said he picked up 10,000 doses in his car from a provider in San Antonio. This week, he’ll be picking up 17,000 more.
Laredo and Nuevo Laredo have been linked for the better part of two centuries, their downtowns separated by only a narrow slice of river.
“It’s one city. It just happens to be in two countries,” said state Rep. Richard Peña Raymond, a Laredo Democrat and early proponent of the program.
Adults and children in Nuevo Laredo often go to work and school every day in Laredo, and a large number of Laredoans have family on the other side of the river. Traveling back and forth for shopping, medical care and celebrations is the norm.
“We work hand in hand, and we feel like we have the same purposes because we cross the bridge daily,” said Estefania Araiza, a Nuevo Laredo nurse who administers doses on the bus for the program.
Last summer, Treviño Sr. was disturbed by the vaccination numbers.
Laredo had one of the highest vaccination rates in the state, but the hospitals were still getting patients every day who were close to death, many of them Nuevo Laredo residents. Treviño, who is also a family doctor, said he had patients from Nuevo Laredo whose family members weren't yet vaccinated. Doctors and nurses across the river were dying at an alarming rate, he said, because they couldn’t get vaccinated.
Treviño knew that there was no way to truly protect both cities unless both sides of the border were highly vaccinated.
One day in late May, Treviño’s son was brainstorming the problem with a friend while they pedaled side by side in a spin class at a Laredo gym.
They talked about collecting expiring doses and delivering them to Nuevo Laredo, but that idea came with a raft of logistical issues, the biggest of which was that the U.S. government had no authorized program to donate those doses.
And even if the U.S. government approved cross-border donations, the doses would likely end up mired in the same kinds of logistical problems that were bogging down Mexico’s vaccination effort.
“It was almost impossible to get a shot” in Mexico at the time, recalled Araiza, the nurse who helps administer the vaccine on the buses.
Treviño Jr. and his friend discussed administering the shots to Mexican citizens in Laredo, but dismissed the idea because at the time, the bridge was closed to all but essential workers from Nuevo Laredo.
“What if we vaccinate them on the bridge?” Treviño Jr. suggested. That way, people who did not have essential worker status wouldn’t technically be entering the U.S. as long as the buses didn’t leave the secured checkpoint area, which would work as long as border officials agreed to the plan.
The friend was enthusiastic and, while they pedaled in the spin class, placed a call to Carmen Lilia Canturosas, a relative who was running for mayor of Nuevo Laredo at the time — she won the election a few weeks later.
She used her connections to get the program rolling — her father and brother were both former mayors, “so she knew everyone,” Treviño Jr. said.
After winning her election, Canturosas called the Mexican Consulate in Laredo, who reached out to U.S. Customs and Border Protection, which runs the checkpoints on the U.S. side of border bridges. CBP officials agreed to let them vaccinate people in the secure area of the bridge only if the Nuevo Laredo residents stayed on the buses.
A few weeks later, the factory workers and their families arrived at the bridge on factory-owned school buses for shots. Trevino’s father, meanwhile, reached out to a prominent doctor’s association in Nuevo Laredo and began getting groups of front-line health workers vaccinated on buses owned by hospitals. Modern buses owned by Mexican bus lines soon joined the effort as more people signed up for shots.
Then in November, the international bridges reopened to all visitors on the U.S.-Mexico border just in time for the Christmas holiday, and popularity of the program exploded, Treviño Jr. said.
For Fabiola Escobar, a 32-year-old factory worker, getting the opportunity to get her booster shot on the bus with her coworkers rather than miss another day of work trying to get one in Nuevo Laredo was a game changer.
She can be less fearful, she said. And she can start getting back to normal life.
“When the pandemic first started, we were all worried we’d get sick and for it to get more serious,” Escobar said. “But now that we have our boosters, I feel like we can be less worried and work more comfortably.”
In late November, Nuevo Laredo city officials honored the senior Treviño’s efforts to vaccinate their residents, which included several programs in addition to the buses, by awarding him the keys to their city in a unanimous decision.
“It is a monumental effort we’re doing,” Treviño Sr. said. “And hopefully it’ll go down in history.”
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