By Dr. Junda Woo, Medical Director and Local Health Authority, San Antonio Metropolitan Health District 

Sandra Zaragoza, Senior Marketing and Communications Specialist, Health Confianza  

San Antonio, TEXAS —   As respiratory virus season approaches, health professionals and community health workers will be working in a shifting vaccine landscape. While guidance and rules may change, the collective goal stays the same – providing access to vaccines and scientifically accurate, evidence-based guidance to support people’s health decisions. 

To help navigate this challenging time, here are some insights and resources. 

Who is Eligible for COVID vaccines? 

The U.S. Centers for Disease Prevention & Control (CDC), U.S. Food and Drug Administration leaders and medical societies all agree that an annual COVID vaccination is recommended for people at risk for severe illness and people ages 65 and older.  

Where they differ is in recommendations for COVID shots for the following populations: healthy adults under 65, pregnant people and healthy children. Part of the reason is that we collectively have more immunity, from infections and vaccinations, than we did in years past. 

We are still waiting for 2025-26 CDC recommendations. For 2024-25 (as of September), see the box below.  

Annual COVID Vaccine Recommendations (As of Sept. 2025)
Group	CDC 2024-25 Immunization Schedule	FDA leaders (New England Journal of Medicine article)	Medical Societies
Healthy adults under 65	Yes	No	Same as CDC
Pregnancy	“No guidance/  Not Applicable”	Yes	Yes (ACOG)
Healthy children	Shared decision-making	Research needed	Yes, especially for ages 6 mos.-2 years (AAP)

 

Because the differences in guidance may be confusing, think about encouraging your patients and clients to engage in shared decision-making with their health care providers. Shared decision-making is where patients and clinicians collaborate to make healthcare decisions, considering both medical evidence and the patient’s own values and preferences. An example of shared decision-making is when parents choose to vaccinate their child after discussing it with their healthcare provider. 

Less Convenient, More Expensive 

Unfortunately, as of Oct. 1, Texas’ Adult Safety Net program will stop covering COVID vaccines for people who are uninsured. We are awaiting news about the Vaccines for Children program coverage.  

Insurers seem likely to cover COVID vaccines for everyone until Jan. 1, 2026, when the new benefit year begins.  

Access to vaccines at pharmacies will vary by state (map). Fortunately, Texas pharmacists will give the vaccine. For people who pay out of their own pockets, discount coupons can lower the cost. 

For people at risk for severe illness who cannot access the vaccine, the old standbys still work: clean air, handwashing, staying away from others who are sick, masking, getting tested. 

Counseling and Consents Are Changing 

In June, the FDA expanded the myocarditis warning on mRNA vaccines. mRNA vaccines have been linked, rarely, to myocarditis and pericarditis—inflammation of the heart muscle and tissue.  

The reaction is most common in males ages 12 to 24, occurring in 27 of every 1 million doses. To lower this risk, the CDC suggests spacing out 1st and 2nd doses by 8 weeks in young men. Importantly, COVID infection and disease also can cause heart conditions.   

When obtaining a COVID vaccine, patients may be asked to sign a new informed consent form that was required by the Texas Legislature (HB 4535). 

Vaccines for Children   

The American Academy of Pediatrics (AAP) published its own evidence-based immunization schedule for children in August. The schedule offers recommendations on RSV, flu and COVID, as well as other key vaccines.  

What’s New with Flu Vaccines? 

Metro Health continues to promote the importance of flu vaccines in reducing severe illness and hospitalization, especially in people who are immunocompromised, children and elders.  Last season, 275 U.S. children died from the flu, and 90% were not fully vaccinated. 

Starting this fall, multidose vials of flu vaccine no longer will contain thimerosal. Thimerosal is an FDA-approved antifungal/antibacterial that was only in multidose flu vials (4% to 7% of flu vaccines). It is not in any routine childhood vaccines. 

You may see ads this fall for a self-administered, at-home nasal spray vaccine. Unlike flu shots, the nasal spray uses a form of the live virus (weakened) and so is not recommended for pregnant or immunosuppressed people, among others. It is approved for ages 2 through 49 and could be a good option for people with needle phobia. 

How is Metro Health Navigating the Conflicting Guidance? 

As vaccine expertise and advice change on a federal level, old-school science-based recommendations will continue through medical specialty societies and new coalitions. Metro Health will monitor the evolving landscape and share credible information with our community as we receive it. Subscribe to Metro Health’s clinician newsletter here. 

 

By Jason Rosenfeld, DrPH, MPH, CHWI, co-director of Health Confianza, director of Global Health, The University of Texas at San Antonio.

Hi everyone and welcome to the third installment of our Health Confianza newsletter. As I was reflecting on what I wanted to say this quarter, I came to the realization that our country is embarking on sweeping changes to public health policy, research funding, and the social safety net, bringing our city, county and collective work to a critical moment. The recently passed One Big Beautiful Bill Act is expected to reshape healthcare access and public health services nationwide, including changes to Medicaid and food assistance programs. In Bexar County, where many residents rely on these programs, these developments will bring both uncertainty and fear—and they call on us, as community leaders, to respond with clarity and compassion. 

At Health Confianza, we believe that trusted relationships and informed action are the foundation of building and sustaining community resilience. To best prepare our diverse San Antonio community for these changes, we feel it is time to reaffirm our shared responsibility and collective efforts to ensure people have access to the most accurate, timely, and trustworthy health information. By applying principles of health literacy—such as plain language, cultural relevance, and active listening, we can help reduce fear, build confidence, and empower our neighbors to make informed decisions about their health and well-being. 

To this end, this issue of our newsletter is full of information and resources to help us navigate this changing landscape. This includes up to date vaccine guidance and recommendations from Dr. Junda Woo, a primer on how to integrate plain language into health communications, an introduction to our new cohort of trusted community collaborators and messengers known as Confianza Ambassadors, a profile on a Confianza Community Changer from the Southside, and an overview of our upcoming Communicating with Confianza ECHO series.  

Together, we can be a steady source of clarity and support in uncertain times. Let’s continue to lead and communicate with confianza—confidence rooted in trust, knowledge, and unity. Thank you for being part of our Confianza Collective where we work towards helping people make the best decisions for themselves and their families. 

Sign up for the Health Confianza Quarterly newsletter: https://forms.office.com/r/jMN7m52Wit 

 

By Sandra Zaragoza, Sr. Marketing and Communications Specialist, Health Confianza

Melanie Stone, DrPH, MEd, Co-director of Health Confianza, Assistant Professor of Family & Community Medicine and Director of Community Service Learning, The University of Texas at San Antonio

San Antonio, TEXAS —  Health communications are an ever-present part of our daily lives — a flyer at a health fair, an in-take document at the doctor’s office, a wellness TikTok, an infographic, or a written follow-up we receive from our health provider.

While health communications are around in different forms, they may be filled with medical jargon, complex sentences and hard-to-follow guidance.

In short, they may not be written in plain language. Plain language is defined as communication with clear wording, structure, and design for the intended audience to easily:

– find what they need
– understand what they find
– use that information

Increasingly, the health care and nonprofit communities are recognizing the important role of plain language in removing barriers to health care, enhancing patient safety and increasing the patient’s ability to make informed health decisions.

At the same time, training in plain language communication is not a part of standard education for health care providers, which means plain language must be intentional.

Fortunately, we are beginning to see more health providers, community health workers and health communicators learning plain language skills and making this a communication priority in their organizational policies and practices.

Spotting the Mistakes

One of the easiest ways to start employing plain language is to be able to spot when it doesn’t meet the standards. To that end, the Institute for Healthcare Advancement (IHA) created a list of the 10 most common errors that health providers make when communicating with patients.

IHA points out that health providers tend to create prescription instructions “that are written at an 11^th grade reading level or higher, rather than 5^th grade reading level at which the majority of the country’s population reads.”

Another common error, according to IHA, is handing out reading material that is printed in a font size too small for the patient, particularly seniors. The type should be at least 12-point font with adequate space between lines.

Additionally, the power of graphics is often overlooked when creating materials, according to experts.

IHA points out that simple visuals for medical instruction can enhance patient understanding. However, they warn that graphics should demonstrate and explain concepts in the text and should never be abstract or for decorative purposes only.

Overburdening patients with numeracy skills is another area to be mindful. Providing context for numbers (use 1 in 5 versus 20%), removing the need for the reader to perform calculations, and using appropriate visuals can help improve plain language numeracy.

Unfortunately, mistakes in health communications come with both a human and financial impact, with an estimated $236 billion in unnecessary health care expenses annually due to the inability of patients to understand what medical providers are communicating to them, according to a 2008 article in Nurse Educator.

The good news is that there is guidance, techniques and tools that encourage the use of plain language.

History of Plain Language

The Plain Writing Act of 2010 requires federal agencies to train staff to use plain language when they communicate with the public. As part of that act, the federal government offers plain language guidance.

Among the most common techniques for achieving plain language:

•  Reader-centered organization
• “You” and other pronouns
• Active voice, not passive
• Short sentences and paragraphs
• Common, everyday words
• Easy-to-follow design features (lists, headers, tables)

Additionally, The Center for Plain Language offers 5 Steps to Plain Language that each include more detailed information:

1. Identify and describe the target audience
2. Structure the content to guide the reader through it
3. Write the content in plain language – keep it short and to the point
4. Use information design to help readers see and understand
5. Work with the target user group to test the design and content

Health literacy experts recommend that health professionals initially introduce the medical term that the patient will encounter (e.g. myocardial infarction), immediately followed by the plain language version (e.g. heart attack). This will help the patient connect the terms.  Also, use analogies the patient may be familiar with to help make the medical concept clearer, such as the mechanics of a car representing your cardiovascular system.

How to Check if it’s Plain Language

There are paid and free tools that can help a health communications professional review and assess adherence to plain language principles.

Some examples are:

Free Resource:  The National Library of Medicine’s Health Education Materials Assessment Tool (HEMAT)
Paid Resource:  Health Literacy Innovation’s Health Literacy Advisor (HLA) – software that assesses and improves the readability of your documents using plain language principles

While technology can be a useful tool to enhance plain language (e.g. using a chatbot to write your information in a conversational tone), a human editor is still needed to check for accuracy, potential misunderstandings, and overall use of plain language principles.

Keeping Plain Language Top of Mind

One way to keep an organization or team thinking in terms of health literacy and plain language is to make sure they have access to trainings, refresher courses and webinars.

The U.S. Centers for Disease Control & Prevention, the Center for Plain Language, Health Confianza are just some of the organizations that offer affordable health literacy education.

“Communication is only effective if the receiver actually comprehends the message sent,” said Melanie Stone, DrPH, MEd, co-director of Health Confianza. “I often remind health care professionals, ‘What’s the point of your medical knowledge if you cannot convey it to the person who needs it?’ I challenge our trainees with the quote from Albert Einstein, “If you can’t explain it simply, you don’t understand it well enough.” Plain language helps ensure people understand what you are saying the first time you say it.”

Related Health Confianza Articles and Resources

A Brief Intro to the 5 Ts of Teach-Back
4 Tips for Better Health Communication
Organizational Health Literacy Toolkit

San Antonio, TEXAS —This fall, Health Confianza is offering “Communicating with Confianza – A Health Literacy ECHO,” a free six-part virtual professional development series on the practical use of health literacy strategies and tools in the workplace. Health Confianza is a four-year old health literacy initiative funded by Bexar County and housed at The University of Texas San Antonio.

Designed for health professionals, including physicians, pharmacists, nurses, community health workers, and more, the series will focus on using health literacy principles in interactions with patients/clients to achieve improved communication and understanding.

The ECHO (Extension for Community Healthcare Outcomes) uses an “all teach, all learn” learning model to develop a virtual community of peers who learn from experts and share best practices with each other. The “Communicating with Confianza” ECHO, covers the following topics: Acknowledging perspectives, stigma, creating a shame-free environment, plain language, shared decision-making, and teach-back.

Participants will learn evidence-based strategies for improving health literacy, ways to convey culturally-sensitive health information, and how to build trust through communication.

Health Confianza will host the series from Sept. 5 through Nov. 21, 2025, on the first and third Fridays of the month from 12 to 1 p.m. Free continuing education (CE) credits are available.

It’s not too late to register! https://iecho.org/public/program/PRGM1751381467565L1MOI1W6LV

Two years ago, Health Confianza’s team met Marissa Gutierrez when she trained as Community Health Club facilitator. Since then, she has led The Untouchables Community Health Club at Southside Lions Senior Center in Southeast San Antonio.

Over the years, we’ve watched as Gutierrez built trust with community and mastered the Community Health Club format. Because of this, she is our first Health Confianza Community Changer, a person working alongside us in public health and health literacy promotion. Read more below about Gutierrez and the community work she does during and outside of work hours.

San Antonio, Texas —  When you visit The Untouchables Community Health Club at Southside Lions Senior Center, expect to find a room full of attentive and laughing members. That’s because, the club’s facilitator, Marissa Gutierrez, with a glint in her eyes, shares a quick wit and easy rapport with the senior women that translates into a fun learning environment.

Given her accomplishments as a facilitator, it would be easy to believe that Gutierrez has years more experience in community building and public health than she does.

It all began in 2020, when Gutierrez and her sister, Lotus Rios, decided to start The Harlandale Sunshine Pantry to give back to the Southside neighborhood where they grew up. The idea was simple: create a mutual-aid pantry filled with food, hygiene items and clothing donated for and by community.

Through the pantry, they started logging the community’s assets and got to know the nonprofit community.

“Essentially, we were doing asset mapping without really knowing what it was,” Gutierrez said, referring to the mapping of resources available in a community. “From there, we started getting connected to more programs within the city, as well as people who were running social movements and mutual-aid movements in the city.”

Over the last five years, the sisters have amassed a consistent donor base of community partners and neighbors.

One supporter of the pantry, Dee Salinas, visited the pantry while her and her family were dealing with housing instability. In addition to food, the sisters were able to connect her with resources and eventually the family did get their own apartment. Having benefitted from the Harlandale Sunshine Pantry, Salinas and her family have made a point to give back in different ways including fundraising, volunteering at events, and volunteering to do a community podcast, Gutierrez said.

“Because my sister and I showed up for them, they show up for us now and for the community,” Gutierrez said.

From Pantry to Public Health Work

Without knowing it at the time, the pantry was a bridge to Gutierrez’s career as a community health worker.

Through her work with the pantry, Gutierrez was introduced to the city of San Antonio’s Healthy Neighborhood program. They later hired her to work in Southeast San Antonio.

Not as familiar with Southeast San Antonio, Gutierrez went about networking and understanding the needs and strengths of the community, slowly building trust with the people around her.

“I’m still building and gathering trust because I have found out that it is a lot easier to garner trust as a neighbor, buddy-friend than it is as a local government worker,” Gutierrez said.

Gutierrez said that she was able to make inroads into a new community by studying the “patterns or grooves in the neighborhood” made by people that had come before her to do similar work.

Making connections is how she was given the opportunity to facilitate the Community Health Club at the Southside Lions Club.

“I just did a cooking demo, and they asked can you come back next week. I was getting training for the (Community Health) Club framework and thought, yeah, I can do this,” she said. “They have been with me now two years as a health club, but three years together.”

Since then, she’s received formal training as a Community Health Worker, which has given her the vocabulary and knowledge to move through community and professional settings.

“I learned that the things that me and my sister were doing instinctively, people had already laid down the methodologies and foundation for,” Gutierrez said. “It has definitely helped me explain to people what we do when we get into spaces where most people are using jargon or formal language.”

Club Takeaways

Gutierrez says that the club format and curriculum have been a big part of the success as was having access to Health Confianza’s Senior Community Outreach Specialists Gracie De Leon, Santos Barrientes and Cynthia De La Garza-Parker.

“I will say the support that Gracie, Santos and Cynthia give; They are great mentors in applying the club framework. The framework itself is excellent and the support they’ve given is awesome,” Gutierrez said “The health club members seem to love the lessons. It’s easy to digest, and I don’t have to change too many words because it’s written in plain language.”

De Leon said Gutierrez has her own way of simply and effectively explaining nutrition and other health topics.

“Marissa does a great job of relating to the community and responding to their ideas with curriculum and different activities. She brings humor and creativity to her role as a health educator,” De Leon said. “You can see the joy in people’s faces at every meeting. They are genuinely connecting and having fun.”

Gutierrez downplays her role in the success of the club, instead shining the light on the club members.

“It’s the people that fill those seats that make it a success,” Gutierrez said. “Community is great. More now than ever, we need our connection to community.”

A Time of Transition

Due to the recent changes in public health infrastructure, Gutierrez is concerned that clubs like The Untouchables will be unable to continue. Public health advocacy is something that Gutierrez is strongly encouraging to ensure that health clubs and public health continue to be funded for the health and equity of our communities.

Regardless of future changes, Gutierrez is staying focused on community.

“In the next year I want to learn more about my community as I possibly can. I would have liked more time. The people I’ve met are unique and their stories are unique as they are,” Gutierrez said. “This job has given me a distinct and wonderful opportunity to learn about people in a capacity I had never really explored before.”

 

San Antonio, TEXAS — This fall, Health Confianza is proud to introduce 15 new Health Confianza Ambassadors trained to help spread the word about preventive health resources in Bexar County, create connections with hard-to-reach populations and serve as advocates who create and disseminate innovative preventive health messages.   

Health Confianza, a four-year-old multi-level health literacy initiative that provides programming for organizations, the health workforce and community, trained these 15 natural community leaders in core health literacy and effective health communications principles, with the goal of designing and delivering scientifically accurate preventive health information, that is both culturally and linguistically appropriate. 

Health Confianza teamed up with its partners — Southside Collaborative, South Central Area Health Education Center (AHEC), WestCare Texas and YWCA San Antonio —to identify natural leaders,  those people in the community who are serving their neighbors either as volunteers, community health workers or public health advocates. 

“We are excited that these trusted and respected community leaders have chosen to join our initiative and to serve as community health educators and resources for our community,” said Jason Rosenfeld, DrPH, associate professor of Medicine, director of Global Health Education at the Cheever Center for Medical Humanities and Ethics, and co-director of Health Confianza. “As a core principle for Health Confianza, we aim to provide health information that is accessible and understandable, so each individual can make the best, informed health decisions for themselves and their families.  Partnering with trusted and respected local leaders in the design and dissemination of messages allows us to center the voice and perspectives of our diverse Bexar County community in that strategy.”  

As part of this work, they will be creating innovative messages and content to share, as well as promoting important preventive health information with the community on issues including child health, chronic disease prevention, and mental wellness promotion.   

At the same time, they will also help Health Confianza elevate community strengths and needs. 

“We look forward to seeing the different ways that our Health Confianza Ambassadors will help our communities take time to focus on their health and encourage healthy actions, including prioritizing screenings, vaccines, annual check-ups, and mental health,” Rosenfeld said.  

Health Confianza’s Ambassadors (By Sponsoring Organization): 

Health Confianza
Timoteo Barrientez
Candi Diaz
Amanda Onochie 

South Central Area Health Education Center (AHEC)
Alice Alvarez
Edna Cruz
Dre Rodriguez

Southside Collaborative
Lisa Espinoza
Alicia Sanchez-Esquivel
Jorgette Gueda

WestCare Texas
Chris Garry
Jocelyn Gonzalez
D’Ajia Goodlow
Sarah Montejano
Krystal Rojas
Jessica Route 

 

  

 

 

 

San Antonio, Texas — Health Confianza’s local nonprofit partners are warning the community about a rise in theft related to Supplemental Nutrition Assistance Program (SNAP) benefits that is affecting Texas families and children.

In Texas, more than 1.7 million children received SNAP benefits in 2022. This represents 23.9% of all SNAP recipients in the state.

SNAP benefits are administered to recipients through electronic benefit transfer (EBT) cards, which are loaded with money every month to use in participating retailers. Like regular debit or credit cards, they are subject to scams. Scammers may reach out through texts and links requesting PIN numbers, use skimming devices on EBT machines, or capture information from online transactions.

Texas Health and Human Services does not replace the benefits lost through fraud.

Protect your benefits against fraud/theft:

• Download Your Texas Benefits App to manage your benefits. The app is available on Google Play or iTunes App Store.
• Freeze your EBT card: Your Texas Benefits app allows you to freeze and unfreeze your EBT card to secure your funds when not in use.
• Limit your online transactions: Some scammers are able to capture your information from transactions with online retailers.
• If you suspect fraud: Change your PIN immediately to prevent further unauthorized purchases and contact your local SNAP office or state agency. In Texas, call the Lone Star Help Desk at 800-777-7328 to change your PIN and cancel your card, then call 2-1-1 and select option 3 to report fraud to the HHSC Office of the Inspector General.

Tip: The Texas Department of State Health Services will never call or text you to ask for your Lone Star Card number or PIN.

San Antonio, Texas — Hey Bexar County, don’t let your child fall behind on their vaccines. Take advantage of a number of Back-to-School events that will be providing free or low-cost childhood vaccines at local schools, community centers and nonprofits this July and August. If you are a parent or caregiver, please note that you must pre-register your child for the vaccine event (some providers may require vaccine records).

Three ways to find or sign-up for Back-to-School Vaccines:

1. Download Back-to-School Vaccine Calendar: BTS Summer 2025 – July and August

2. Sign-up for Back-to-School Vaccines at the QR Code:

 

 

3. Check out Additional Calendars:

YWCA San Antonio (vaccine calendar)
The University of Incarnate Word (UIW)

 

 

 

San Antonio, Texas — Health Confianza’s partner, the WestCare Foundation, is hosting a Summer Extravaganza summer program for children and teens. It is also co-hosting a mental health symposium in late June, and is capping September with family summit on mental health and substance misuse.

Check out the flyers below to see how you can get involved:

 

 

 

 

 

 

 

 

For More Information About the WestCare Texas Summer Extravaganza 2025 Call: 726-229-0795 Email: LeReta.GatlinMcDavid@westcare.com or Julie.Jones@westcare.com
Download the flyer here.

 

 

 

 

 

 

 

Pre-registration is required. Use the QR code to register.

Please Register by September 26, 2025, by clicking this link or copy and paste into your browser: https://stxhidta.org//
Download the flyer here.

San Antonio, Texas — Back-to-school health fairs are a fun way to provide families with the tools they need to stay healthy. Here’s an evolving round-up of upcoming back to school events that include health and community resources. Some may also offer vaccines for children and adults, but keep in mind that it may require pre-registration.

• Back-to-School Extravaganza, July 24th
• South Central AHEC’s Back to School Health and Wellness Fair, Q&A with a doctor and psychologist, Aug. 2

Download Flyer: 2025 Back to School Flyer (PDF)