Indian Health Service plans for COVID vaccine distribution

FLAGSTAFF, Ariz. (AP) — The federal agency that provides health care to Native Americans said Friday it will receive more than enough vaccines to protect all the people working in hospitals and clinics, including doctors, nurses and support staff.

The Indian Health Service, treated much like a state for distribution purposes, submitted a plan to vaccinate more than 2 million Native Americans and Alaska Natives. The agency expects to receive 22,425 doses of the Pfizer vaccine next week and 46,000 doses of the Moderna vaccine before the end of the year, officials said.

More than 44,000 people work at the 338 facilities that chose to get the vaccines through the Indian Health Service. Other tribal health facilities opted to be covered under states' allocations.

The ones under the Indian Health Service are encouraged to follow U.S. Centers for Disease Control and Prevention guidelines, which prioritize health care workers, said Rear Adm. Francis Frazier, who is leading the agency's COVID-19 Vaccine Task Force. Tribes can deviate from the guidelines. For example, a tribe might consider elders as being 55 and older, rather than 65.

"They really are the best determinants of the needs of their population," he told The Associated Press.

The Navajo Nation is expecting 3,900 doses on Monday and Tuesday that will be delivered under police escort, said Dr. Loretta Christensen, the chief medical officer for the Navajo area Indian Health Service. About 7,900 doses of the Moderna vaccine should arrive the following week.

Those vaccines will cover healthcare workers, emergency medical staff, traditional practitioners working in Indian Health Service facilities, and the staff and patients in long-term nursing facilities, Christensen said.

The first in line for vaccinations within the Cherokee Nation in Oklahoma includes hospital workers, first responders, and participants and workers in the Cherokee Elder Program. Those whose first language is Cherokee and others considered tribal treasures would follow.

"I know some of our Cherokee elders may have reservations about taking the vaccine," Cherokee Nation Principal Chief Chuck Hoskin Jr. said in a statement. "But it will save our elders, our speakers, our national treasures and frontline workers."

The Navajo, Phoenix and Oklahoma City areas serve the largest populations of Native Americans, meaning they will get more vaccines than other Indian Health Service areas. The Alaska region chose to get allocations from the state, while one facility in the Navajo area — the Utah Navajo Health System — also went with the state for distribution.

The Seattle Indian Health Board chose to get its allocation from Washington because of its relationship with state officials and knowing that the Indian Health Service is chronically underfunded, said Abigail Echo-Hawk, the board's chief research officer.

"Making us choose one or the other is, in my perspective, a very bad decision," she said. "It is limiting our access to life-saving vaccines. We need as much access as possible because we have been more disproportionately impacted."

Like others, she expects some hesitancy in Indian Country.

Tribal health facilities across the U.S. have relied on elders as trusted members of the community to advocate for previous vaccines, as well as messaging that promotes protection of the next generation, Indian Health Service officials said.

Annarita Begay has been researching the coronavirus vaccines but still has questions about any adverse, long-term effects. Still, she's keeping an open mind because she is considered an essential employee and has a grandmother and other high-risk people at home.

"(It's) kind of like a pick-your-poison game at this point," said Begay, who is Dine, the Navajo word for "the people." "If you have underlying conditions like asthma, high blood pressure, obesity, diabetes, you either have that and get COVID, or you take a vaccine and experience some side effects later on."

"If I could get it, I would probably be setting an example for my own family to see how it would work," she said.

Crystal Kee, a 43-year-old Navajo woman who works in early childhood development, wouldn't be among the first group vaccinated. But she encouraged anyone who is able to get the vaccine to help protect children, the elderly and healthcare workers.

"Along this entire journey has been significant heartbreak and loss," said Kee, of Steamboat, Arizona. "In terms of just the vaccine development, I feel like it offers us a glimmer of hope and protection, not selfishly ... but really for others."