Reflecting on the Native Americans’ Vaccination Success

With about 145 million people having received at least one dose of the vaccine, the United States is now one of the top vaccinated nations in the world¹. To help reach president Biden’s July 4th goal, many states are currently coming up with additional ways to help to boost vaccination rates². These methods include but are not limited to allocating additional vaccine doses for heavily affected regions, setting up call centers for people who may not have easy internet access or are inept at navigating online signup, and clarifying upfront on the free-of-cost aspect of the vaccine, etc.

However, looking at the current data, it is not hard to notice that racial disparities in vaccination across the states are still an issue despite the current climbing inoculation rate and effort³ ⁴.

It is important to note that both Latino and Black Americans have made major vaccination progress since the beginning of March 2021. There were only about 5% Latino and 7% black Americans who received at least one dose of the vaccine back then³. Within a little over a month, these numbers improved to 22% and 21.8% respectively⁴. However, when comparing to the national average vaccination rate, there is still a significant lag. To further address this lag, various barriers such as vaccine hesitancy and access issues need to be overcome.

Why is it helpful to learn more from Native American’s vaccination experience?

Being gravely impacted by COVID-19, the Native American community’s mortality rate reached an all-time high just about 2 months ago⁶. In fact, the Native American’s COVID mortality rate was the highest among all ethnic groups in March. The tragedy has transformed into great motivation and the Native American communities are doing a great job at rolling out vaccines for their people.

Over 30% of the Native Americans were vaccinated with at least one dose of the vaccine⁴. In some communities, nearly 90% of its elders were vaccinated and the communities are extending eligibility to even non-Native adults outside of the community⁸. 

With about 18% of Native Americans without broadband internet access, 26.8% living below the poverty line, 75% of its existing roads unpaved, many native Americans are living in harsh conditions that are not ideal for vaccine outreach. Therefore, the vaccination rate is even more impressive than the number alone suggests⁷. Though many Native Americans had traumatic experiences that led them to be skeptical of the medical community due to incidences such as the law that led to mass sterilization in 1970, survey suggests that over 75% of the Native Americans were willing to receive COVID vaccine thanks to the community’s relentless effort⁹ ¹³. 

The Native American’s difficult living conditions that lead to vaccine access issues and the precursors to vaccine hesitation can be found in many of the American Ethic groups¹⁴. The Native American’s success at overcoming these barriers can help to address the current racial disparities in vaccination⁷.

So how have the Native Americans been addressing the challenges and inoculating their community so quickly?

1. Spending upfront effort to build trust.

Many native American communities had their esteemed elders getting vaccinated on TV to help to advocate for the vaccine. Additionally, sharing culturally relevant messaging such as the rationale behind vaccination and its effect on protecting others in the community helped to boost the sense of duty that people cherish[10]. This helped to avoid people thinking that they are not vulnerable to the effect of infection, and therefore vaccination is not needed.

2. Addressing vaccine-related questions frequently and publicly

Townhall meetings have been used to address questions that people have about the vaccine. Additionally, there are open hotlines on the radio to address additional concerns that anyone may have and share the knowledge publicly. Some native American communities also brought in experts, such as Dr. Fauci to help further address people’s questions.

3. More efforts to avoid wasting vaccine and to deliver to as many people as they can daily

The Native American communities are going the extra mile to deliver the vaccine to their people, literally¹¹. Many Native Americans don’t have internet access or are living in very remote places that have extreme temperature conditions. The tribe’s vaccination task force would drive the vaccine to them and come up with creative solutions to maintain the appropriate storage temperature for the vaccine or provide vaccine under uncommonly cold temperature¹². These efforts not only extended their reach but also decreased the number of wasted vaccines.

4. Using familiar community gathering places and respecting people’s needs

Many Native American communities are choosing their common community gathering facilities to inoculate people so that people in need can also get a warm meal in the process and feel more comfortable being in a familiar place. Additionally, some of the vaccination centers and task forces such as the Indian Health Service allow people to follow traditional practices that are important to many people¹³.

To ensure the safety of the community, Native Americans had made a great effort to ensure fast and effective vaccine rollout among their people. Despite the difficult situation as a result of their harsh condition and traumatic past experience, creative and diligent task force combined with culturally relevant campaigns and outreach methods led to an impressive success story. Learnings from this success story can be implemented for other minority groups who are currently lagging in terms of their vaccination rate to help protect additional people who are at great risk of the COVID infection quickly.

References:

1. https://ourworldindata.org/covid-vaccinations
2. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-are-states-addressing-racial-equity-in-covid-19-vaccine-efforts/
3. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/
4. https://www.apmresearchlab.org/covid/vaccines-by-race
5. https://www.ama-assn.org/delivering-care/public-health/how-overcome-covid-19-vaccine-hesitancy-among-black-patients
6. https://www.apmresearchlab.org/covid/deaths-by-race
7. https://www.ncai.org/about-tribes/demographics
8. https://twitter.com/LtGovFlanagan/status/1368683563244269577?s=20
9. https://time.com/5737080/native-american-sterilization-history/
10. https://www.uihi.org/projects/strengthening-vaccine-efforts-in-indian-country/
11. https://www.kff.org/racial-equity-and-health-policy/issue-brief/covid-19-vaccination-american-indian-alaska-native-people/
12. https://www.npr.org/2021/02/19/969046248/why-native-americans-are-getting-the-covid-19-vaccines-faster
13. https://www.ama-assn.org/delivering-care/population-care/siobhan-wescott-md-mph-discusses-vaccination-native-american
14. Razai M S, Osama T, McKechnie D G J, Majeed A. Covid-19 vaccine hesitancy among ethnic minority groups BMJ 2021; 372 :n513 doi:10.1136/bmj.n513