The Pfizer COVID-19 vaccine arrived at several California hospitals this week, where it was given to frontline health care workers.
A parallel roll-out is occurring at several of California’s tribal clinics, with many more expected to receive the Moderna vaccine for their health workers in the coming weeks. Tribal leaders say it’s important that Native people be prioritized, considering the disproportionate impact the virus is having on their communities.
But there is hesitancy from many Native people, given a historical distrust of the federal government and some ingrained cultural beliefs around immunization. Many of the state’s tribal health organizations are working to educate community members about the vaccine.
The Indian Health Service (IHS) says 975 doses of the Pfizer vaccine have been distributed to the Pit River Health Service in the small Shasta County town Burney, because it has the required ultra-cold storage. Seven other IHS clinics have signed on for this round and are currently coordinating how to pick the vaccine up. Once they get it back to their own sites, they’ll have a limited window in which to distribute the doses to health workers before they expire.
At Chapa-De Indian Health in Auburn, chief executive officer Lisa Davies says they opted not to receive the Pfizer vaccine in this round because of the logistical challenges.
“Had it been able to be produced in quantity, that would’ve made a lot of sense then,” she said. “We would’ve been able to vaccinate our employees and some at-risk patients. But why with such a small quantity would you invest in the equipment when you don’t know if it’s going to be the vaccine of choice down the line?”
IHS plans to distribute more than 5,000 doses of the Moderna vaccine to California tribal clinics once it’s authorized for emergency use. Earlier this year, tribal clinics had a choice of working with their counties to receive vaccine allotments from the state, or receiving doses from IHS.
Davies says her staff is gearing up to be able to receive the Moderna vaccine from IHS.
“Just working out the logistics of a vaccine that will require two doses and all that entails, and the new reporting requirements to the CDC,” she said, referring to metrics about adverse events and how many people return for a second dose.
“We’re used to vaccines,” she said. “For the flu, for children. This seems like a new animal.”
On top of the logistics, there are cultural concerns to consider when promoting vaccination among Native residents.
Virginia Hedrick is a Yurok tribe member who heads the California Consortium on Urban Indian Health, serving 10 tribal clinics throughout the state. She says when news got out that the vaccine would be available, there were a range of reactions from programs. One clinic told her less than 20% of their staff wanted to take the vaccine, while another told her nearly 70% of workers would.
“You take into account this new vaccine under administration that has been atrocious to Indian country — are we lining up to take it or are we saying maybe you go first?” Hedrick said. “I myself have been doing my own personal public education campaign around the vaccine with Facebook lives and posting and getting a lot of questions all the time.”
She says the hesitancy dates back to a long history of Native Americans distrusting the U.S. government due to the violent acquisition of tribal land, the spread of infectious diseases like smallpox and measles from white colonizers, and later the involuntary sterilization of Native Women.
“In terms of this pandemic, has it triggered historical trauma? Absolutely,” Hedrick said.
She says for those reasons, Native people tend to rely more on traditional healing practices and spiritual gatherings. And they’ve continued to do so, even during the pandemic.
“We know from a public health perspective that gathering in close proximity, those are considered super spreading events,” she said. “And yet we do see tribal communities doing this, because that's how we know how to heal ourselves. That's what's in the fabric of who we are. Is that also reckoning historical trauma from early spreads of infection? Absolutely.”
There’s also a cultural belief around “speaking things into existence.”
“You don't speak a bad wish because then you're wishing it into happening,” Hedrick said. “So if your provider says, ‘I'd like to give you a COVID test,’ the very fact of saying, ‘yes, I think I need a COVID test,’ are you then giving that energy?”
But Hedrick says there are also traditional teachings related to immunization, such as consuming poison oak early in the season to prevent a reaction on your skin later in the summer months. She and other tribal leaders are building on those traditions, and on messages about protecting family members and elders, to try to promote adherence to the vaccine in effort to slow the spread of the virus among tribes.
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