GREAT FALLS, Mont. – Josie Passes doesn’t want to get the COVID-19 vaccine when it becomes available.
Passes, 30, is a member of the Crow Nation, and, like many tribal members, she has seen firsthand the devastation of the virus. Her son tested positive but was asymptomatic, her father had COVID-19 and is slowly recovering, and her grandfather died of it.
For many, the promise of a vaccine offers hope and relief. But Passes is wary of its long-term consequences, which she said are unknown.
Though tribal communities have been disproportionately ravaged by COVID-19 nationwide, Passes is not alone in her reluctance. As tribes begin to receive and distribute COVID-19 vaccines, many tribal members hesitate to get immunized.
Some people fear Indigenous populations will be used as guinea pigs, while others are reluctant to trust the Indian Health Service. Some feel invincible, as tribes have survived devastating diseases, such as smallpox, and violent massacres. Many would prefer to wait and observe the effects of the vaccine as more people receive it.
Experts say the skepticism is warranted as tribes have experienced disinvestment, incompetence and brutality at the hands of the federal government. The consequences of such neglect transcend generations and manifest today as systemic inequalities, many of which were further exposed by the COVID-19 pandemic.
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In Montana, Native Americans comprise 6.7% of the state’s population. They account for 14% of the state’s COVID-19 cases and at least 25% of deaths from the virus, according to a Dec. 11 Department of Public Health and Human Services report.
Nationwide, Indigenous people are more than four times more likely to be hospitalized from COVID-19 compared with whites, according to Indian Health Service.
Because COVID-19 has disproportionately devastated Indigenous communities, the vaccine could be crucial to curbing the virus’ spread and saving lives. Experts say refusal in these communities to take the vaccine could be a “catastrophe.”
It’s up to tribal members themselves to dispel myths, correct misinformation and reassure their communities of the efficacy of the vaccine.
A legacy of maltreatment
It is not a surprise that Indigenous people mistrust the federal government and are skeptical of their health care system, which has been neglected for generations.
A National Congress of American Indians 2017 health care budget said the Indian Health Service (IHS) was “severely underfunded at only 59% of total need.”
Jason Begay, who is Navajo and an associate professor at the University of Montana School of Journalism, said he knows firsthand the frustrations of receiving tribal health care.
“IHS is kind of a joke. Everyone has jokes about waiting in line all day for a checkup. It’s pretty rudimentary care,” he said, adding that IHS workers are overworked and likely underpaid.
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“Compared to the medical care I get now that I’m insured, I can see a night-and-day difference in the quality and intensiveness of service,” Begay said.
Bryar Flansburg-Gilham, a Fort Belknap, Montana, public health nurse, vaccinates Belva Bell, a tribal health nurse.
This neglect is compounded with corruption and exploitation within IHS, said Joseph Gone, faculty director of Harvard University’s Native American Program.
“Some doctors have sterilized Indian women without their consent, which is an example of how corruption plays out in Indian Affairs that you don’t usually find in other sectors of government,” Gone said. “And Indian people know this. People know this, even if it wasn’t an official policy or widespread.”
Between 1973 to 1976, four Indian Health Service regions sterilized at least 3,406 Indigenous women without their permission, according to the National Library of Medicine.
Gone said the legacy of government exploitation and incompetence affects their communities today.
“We’re sensitized to and wary of government because we carry wounds of prior subjugation into current consciousness. It translates to acts of mistrust,” he said.
Gone said apprehension has amplified under the Trump administration.
“The president is dismantling the ability of the federal government to be competent and responsible. He muddies the waters of what’s truth and what’s false and amplifies anxieties and fears,” he said “So, for a lot of people, these past years have given them even more reason to worry.”
Employees and providers at the Great Falls Clinic receive the first batch of COVID-19 vaccinations in Great Falls on Dec. 16, 2020.’We can’t afford to lose more. We need this vaccine’
Though Gone understands why tribal members might be skeptical of the vaccine, their hesitance also gives him concern. Gone has lived all over Montana and is a member of the Aaniiih-Gros Ventre Tribe headquartered in Fort Belknap.
His father, who lived in Havre, died of COVID-19 in October.
“It would be a catastrophe if this kind of mistrust prevents us from accessing technology that could keep older people alive,” Gone said.
“When we lose an elder, we lose an entire body of knowledge, and we can’t afford to lose more. We need this vaccine.”
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Montana Medical Officer Gregory Holzman said it’s important for all government employees to “acknowledge the history and understand why groups may be concerned” about the vaccine.
“We want to be as transparent as possible to help people make an informed decision,” he said, adding that development and protocols for the COVID-19 vaccines have been strongly surveilled.
Mary Lynne Billy, transformation program officer with the Indian Family Health Clinic, addresses the Missing Indigenous Persons Task Force meeting.
Of course, not all tribal members are hesitant to be vaccinated.
Mary Lynne Billy, chief innovation officer of the Indian Family Health Clinic in Great Falls, said she has seen the opposite effect among the urban Indian population.
“We’re seeing an increased level of people wanting to take the vaccine,” she said, adding that the clinic, which serves more than 1,700 people across 92 tribes, has implemented a “one-to-one outreach” method to personally reach patients through phone calls, mailers and letters.
COVID-19: How to persuade someone to take the vaccine
Nicole Walksalong, a health care worker in Hardin, encourages people to educate themselves about the COVID-19 vaccine.Getting creative to gain trust
When Nicole Walksalong, a social worker in Hardin, Montana, got her COVID-19 vaccine on Dec. 17, she made sure to record a video.
She’d heard rumors and misconceptions surrounding the shot and wanted to show her community that she felt safe getting immunized.
Walksalong, 33, is Blackfeet. She said she had “zero hesitation” when it came to getting the vaccine. She has four children, and her husband is a front-line health care worker, so she was eager to reduce the risk of infecting her family.
“I’m hearing from patients that they’re fearful. They fear the plan is to vaccinate Native Americans and ‘get rid of us that way,'” she said.
“But it’s important for people to do research and make the right decision for themselves and their family. Education is key.”
Walksalong said she had no side effects after receiving the vaccine, other than slight soreness in her arm, which she expected.
Like Walksalong, other tribal members who received early allocations of the COVID-19 vaccine share their videos on Facebook Live.
Cal Walks Over Ice, a member of the Crow Tribe, said he shared a video “to show people it was a normal shot procedure.”
Mary Foote, a member of the Northern Cheyenne and Crow tribes, said she tries to reassure her communities of the vaccine by appealing to her husband’s reputation as a medicine man.
She said some tribal members prefer to use traditional medicines, rather than a vaccine, to combat COVID-19. But she hopes her husband’s willingness to be immunized will open people’s minds.
“I know people trust him, so I try to speak up about it,” she said, adding that she often shares vaccine information on social media.
“There’s some thinking that we don’t need a vaccine because we can go to sweats or pray, and that’s good, I believe in the power of prayer, too,” she said. “But the vaccine is something good. We shouldn’t be afraid of it.”
Foote said she and her husband have lost multiple relatives to COVID-19.
“I want people to understand that we can do both. We can believe in our Indian ways and we can believe in science in this new, modern world,” she said.
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The Pikuni Press and Newsfeed, a Facebook page that shares news related to the Blackfeet Nation, published an editorial addressing mistrust of the vaccine and encouraged readers to “examine your fear with a strong measure of reality.”
The editorial acknowledged that it’s “hardly surprising that the poor, a large portion of whom are minorities, do not trust the health care system,” but it urged readers to overcome their fears to “eradicate the real, current enemy” of COVID-19.
James McNeely, public information officer for the Blackfeet Nation, said the tribe received a shipment of Moderna vaccines Wednesday and is following Centers for Disease Control and Prevention guidelines, which prioritize immunizations for front-line health care workers.
As vaccines arrived on the reservation, the tribe’s COVID-19 Incident Command shared an announcement featuring a shaggy “rez dog” puppet, who speaks interchangeably in English and the Blackfoot language.
The Blackfeet Nation’s “Rez Dog Rep” asks a family nurse practicioner about the COVID-19 vaccine in a humorous and widely-shared PSA.
In the video, the self-identified “Rez Dog Rep” asks a family nurse practitioner questions ranging from the cost of the vaccine and whether he will need to continue to wear a mask after being immunized to who gets it first and potential side effects.
The video was shared widely after it was posted.
“Indian people like humor,” McNeely said. “The idea of the PSA is to help ease people’s minds, give them a sense of comfort and an education on the vaccine.”
After hearing from the nurse practitioner, the Rez Dog Rep concludes he will get the vaccine.
“If all the doctors and medical professionals say the vaccine is safe, then I’ll say it’s safe, too,” he said.
Follow reporter Nora Mabie on Twitter @NoraMabie.
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This article originally appeared on Great Falls Tribune: Some Native American Tribal members hesitant to get COVID-19 vaccine