National Indian Health Board (NIHB)

To our Partners in Tribal Health and Public Health:

 

As experts agree and data has shown, getting a COVID-19 vaccine is the most effective defense strategy we have against the virus. Longstanding inequalities fueled by federal policies have helped fuel COVID-19 spread in Native American communities. The American Indian/Alaska Native (AI/AN) population sees infection rates more than 3.5 times the average infection rate, hospitalization rates four times higher than average, and mortality rates higher than white Americans¹. As of January 14, 2022, nearly 8.5 million children have tested positive for COVID-19 since the onset of the pandemic². COVID cases among children are extremely high: nearly 580,000 child cases were added the past week, an increase of nearly 78% over the last two weeks².

 

The effects of the pandemic on Tribal communities left many AI/ANs with a sense of urgency toward getting their COVID-19 vaccine. Native communities met this challenge and overall, Tribal communities have shown remarkable achievement in administering COVID-19 vaccinations. According to data from the Centers for Disease Control and Prevention (CDC), AI/AN people are being vaccinated at a higher rate compared to other racial/ethnic groups⁵. The high vaccination rate among AI/AN people largely reflects Tribal leadership in implementing vaccine prioritization and distribution strategies that meet the preferences and needs of AI/AN communities across the country. Tribal systems equipped with the infrastructure in place to successfully administer vaccines are another important factor to success. This is no surprise, as pre-pandemic data shows Tribes being the main providers of adult and childhood immunizations in their communities, with 80% and 78% respondents reporting that service, respectively⁶. According to data from January 14, 2022, nearly 1.4 million eligible AI/ANs ages 12 and older have been fully vaccinated against COVID-19, and over 1.6 million have received at least one dose of the COVID-19 vaccine⁵, but, as suggested by recent data, COVID-19 vaccine coverage is the lowest among 12-15-year-olds⁷. This could be due, partially in part, because the Pfizer (now Comirnaty) vaccine is the only available COVID-19 vaccine authorized for use for youth ages 12 and older. Compared to the overall vaccination rates for Americans ages 18 and older, the overall youth (12-17) vaccination rate is 24%⁸.  

 

On October 29, 2021, the U.S. Food and Drug Administration (FDA) authorized the Pfizer-BioNTech vaccine for emergency use in children ages 5-11. This is something to be excited about! The pediatric vaccine is different from the adult vaccine – not only does the pediatric vaccine use smaller doses, but it also has different packaging, making it easily recognizable for healthcare providers. During clinical trials, Pfizer’s youth vaccine showed similar levels of protection compared to the adult vaccine. Young children are still growing and developing; therefore, research and trials are done to evaluate the immune response and ensure the safety of our youth. According to the FDA, this process is expected to include a follow-up period of at least two months, to allow for proper safety monitoring following the administration of vaccine doses for at least half of the clinical trial vaccine recipients.  Additionally, there were no cases of myocarditis during the pediatric dose clinical trial. As we’ve seen throughout the COVID-19 pandemic, AI/AN adults have been disproportionally affected by COVID-19, and data have suggested the same thing for AI/AN youth⁵. On January 5, 2021, the CDC expanded booster shot eligibility to include youth ages 12-15 years old. At this time, only the Pfizer vaccine is authorized and recommended for Native youth ages 12-17.

 

Culturally relevant data is limited, as most data sources do not report the race/ethnicity of vaccinated people by age. However, as of January 14, at least 4.8 million children aged 5-11 have received a dose of the Pfizer COVID-19 vaccine, which is roughly 17% of eligible kids in that age group¹¹. Although we won’t know for sure until more children are vaccinated, we can assume that there will be a correlation between parental vaccination status, and their feelings about the COVID-19 vaccine, and the vaccination status of their child(ren). The increase in eligibility for AI/AN children and youth can help increase the number of fully vaccinated Tribal citizens and provide additional protection for Tribal communities.

Early in the pandemic children could not go to school, hang out with their friends, see their loved ones, or even really have the experience of being a kid. Data has shown that adolescents, and parents of young children (5-12 years old), reported worsened emotional, cognitive, and mental health³. Access to mental health care via telehealth has increased, however, access to mental health care in schools – a common source of care for school-aged children – has likely decreased due to school closures during the pandemic³. Additionally, once schools transitioned to a virtual model, a lack of internet access – an issue for thousands of children across Indian Country – was a barrier that was extremely challenging to overcome. This, in part, is why it has been so important to get Native youth safely back into the classroom. As schools across the country have opened back up for in-person learning, it is more crucial than ever to protect our Native youth. To further protect students, the Bureau of Indian Education (BIE) mandated COVID-19 vaccines for employees to help prevent future COVID-19 outbreaks and to protect the students and faculty at BIE-operated schools.  

 

Despite the hardships they faced throughout the COVID-19 pandemic, several Tribes across the country have made significant progress in vaccinating their populations. Data has shown that AI/ANs have the highest COVID-19 vaccination rate in the country¹. As of June of 2021, the Blackfeet Nation reported that roughly 98% of the reservation’s eligible population has been fully vaccinated against COVID-19⁹. Approximately 90% of eligible AI/ANs in Virginia have received at least one dose of the COVID-19 vaccine as of August 2021¹⁰. Tribal nations have more than proved their resiliency in the past and are continuing to do the same today. We’re all hopeful that the end of this pandemic comes to us sooner rather than later, but until then, we still need to be diligent in protecting ourselves and others from COVID-19. It is important to continue to show your Acts of Love to your community by wearing a mask, washing your hands for at least 20 seconds with soap and water (or using hand sanitizer), getting your COVID-19 vaccine if you haven’t yet, staying physically distanced, and getting tested for COVID-19. There are several in-person and home testing options available to Tribal members across the country. To learn more about how to show your Acts of Love for your community, visit the NIHB website.  

 

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