National Post (National Edition)
Indigenous communities overcome vaccine mistrust
Successful rollout follows training of local health teams
WE DO OUR BEST TO RESPECT AND NOT TO INFRINGE ON PEOPLE'S RIGHTS, BUT TO PROMOTE (THE VACCINE) AS SOMETHING WE COULD USE TO HELP BATTLE THE VIRUS. OF COURSE, THERE WERE THE SKEPTICS. — BERTIE WAPACHEE, CREE HEALTH BOARD
If Canada's Indigenous population was its own nation, it would rank five spots ahead of Canada on Bloomberg's world vaccine tracker, which compares countries based on how many doses of a COVID-19 vaccine have been administered per 100 people.
That's how successful the vaccination program has been in northern and remote Indigenous communities that have been prioritized in the rollout, despite the unique challenges of isolation and a history of vaccine hesitancy born of a mistrust of Canadian health care.
“We did really well during the first week,” said Bertie Wapachee, chairperson of the Cree Health Board. “... From that time on, we've managed to reach over 9,000 (people).”
The Cree Health Board provides health and social services to nine Cree communities in northern Quebec, near the James Bay coast. Its most northern communities are accessed by a single highway.
Wapachee said that turnout in his communities has been high since the first doses were delivered, but he acknowledged that vaccine hesitancy remains.
“We do our best to respect and not to infringe on people's rights, but to promote (the vaccine) as something we could use to help battle the virus,” Wapachee said. “Of course, there were the skeptics and the conspiracy theorists. Those that shared that type of information probably made some people hesitant and afraid of it.”
Indigenous Services Canada says at least 400 Indigenous communities have vaccinations underway and that “several First Nations communities or long-term care facilities have completed vaccinations.”
Cherilyn Georgekish is a Cree woman in her 20s from Wemindji, one of the communities the Cree Health Board oversees. She said she decided to get vaccinated to protect her loved ones, although there are some youth in Wemindji who don't want to get the shot.
“I know a lot of people don't want to get it,” said Georgekish. “Maybe they weren't really informed on how the vaccines really work.”
Michelle Driedger, a professor in the department of Community and Health Sciences at the University of Manitoba, was part of a team that conducted research on a focus group of First Nations and Métis people during the 2009 H1N1 pandemic and subsequent vaccine rollout, during which many Indigenous people in Manitoba were prioritized.
“That prioritization was met with a great deal of distrust,” Driedger said. “There were fears that, `The white guys can't even get it, so they're testing it on us before they decide it's safe enough.' ”
“Historically, when have Indigenous people ever been placed first in line to receive something good before?”
Indigenous Services Canada acknowledged that vaccine hesitancy in Indigenous communities is an issue it's working to manage.
“Vaccine hesitancy exists throughout Canada, but may be more acute in Indigenous communities given colonial context and realities of systemic racism in health care,” the statement said. “Addressing vaccine concerns and restoring public confidence and positive public attitudes towards vaccines is a priority for the Government of Canada.”
Indigenous people may have different reasons for vaccine hesitancy than non-Indigenous Canadians but they're no more likely to be vaccine hesitant than the general population, Driedger said.
Rather than specific mistrust of vaccines, Driedger said that past mistreatment of Indigenous people by Canadian governments has led to a general mistrust in the health-care system, and vaccines by extension.
“A lot of the Indigenous experiences around the management of tuberculosis, historically, saw people removed from their communities and placed into sanatoriums for their recovery,” Driedger said. “People back home never even heard if their loved one died and, if they did, those bodies were never sent back. That kind of legacy and trauma leaves a substantive mark.”
Indigenous leaders point not only to historic injustices, but also to everyday experiences as one of the reasons for mistrust in the health-care system.
The death of a 37-year-old Indigenous woman, Joyce Echaquan, in Quebec in September 2020 highlighted the racist treatment many Indigenous people are subjected to within the system.
Echaquan recorded nurses saying she was stupid and better off dead as she lay in pain before dying shortly after.
Compared to past pandemics, there's been more engagement of First Nations leadership in planning and management of COVID-19, Driedger said, and after months of delays, shipments of both Pfizer and Moderna vaccine doses are expected to increase in the coming weeks, which will allow for more Indigenous communities to set up or complete their vaccination programs.
But off-reserve, Métis, Inuit and urban Indigenous people tend to fall through the cracks during vaccine rollouts such as these, said Driedger, since they aren't under the jurisdiction of the federal government and are often overlooked by the provinces and territories.
Wapachee said that training local health teams in each of his communities on how to properly store, prepare and administer the vaccine before doses started arriving is what has allowed for the success of the rollout so far.
The Moderna vaccine was chosen for these communities in part due to ease of storage and transportation compared to the Pfizer vaccine. Moderna doses need to be kept at around -20 C, while the Pfizer vaccine must be kept much colder, at -70 C.
More than 9,486 people in the communities under the jurisdiction of the Cree Health Board have received their first dose — well over half of the entire population.
The communities in this region administered vaccines to those 45 years or older first, prioritizing elders and those with pre-existing conditions, then opened it up to anyone above 18. Other Indigenous health boards such as British Columbia's First Nations Health Authority have taken a “whole community" approach, in which everyone age 18 and over is offered immunizations right away.
Wapachee said that what helped the Cree communities in northwestern Quebec with any hesitancy or fears of taking the vaccine was to pair their vaccination program with prayer.
“It's part of our culture and we continue to use prayer with everything that we do.”
WE'VE MANAGED TO REACH OVER 9,000 (PEOPLE).