COVID-19 Vaccination Successes in Indian Country

American Indian and Alaska Native (AI/AN) populations have been disproportionally impacted by COVID-19, with reports demonstrating impact at rates higher than any other population.[1] In December 2020, the world received welcoming news on the best hope to address the pandemic: vaccinations. The vaccines reached Indian Country quickly, an outcome for which the National Indian Health Board (NIHB) strongly advocated. Tribes were able to move swiftly to distribute the vaccine to their communities, resulting in AI/ANs receiving the vaccine at a rate that succeeded other racial and ethnic groups in the U.S.

While data on COVID-19 impacts and vaccinations remain incomplete (e.g. race is only known for about 80 percent of COVID deaths and 65-70 percent of those vaccinated), the numbers are sufficient to show the success of vaccine distribution in Indian Country. The vaccination rate for AI/ANs is higher than for any other racial or ethnic group, this national data includes the majority of AI/ANs who do not live on or near Tribal homelands. Reports from a number of Tribes suggest they have achieved vaccination rates even higher than those nation-wide. One can see evidence of this in counties with large AI/AN populations. Glacier County in Montana, for example, reports a vaccination rate of 83 percent. McKinley County, New Mexico boasts a vaccination rate near 100 percent.

These successes are even more remarkable considering the comparably low vaccination rates in counties and states surrounding these Tribes. The counties around McKinley, New Mexico have vaccination rates as low as 30 percent. The Navajo and some Tribes in Montana report vaccination rates over 70 percent, compared to the 56 percent and 50 percent overall vaccination rates in Arizona and Montana, respectively. Alaska Native Health Organizations also reports vaccination rates over 70 percent, compared to only 52 percent for Alaska statewide. These higher rates show that vaccination strategies used by Tribes, like incentives and workplace and enterprise policies, have had significant success.

Due to the effectiveness of Tribal vaccination efforts, the disproportionate impact of COVID-19 on AI/ANs has receded since the early days of the pandemic. COVID-19 deaths for AI/ANs drastically declined in the weeks after the vaccine became available. The allocation and early distribution of vaccines by Tribes were efficient and saved lives, enhancing the success of additional public health measures like social distancing, closures, and mask requirements.

With the ever-changing nature of the COVID-19 pandemic, expert estimates have varied on predictions for the vaccination rate necessary to achieve herd immunity. With new variants emerging, full herd immunity may not even be possible. The Delta variant has been deadly and the weekly increase in deaths for AI/ANs reached 107 in the first week of September 2021, according to the Centers for Disease Control and Prevention (CDC). However, continuing to increase vaccination rates – and administering booster shots as recommended – remains our best chance of curtailing the deadly impact of COVID-19 in our communities.

We can celebrate and learn from our successes while continuing the important work of ensuring every member of our AI/AN communities are fully vaccinated.