Indian Country Continues to Protect its Citizens as Vaccination Efforts Go On

The COVID-19 pandemic has highlighted many disparities that exist in Indian Country. As sovereign nations, Tribes have the authority and responsibility to maintain the safety and well-being of their citizens. Throughout the pandemic, Tribal governments have enacted public health measures to limit exposure to SARS-CoV-2, demonstrating the resilience and innovation that exists within Tribal communities. For the past 18 months Tribal leaders, Tribal frontline workers, and Tribal citizens have worked tirelessly to protect elders, children, and the most vulnerable Tribal citizens. During a time of uncertainty, Tribal communities acted fast to mitigate the impacts of COVID-19. Responses included closing Tribal homelands  and implementing curfews.  Innovative strategies, such as the “colored paper project” were employed to deliver services while maintaining distancing.   The colored paper project was implemented by Wabanaki Public Health and Wellness, which serves four federally recognized Tribes in Maine. Last year they started using colored paper as a coding system for Tribal members to communicate their needs and receive supplies while maintaining physical distance.[1] Each colored piece of paper represented a different need. For example, blue meant the elder needed someone to talk to whereas yellow meant supplies were needed. Tribal elders would leave the colored paper on the door and staff would drive by and be able to know who needs what. This is one example of the work Tribes have done to help reduce the spread of SARS-CoV-2, the virus that causes COVID-19.

During the pandemic Indian Country has been proactive in the fight against COVID-19, not only in utilizing infection prevention strategies but in vaccine administration as well. As the more contagious Delta variant spreads, Tribal nations have done a remarkable job getting Tribal citizens vaccinated. Based on available race/ethnicity data, just over one million American Indian Alaska Natives (AI/ANs) are fully vaccinated. For example, the Sac and Fox Tribe of the Mississippi had 70 percent of its vaccine eligible citizens fully vaccinated as early as May 2021.[2] Some Tribes who incorporated guidelines into their emergency preparedness or vaccination plans extended their efforts and provided vaccines to non-native staff, non-native family members of native households, and surrounding border towns, which further protected their citizens.

Many vaccination milestones have occurred since the vaccine rollout. For instance, in August the Food and Drug Administration (FDA) granted full approval of the Pfizer-BioNTech COVID-19 vaccine for people ages 16 and older. This was the first vaccine to receive approval and provided additional confidence in the safety and efficacy of the Pfizer (Comirnaty) vaccine. There is hope that full approval will help vaccine-hesitant AI/ANs arrive at the decision to get vaccinated. Furthermore, full approval can provide additional support for vaccine mandates. The Department of Interior announced that all staff and faculty at Bureau of Indian Education schools must be vaccinated, which may in part be due to Pfizer receiving full approval. Vaccinating faculty, staff and students, in addition to infection prevention methods aids in protecting those who are not eligible for vaccination or cannot receive the vaccine due to a medical condition. Protecting the youngest and the oldest is vital in keeping Tribal communities healthy for generations to come.

As the pandemic continues, vaccination against COVID-19 is the strongest tool we have. Vaccines play a vital role in protecting AI/AN elders, children, and Tribal communities. All three vaccines, Pfizer (Comirnaty), Moderna, and Johnson & Johnson (J&J) are safe, effective, and available for use in Indian Health Service (IHS) facilities and Tribal health systems.  Additionally, the National Indian Health Board (NIHB) created the Act of Love campaign to encourage AI/ANs to show their love for their communities by adhering to simple Tribal public health precautions, such as wearing a mask, physical distancing, and getting the COVID-19 vaccine. United in our love for Tribal communities and culture, the Act of Love campaign seeks to reduce the spread and impact of COVID-19 in our Tribal communities. To learn more about what NIHB is doing to support and encourage COVID-19 vaccination, visit our and COVID-19 Tribal Resource Center websites. For additional resources on the COVID-19 vaccines visit the Centers for Disease Control and Prevention and Food and Drug Administration websites.

[1] Andrews, C. (2020, July 28). Why colored paper in a doorway is a key part of Maine tribes’ coronavirus response. Bangor Daily News. Retrieved from

[2] Hatzipanagos, R. (2021, May). How Native Americans launched successful coronavirus vaccination drives: ‘A story of resilience’. The Washington Post. Retrieved from