The New York Times
Lots of vaccinations, but not enough weapons: a warning sign in Cherokee Nation
TAHLEQUAH, Okla. While people across the United States are jockeying and waiting to be vaccinated, there is a surprising problem in the Cherokee Nation: many shots, but not enough arms. “We no longer have people to vaccinate,” said Brian Hail, who helps oversee the vaccination of the strain. He pulled over when he set up the day schedule a recent morning: vaccinations are open to everyone throughout the discussion, but 823 appointments are unclaimed. Tribal health officials said it was a side effect of early success. With many enthusiastic patients being vaccinated and new coronavirus infections on the decline, the urgency of vaccines is alarmingly quiet. Subscribe to The Morning Newsletter of the New York Times Now the tribe is facing what emerges as a major obstacle for the whole country as the vaccine supply swells to meet the question: how to vaccinate everyone who is not eager set up for a shot. This is a dizzying public health challenge that stretches across the country. It involves convincing skeptics, calling people who do not realize they are now eligible, and making vaccines accessible to home-bound patients, overworked families, and people in rural and minority communities. The Cherokee Nation has administered more than 33,000 doses at nine vaccination sites throughout its coverage, spreading from cities through rural woodland, pastures and poultry farms in northeastern Oklahoma. After the health workers, Cherokee-speaking elders and essential workers were vaccinated, the tribe opened appointments for anyone who qualifies, tribe member or not, who lives within its boundaries. Yet hundreds of slots have not been filled, health officials said. Cherokee-speaking vaccination schedulers hired to make appointments wait until their phones ring. “The initial waves of people really wanting and needing the vaccine – we worked through it,” said Hail, deputy executive director of external operations at Cherokee Nation Health Services. The tribe counts 141,000 citizens on the reservation and 380,000 worldwide. “We struggle to get people in.” Dennis Chewey, 60, gave his brother and sister the vaccination system of the tribe and asked them to switch. Chewey’s wife was at high risk for her job as a casino housekeeper, and he knew several people who died, including a health worker who helped him treat his diabetes. But none of them called. “They’re very eager to take it,” Chewey said minutes after he and his wife, Clara, received their second dose at the glittering new outpatient clinic. “They are my family. I can not let anyone do anything. Public health teams across the country are focusing their energy and resources on vaccinating people. They collapse into New York neighborhoods to reach people who are at home, and visit rural communities where unreliable internet makes it difficult to sign up for appointments or sign up for vaccination sites. They drive long dirt roads to reach families without the cars or gas money to visit vaccination clinics. The Navajo Nation, which says it has vaccinated about 70% of its citizens, has sent public health workers to rural corners of the high desert to vaccinate as many as 5,000 people near their homes. The Cherokee Nation is planning ‘strike teams’ of single-dose Johnson & Johnson vaccines. The Osage Nation, in northeastern Oklahoma, vaccinated about 200 people a day in a clinic that can give 500 shots. He tried two massive vaccinations at his casinos, but the results were disappointing. The tribe has therefore purchased two 30-foot medical RVs that will run out in smaller towns such as Hominy and Fairfax to reach the 30% to 40% of tribal elders and essential workers who have not been vaccinated voluntarily. It is a house-to-house campaign against misinformation and caution, conducted with long conversations and patience. “You’re fine-tuning it,” said Dr Ronald Shaw, medical director of the 23,000-member Osage Nation. “We tried to remove every obstacle for people sitting on the fence.” The coronavirus was particularly devastating to indigenous communities. It has killed American Indians and Alaska natives by nearly twice as many as white people, causing a cultural crisis by killing the elders who transmit language and traditional teachings. The economic toll of the pandemic has toppled indigenous economies that have already been plagued by extreme poverty and unemployment. The explosion of vaccines in indigenous communities has been a surprising source of strength, especially since vaccinations of other communities, such as black and Hispanic Americans, are still lagging behind the white population. If they work through the Indian health service and long-established networks of clinics run by tribal service, tribes cover a large part of the country and are already giving shots to healthy adults and suitable teenagers. Some even opened the doors to non-rural members within their borders. A total of 1.1 million vaccines were distributed by the Indian Health Service and 670,000 were administered. Health advocates said frustrating gaps still exist. Many indigenous people in large cities and areas without tribal health centers have struggled to find vaccines. Indigenous health workers are desperately hoping to get through to people like Nora Birdtail, 64, one of a shrinking number of Cherokee-speaking elders. Their names are indicated in a textbook created to record their importance to Cherokee heritage and culture. Today, the notebook is a register of loss – of at least 35 lives and numerous stories cut short by the virus. Even when hundreds of elders were vaccinated, Birdtail resisted. She is vulnerable to a stroke for the coronavirus. Her work as a teacher’s assistant brings her into close contact with children at Cherokee Immersion School, where personal classes are expected to resume soon. But Birdtail is afraid of being vaccinated, mainly because she died once after receiving a penicillin shot years ago. The government’s legacy of medical malpractices in the Indian country – a history of coercive treatments, sloppy care, forced sterilizations and more – has also aroused deep skepticism about taking a vaccine supported by the government. “It made me think back to the Trail of Tears, how they all got sick,” Birdtail said. “I do not trust it.” The number of Americans willing to be vaccinated has increased as people watch family and friends, politicians and Dolly Parton roll up their sleeves. About 18% of U.S. adults said they are unlikely or definitely not going to be vaccinated, according to a recent survey by the Census Bureau. Nationwide, people’s embrace of the vaccine has been sharply divided on biased lines, with a third of Republicans saying according to the CBS News / YouGov poll that they will not take the vaccine, with another 20% saying that they are uncertain. Ten percent of Democrats said they would not take the vaccine. Across the Cherokee Nation, people who have jumped in to be vaccinated have said they want to protect themselves and, more importantly, their community, older people and children who are not yet eligible to get shots. Those who were hesitant said they still had too many questions – about the effectiveness of the vaccines, side effects and the speed it brought to market. The three vaccines that received emergency authorization in the United States have been shown to significantly reduce serious illnesses and deaths due to the virus, and these have all been reviewed by government and external scientists. But the insurance had to reach another trailer in the Dry Creek community where Fred Walker, 65, had to fetch his drinking water from a neighbor’s house. Walker is unfit and is worried about the virus. But he avoided the vaccine because he feared it could harm his health. He said no health workers were issued to plan an appointment or answer his questions. “Nobody said anything about it,” he said. It seems like others just want a beating. At a Walmart survey, unvaccinated buyers said they were not so much opposed to it as just waiting. For more information. For a doctor’s recommendation. For more people to take it. Even in places where a lot of vaccination is done, some people are worried about stealing a spot. Shelldon Miggletto, a 4,000-person Cherokee and economic development citizen for the city of Stilwell (Strawberry Capital of the World), held out because he did not want to cut anyone with asthma or diabetes. Similar issues have arisen in Alaska, where the vaccines have not been filled because people do not realize they are eligible. The nurses who run the Cherokee Nation’s vaccination program are obsessed with how to recruit more people. They plan to be eligible for students at Sequoyah High School. There is talk of vaccinations at the braai, and T-shirts for newly vaccinated. The health service called mass texts and sent them out to ask unvaccinated members if they were willing to come in. Sherry Garrett, 68, was found in one of the messages. She and her husband had deep suspicions about the vaccine and intended to refuse it. But then her sister died in July after her family allegedly had an undiagnosed case of COVID-19 months earlier. Someone at Walmart coughs in Garrett’s face. And when a Cherokee health worker called to offer a lock, Garrett said she conceded and convinced her husband, Larry, to come along. While sitting in a half-empty monitoring area, waiting the necessary 15 minutes for Larry’s first dose, Garrett said she now sees the opportunity as part of who she was: ‘I’m Cherokee, so I have to do it. ‘ This article originally appeared in The New York Times. © 2021 The New York Times Company