Providers with the Kenaitze Indian Tribe have opened up COVID-19 vaccinations to all Indian Health Service beneficiaries 16 and older.
As of Wednesday night, a small team of medical staff at the Dena’ina Wellness Center in Kenai had vaccinated 427 people, said Sheilah Kean, a registered nurse and primary care practice manager with the Tribe.
“Our Tribal council had made that decision to open it up by 10 years each week," she said. "But the priority for that week is always going to be the oldest on that list.”
Under guidance from the Trump administration, U.S. Tribes are treated as sovereign governments in the vaccine allocation process. As such, they’re receiving special shipments through the IHS.
That’s why many Alaska Tribal providers have been able to open up their vaccination tiers to more age groups, while the state is still limiting eligibility to healthcare providers and Alaskans 65 and older.
The Tribe reserved its early doses for elders and people with other underlying health conditions. As they vaccinated more people, they opened eligibility to individuals 55 and older, then 45 and so on.
Kean said the Tribe orders the maximum amount of doses it thinks it can administer with the staff on hand, which at the moment includes a pharmacist and nurses who rotate shifts. At first, they were vaccinating between 15 and 20 people daily.
“Now that we’ve got our processes smoothed out, we can usually do about 40 a day," she said.
Kenaitze providers are getting new shipments from the IHS every week. That’s because doses of the Pfizer-BioNTech vaccine can only last outside ultra-cold freezers for up to five days.
In February, they’ll get 400 first doses, most of which are from the IHS. Fifty are from the state — the first shipment from Alaska that the Tribe will receive since a small one early on, meant for the vaccine providers themselves.
Despite the expanded eligibility criteria, not every person who’s eligible has come in to claim their dose. And it’s hard to know exactly how many people are eligible. Kean said the Wellness Center has an adult patient population of 4,800 people.
“Those are probably not all the people that are currently receiving services here but that just have in the last three years," she said. "So that gives us a pretty good ballpark number.”
But that number doesn’t account for those who may have moved. Also, people who have not used Wellness Center services are allowed to get the vaccine from the clinic.
Overall, Kean said reception has been good. She expects there will be even more interest with time.
“You know, in this culture they definitely respect their elders and take their lead from their elders," she said. "And so having so many of the elders to come in and get the vaccine, and then being vocal about it, is definitely helping the younger people decide to follow suit.”
Diana Zirul was one of the first in the Tribe to get vaccinated. She’s the treasurer of the Tribal Council and chairs the Tribe’s Kahtnuht’ana Dena’ina Health Board.
“Our providers are very aware of the safety of the vaccine and providing that information to our un’ina, who are our customers, the beneficiaries that we serve," she said. "And so they provide a lot of education during a normal visit and then the vaccine is offered at that time. We have postings over at the Dena’ina Wellness Center that open the door for people to ask questions about the vaccine. We have sent out newsletters to our membership and on our website we have information about the vaccine.”
Part of the justification for the separate IHS allocation is that the pandemic has had a disproportionate effect on Alaska Native people. Kean said while the long-term effects of the virus are still largely unknown, they’ve been relatively fortunate in how Kenaitze Tribe members have experienced the virus in the short term.
“We’ve definitely seen cases but we haven’t seen the death tolls that they’ve seen in other locations," she said.
Dena’ina Wellness Center staff administer vaccines between 8:30 a.m. and 4 p.m. every weekday. Like other providers, they have a shortlist of people who could come in at a moment’s notice, in case there are cancellations.
They're also holding a Saturday clinic in February. To be eligible for a dose, you must be a beneficiary of the Indian Health Service. Those who have not previously used Dena'ina Wellness Center services are still eligible.