IHS director praises Fort Belknap vaccine work

The head of Indian Health Services was in north-central Montana Tuesday, complimenting the work being done in vaccinations on Fort Belknap Indian Reservation.

Fort Belknap Hospital and the Fort Belknap Tribal Public Health Department continue their efforts to vaccinate as many people in the area as possible, and have been recognized by IHS as performing better than any area in the region.

Indian Health Services Acting Director Elizabeth Fowler visited Fort Belknap Hospital after a brief visit to their satellite facility in Hays and said Fort Belknap's work distributing the vaccine has been admirable.

Fowler said the areas IHS serves had a seven-day-average positivity rate in the double digits at the beginning of the year, but now they are at 2.9 percent.

She said some regions are seeing spikes, but for the most part areas under IHS care have stayed below 5 percent. She said lower is always better, but anything under 5 percent is still good.

Fort Belknap Service Unit CEO Jessica Windy Boy, an enrolled tribal member, said more than 60 percent of the people on Fort Belknap 18 and older have received a vaccination and a recent shipment of the Pfizer vaccine has enabled them to shift their focus to vaccinating 16- and 17-year-olds.

A vaccination clinic was held at Harlem High School Tuesday.

Windy Boy said IHS and tribal public health have been coordinating during the pandemic and effectively working as one system with tribal health taking the lead, supported by IHS.

"In my opinion (the reason we're doing so well) is the partnership we have with our tribal health department," she said.

Public Health Nurse Cindy LaMere said it has been a frightening year for many on Fort Belknap, even if they didn't start seeing a significant amount of positive cases until September.

Fort Belknap reported on its tribal council Facebook page Monday evening that the reservation has had 430 total confirmed cases, with one active now although it has no active hospitalizations and has had 12-COVID-19-related deaths on the reservation.

LeMere said that, after the cases started coming in, public health needed to do a lot of case investigations and contact tracing, but since the vaccine has come out administering it has been their primary concern.

"It's so much better now that people are getting vaccinated and we can find a reprieve now," she said.

LaMere said her department has found great success in getting the vaccine to as many as possible, partially by, in her words, bugging people.

"We'll be in the grocery store and be like, 'Did you get your vaccine, did you get your vaccine?'" she said.

She said since Fort Belknap started vaccinating non-Native Americans she's seen people come from as far as Belgrade for the vaccine and most people are just relieved to be able to get it.

LaMere said, despite ongoing successes in vaccine administration, people in the community still need to wear masks, socially distance and practice hand hygiene, especially with COVID-19 variants becoming more common in the state.

Windy Boy said the pandemic has been a difficult situation to deal with, especially early on, though she did say that the Centers for Disease Control's assistance with mass testing events was very helpful.

"The hardest part of this vaccination effort was trying to get our elders and the most vulnerable vaccinated first, and that's just because we were limited in the amount of vaccine we were getting," she said.

She said they were also able to vaccinate educators early.

"I truly believe that saved lives," she said.

Fort Belknap is now able to vaccinate more students using the Pfizer vaccine, but Windy Boy said, even with access to an ultra-cold freezer, the it can be difficult to work with because it requires such low temperatures to store properly.

In fact, they will be vaccinating 16- and 17-year-olds in Havre Thursday.

Fowler said IHS has distributed 1.5 million vaccines so far and the roll-out is proceeding swiftly and continues to expand its scope.

"The roll-out is to the point now where many sites across IHS's areas of service have opened up to vaccinating community members who are not Native Americans," she said.

She said IHS' vaccine supply has grown to the point that they no longer have a centralized allocation system for various areas and these sites can just order as much as they need. This growth in supply has been enabled by significant vaccine production increases across the U.S.

"We're really happy about that," she said.

She said the Biden Administration's focus on increasing production in the months since he took office has been extremely helpful to IHS, and things have changed significantly for the better since.

Fowler said she wasn't in her current position during the Trump Administration so she can't make a perfect one-to-one comparison but she spent years in a senior leadership role at IHS' headquarters and the amount of support from the Whitehouse has been greater than it was any other administration she's seen.

She said IHS has a unique position within U.S. Department of Health and Human Services in that they provide direct health care delivery, while other organizations under the department mostly work in grant writing and resource management.

She said this unique position often causes them to be overlooked when policy decisions are made for HHS, but under the Biden Administration that situation has improved significantly.

"We stick out like a sore thumb, but they forget about us sometimes and they forget that we're different," she said. "But now we're not constantly raising our hands and saying, 'Don't forget about IHS' when they issue policies or guidance, because they brought us into that. ... It's been a tremendous change."

Vaccine recipients

Harlem High School is Titan Brockie received his second dose Tuesday through IHS and said he's happy to be able to travel with his family without worry of catching COVID-19.

"Even though I still have to wear a mask, it still feels a lot better to know you're not going to get it," he said.

Amilia Blackcrow, another Harlem High student, also received her second dose and said she feels better now that she can be near older family members and not fear for their safety as much.

"I have a grandpa and now I get to see him without worrying. ... He's having surgery so I feel way better about being around him," she said.

She said the arrival of the pandemic was a shock to the system for a lot of people in the community and having to stay home all of a sudden is difficult, and quarantine is even worse.

She said she has been quarantined twice and having to stay in a room alone "is just a sad experience."

Koda Cochran got her second dose of the vaccine at Fort Belknap Hospital that day as well and said being only a few weeks away from maximum immunization is a great feeling.

"We have a lot of elders in our family, so I feel better," she said.

Cochran said after being quarantined early in the pandemic, she contracted COVID-19 about a month ago and had severe symptoms while her children just got runny noses.

"My sense of taste is just now coming back," she said.

Cochran said now that the disease has passed, and she's fully vaccinated the stigma surrounding her has gone away, and the more people get vaccinated the better it will be for everyone especially the elders.

She said local public health has done a great job this past year, especially in the communication department, and the prevention measures taken on Fort Belknap really helped.

Vaccine hesitancy and misinformation

Cochran said she does know people who are hesitant to get the vaccine including some who think the vaccine will interfere with their ability to have children, which medical professionals have said is untrue.

"I know a few teen girls who are afraid it's going to mess with them having babies later on," she said. "... that's not going to happen."

LaMere said she's also heard concerns about the vaccine containing micro-chips which is also entirely false.

She said most people who express concerns do so about the possible side-effects of the vaccine, and she tries to make it clear to people that if they feel ill after being vaccinated it's not in fact a side-effect at all, but the body's natural immune-response which is, if anything, a good sign that they are developing immunity.

She said she was in public health during the swine flu pandemic of 2009 and the prevalence of social media has definitely changed things this time around.

She said social media is something of a double-edged sword. On the one hand it is another way to put out information quickly and many people try to be positive and informed when putting information out there, but it also can enabled a massive spread of misinformation.

LaMere said people looking for information should not use Google or similar search engines and instead go directly to reliable sources of medical information like the CDC.

Windy Boy said the circumstances around the creation and approval of these vaccines and the media coverage have played a part in creating unwarranted skepticism and concern regarding them.

No one cares who makes your flu vaccine, she said, you just get it.

She said the media's focus on the vaccines and their approval process has become a barrier because it gave people the impression that their development or approval was rushed.

"We've had to do a lot of education with our population on that," she said.