Kansas tribes, health providers aim to continue progress on vaccinating American Indian residents

Andrew Bahl
Topeka Capital-Journal
Prairie Band Potawatomi Nation Chairman Joseph Rupnick receives the first dose of the COVID-19 vaccine at the Prairie Band Health Center in December 2020.

Tribal health providers aim to continue progress in getting American Indian residents vaccinated against COVID-19, officials say, with around two-thirds of those receiving federal Indian Health Service care in Kansas immunized against the virus.

Even though native populations have similar vaccination rates to Kansas as a whole, traditional mistrust of government and health officials, as well as balancing a complex network of state, tribal and federal entities, have posed barriers over the course of the pandemic.

Native populations are more likely to be hit by the COVID-19 pandemic, with federal data showing American Indians and Alaska Natives are 3.5 times more likely to be infected than non-Hispanic whites and more than four times more likely to be hospitalized due to the virus.

More:Fewer COVID-19 vaccines are getting to Kansans of color. What can be done to change that?

But health experts have touted the rollout of vaccines in Indian country as a success. An April report from the Kaiser Family Foundation found American Indian and Alaska Native groups had disproportionately high levels of vaccination, despite historic friction with government institutions and chronic underfunding of IHS.

"The high vaccination rate among AIAN people largely reflects Tribal leadership in implementing vaccine prioritization and distribution strategies that meet the preferences and needs of their communities," the report said.

The great seal of the Citizen Potawatomi Nation, based in Oklahoma, sits alongside flags at a ceremony at Burnett's Mound in Topeka in April. Tribes in Kansas and Oklahoma have worked with federal partners to get their members vaccinated in recent months.

On the high plains, Rear Admiral Travis Watts, who runs the IHS region that includes Kansas, Oklahoma and parts of Texas, told a state task force on vaccine equity that the pandemic has required better communication between his agency and state and local partners — something that has historically proved difficult due to turnover.

The four federally recognized tribes in Kansas have smaller populations than some of their larger counterparts in Oklahoma, such as the Chickasaw and Choctaw nations.

But vaccine efforts have still been ongoing.

Health clinics for the Prairie Band Potawatomi Nation, the Kansas Kickapoo Tribe and a clinic serving both the Iowa Tribe of Kansas and Nebraska and the Sac and Fox Nation of Missouri in Kansas and Nebraska have been receiving doses from IHS, as have providers at Haskell Indian Nations University in Lawrence.

Room for growth remains in tribal vaccination efforts

Vaccination rates in Kansas are roughly equal for native residents and the population as a whole, according to data from the Kansas Department of Health and Education.

For the Kickapoo Tribe, health clinic director Paul Austin said 55% of the 632 individuals served by his clinic had been vaccinated, although that doesn't include tribal members who get jabbed in Brown County or elsewhere.

This largely mirrors vaccination rates for American Indian residents statewide. IHS data shows 4,310 American Indian Kansans have gotten both doses, with the agency's facilities serving about 6,500 residents across the state.

Austin added that uptake was highest among those aged 65 and older, as well as teens.

"It's pretty good," he said. "We're lagging behind in the 18 to 64 age group, but I think we added four or five new people last week, which is pretty good for a clinic our size."

Tribal clinics were given the option of whether to partner with IHS or get their vaccine doses through the state health department. All opted for the federal partnership, something Austin said was a "godsend."

More:Kansas providers forge ahead on boosters. Those eligible for 3rd shots are 65+ or at high risk for COVID

He noted the tribes would consistently share doses if one clinic was in need of shots. And because of the steady availability of vaccine, tribes were able to move on to younger residents sooner than the state as a whole.

"I felt I had more faith in them within the state to get it to us fast," Austin said. "We potentially were the first people in the county to start doing vaccinations."

Providers combat government, public health mistrust among native residents

But like other underserved populations, officials note skepticism remains in getting vaccinated in the first place.

At Hunter Health in Wichita, an IHS-backed facility targeting urban native populations, 44% of residents said they were set against getting vaccinated. While many echoed the same concerns expressed by residents across the state, historic mistrust of government and public health research played a role as well.

That includes a 1956 study, carried out by U.S. Air Force researchers in Alaska, gave a group of largely Alaska Native individuals radioactive iodine. And a 2009 study found native patients had lower levels of satisfaction and trust in the health care they received.

"(They are) worried as being used as guinea pigs, as has historically been the case in some populations," said Tara Nolen, community health manager at Hunter Health.

A nurse administers vaccines at a clinic run by the Coquille Indian Tribe in Eugene, Ore. Health experts have praised efforts by tribes nationally to get members vaccinated.

Federal agencies acknowledge those issues as well. Watts, of the IHS region, said they aim to let local faith and political leaders handle addressing misinformation, understanding the complicated relationship many have with the IHS.

"We don’t need to be showing up at the doorstep with a bunch of CDC information because it is not a trusted environment," Watts said. "Those kinds of relationships take time."

And Watts added there is a broader challenge in maintaining those bonds as the nature of the pandemic changes and, in many respects, becomes a permanent fixture in Indian Country and Kansas as a whole.

While the pandemic has helped federal agencies better understand the needs of tribes, Watts said, work between local, state and federal partners often remains fragmented.

Improving coordination would be key, he added, with society returning to some semblance of normalcy.

"Our communities are telling us it's time," Watts said. "They don’t want to have funerals with nobody there. They don’t want to have dances or ceremonies delayed anymore. They want to live life and it is important for us, whether it is through testing or vaccinations, to sustain this process going forward."

Andrew Bahl is a senior statehouse reporter for the Topeka Capital-Journal. He can be reached at abahl@gannett.com or by phone at 443-979-6100.