As vaccination campaigns against COVID-19 ramp up across the country, many First Nation communities are already sticking needles in arms. Federal and provincial authorities have pledged to prioritize vulnerable Indigenous populations, but the situation looks different depending where you are in the country.

“My schedule has been hectic with clinics underway,” says Lindsay Peach, the executive director of Tajikeimik (Mi’kmaw Health and Wellness), a health authority for all 13 First Nations in Nova Scotia.

Peach explained that clinics began administering first doses of the Pfizer vaccine for First Nation communities during the last week of February. The second dose will be given three weeks later.

“This is not changing to a four-month interval as the first and second clinics have already been scheduled,” she says, referring to the recent decision of many provinces to delay administration of follow-up doses in order to stretch vaccine supply further.

Keeping COVID-19 out of Mi’kma’ki

The federal government has identified First Nations, Métis and Inuit as a priority in the first stage of vaccine rollouts due to their reduced access to health care, overcrowded housing, and limited access to clean water.

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Wagmatcook First Nation is home to approximately 700 people and is one of five Mi’kmaw communities located on Cape Breton Island in Nova Scotia. According to local health manager Elaine Allison, her community started the rollout for those aged 55 and over last week.

“We asked for our elders and our knowledge keepers, so that’s how we got to 55 while the rest of the province is doing 80 and up,” Allison says.

According to Peach, community response to the clinics across the province has been very positive. They have not seen significant vaccine hesitancy, but that is an issue they continue to monitor. “As health centre staff have been contacting individuals to schedule appointments,” Peach explains, “they have been taking the time to explain the vaccine process to them and to answer any questions that they have, to address any hesitancy.”

It isn’t a one-size-fits-all scenario, Peach emphasizes. The type of clinic varies depending on the size of the community. “Some vaccine clinics are offered within the community health centre, and others are operated at larger venues to accommodate more immunizers.” A clinic may be offered for one day or over a series of days, depending on what works best for the community.

To date, there have been only three confirmed cases of COVID-19 in Mi’kmaw First Nations in Nova Scotia.

Black alert in Six Nations

That’s a sharp contrast to Six Nations in southern Ontario, near Hamilton. It is the largest First Nation in Canada by population, and as of March 10 had five deaths.

While nearby communities are loosening restrictions, Six Nations has said it will remain at the Black alert level and urges community members to stay at home.

Vaccination clinics have begun on the territory and community members are being immunized as per the priority guidelines for ages 55 and over. The elected council passed a motion to temporarily close departments and mandate community-wide reduced hours of service for the next two weeks.

COVID-19 case data suggests the vaccine prioritization, combined with other government and community measures, is beginning to yield positive results. Case numbers in First Nations communities across Canada have declined consistently since peaking in January. The most recent data shows British Columbia with the most reported active cases among First Nations, followed by Alberta.

‘Needles into arms as soon as possible’

In Manitoba, plans are underway to expand vaccine delivery based on Manitoba’s community prioritization index. The province announced a few days ago that widespread vaccination in First Nation communities will commence by mid-March and It will include 63 First Nations, as well as six northern rural municipalities and 47 Northern Affairs communities that include Métis, First Nations and non-Indigenous people.

Dr. Marcia Anderson is the public health lead for the Manitoba First Nation COVID-19 Pandemic Response Coordination Team. The remote location of many First Nations communities, she explains, is being factored into the province’s vaccine deployment. “Reaching these communities in one trip is more effective than making multiple trips, especially for First Nations that are challenging to access,” notes Dr. Anderson. “Therefore, community residents aged 18 and over will be eligible to receive their vaccine at a community-based vaccination site.”

The federal government’s prioritization of Indigenous people has faced criticism from certain political quarters. Manitoba Premier Brian Pallister, for instance, made headlines last year for suggesting the policy risked “short-changing” non-Indigenous residents of the province.

“We know First Nations people in Manitoba are more at risk of COVID-19 and at younger ages. In addition, many of these communities may face evacuation due to fires and floods or have geographical issues that make it hard to get there,” said Dr. Anderson. “It’s important to get needles into arms as soon as possible and detailed planning is now underway to schedule vaccinations in these communities.”

Dr. Anderson noted that as communities are being prioritized, work is also underway to plan for staffing to provide the immunizations in these communities.

Annette Francis has been sharing Indigenous stories for 15 years, including as a broadcast journalist with The Aboriginal Peoples Television Network. She is Anishinaabe and lives in Alderville First Nation with her family.