Work with communities to address vaccine hesitancy, say Indigenous leaders
Public health education will go a long way in building trust, say officials
As the Moderna vaccine rolls out in the N.W.T., Indigenous leaders say the territorial government must address vaccine hesitancy if it wants to reach target immunization levels.
The territory received 7,200 doses of the Moderna COVID-19 vaccine last week, and unveiled its vaccination strategy on Tuesday.
But Inuvik MLA Lesa Semmler says information sessions should have been conducted earlier by community health nurses to increase confidence in the vaccine.
"What really frustrates me is right now we're just only starting to release information. People need time. You need the health education before," she said.
Prior to becoming an MLA, Semmler was a nurse and health advocate for 20 years. Her primary job was in health promotion and vaccines.
Lessons to be learned from H1N1 vaccine rollout
Nurses throughout the territory are wondering why they were not enlisted earlier to do public health education before the Moderna vaccine arrived, Semmler said.
She said it is important the government have "people in the community getting educated by the nurses that they know, that they trust already rather than having a team come in."
She said during the 2009 H1N1 pandemic, it took almost four months for people to feel comfortable taking the vaccine.
What really frustrates me is right now we're just only starting to release information. People need time. You need the health education before.- Inuvik MLA Lesa Semmler
"There was a lot of vaccine hesitancy," she said.
At the time, Semmler would tackle misinformation by directing people to reliable sources of information like Health Canada and the U.S. Centers for Disease Control.
Social media impact
During COVID-19, Facebook has been used to spread misinformation, such as the inaccurate claims that the vaccine was rushed or that it contains the virus itself.
"Now you're seeing a lot more hesitancy because there is fear mongering on social media," Semmler said.
Semmler worries that hesitancy will lead to vaccines sitting unused, and if this becomes the case, she hopes those doses will be made available for members of the general public and in regional centres who are prepared to take it.
"Those who live in the regional centres know that not everybody is compliant," she said.
Semmler said that while people continue to travel interprovincially, noncompliance exposes regional centres to transmission of COVID-19.
Leaders critical of communications on vaccination plan
Deh Cho MLA Ron Bonnetrouge said there are few public notices in communities like Fort Providence, Kakisa, Kátł'odeeche First Nation and Enterprise and that health centres are not disseminating enough information.
In Jean Marie River, Chief Stanley Sanguez said nurses need to come to the community to address concerns.
"Some people are saying, 'We're not going to take the shot' and that's their prerogative … if that's what you want, but as a community, it would be a lot safer if you just go ahead and take that shot," he said.
Sanguez said he worries about protecting people under the age of 18 who cannot take the shot.
"As the chief, I'll take that shot too, because if it will help me to protect my community then I will do it."
N.W.T. leaders taking shot first will inspire confidence
In Wrigley, band manager Kelly Pennycook said many in the community are "leery" of the vaccine and want to see leaders like Premier Caroline Cochrane and Chief Public Health Officer Dr. Kami Kandola publicly take the Moderna vaccine first.
Some elders in Wrigley told Pennycook they believe the vaccine is "bad medicine" because it is "not natural" and not traditional.
Pennycook said the community needs pre-vaccination information sessions.
He knows of one person in the community so far who says they plan to take the vaccine.
"They'll have to do a few hours of lobbying and negotiating with people before people do show up," he said.
Communities close to regional centres just as urgent
Dettah Chief Eddie Sangris says once Moderna is available, he'll take the vaccine to set an example for others.
Sangris said some members are taking a wait-and-see approach because they are concerned about side effects and that more information should be shared to put those fears at ease.
Although Dettah and Ndilo have access to Stanton Territorial Hospital, housing insecurity and multi-generational homes with up to 10 inhabitants pose a risk of rapid transmission like that seen in Nunavut recently.
"The housing problems we face today are unreal. If one person gets it then the whole household gets it," Sangris said.
"If one person gets it, then the whole community gets it."
Sangris said he wants the Yellowknives Dene First Nation communities of Dettah and Ndilo to be given the same access to the Moderna vaccine as remote communities without road access.
Communities keeping members informed
Tłı̨chǫ government staff have been phoning elders regularly and providing messages in their language on CKLB and CBC radio to keep people informed, said Whati Chief Alfonz Nitsiza.
Nitsiza said he has already scheduled his shot with the health centre, and that staff are calling every eligible resident over the age of 18 to schedule their shots.
It's welcome news for Whati, which has gone through a "dark period" of limited social gatherings and being unable to visit elders.
Radio critical to sharing COVID-19 vaccine information
Gwich'in Tribal Council Grand Chief Ken Smith said the Gwich'in Tribal Council holds weekly calls with Gwich'in leadership to provide regular updates.
A community elder from Fort McPherson joins this call and shares a summary of that information weekly on CBC's Nantaii radio program.
"Radio is a very important medium for us," he said, adding that volunteer radio stations in Aklavik, Fort McPherson and Tsiigehtchic provide trustworthy information.
"There is a lot of misinformation on social media," he said. "This vaccine will save lives."
"We're very fortunate here in the North that upwards of three quarters of the adult population have access to this vaccine in the coming months," he said.
It's a fundamentally different situation for southern Canada, where the vaccine is not as widely available.
Smith says that as an asthmatic, he plans to take the vaccine as soon as he can and encourages others to do the same.
Historic medical racism leads to hesitancy today, says filmmaker
Vaccine hesitancy comes as no surprise to Raymond Yakeleya, the filmmaker documenting widespread abuse at the Charles Camsell Indian Hospital, which treated tuberculosis patients between 1945 and 1981.
The fear and scepticism from this history lingers today, he said, because family members remember their loved ones being buried in unmarked graves and instances of malpractice, including experimentation on children and the removal, without anesthetic, of a rib bone in one patient.
"Native people have great suspicion of the medical system and also the education system and I think that's part of the legacy of the colonization of Native people in Canada," he said.
"The government needs to have more dialogue with our First Nations, especially elders. Our leaders are on our front lines, and they should invest a lot of time and money so we can have confidence in our health system," he said.
Vaccine delivery strategy focused on equity and cultural competency, says CPHO
During a standing committee meeting Wednesday, Dr. Kami Kandola said the pandemic response recognizes historical experiences of colonization and systemic racism which affect the level of trust in the health care system.
Promoting public trust will be behind "every decision" made regarding the vaccine rollout, Kandola said.
Health Minister Julie Green said that while the vaccine is not mandatory, there will be future opportunities for those who are hesitant to get the vaccine.
Strong adult immunization levels would allow for a loosening of some restrictions across the territories, Kandola said.
- This article was updated from a previous version that mistakenly said elders in Jean Marie River told Pennycook they believe the vaccine is "bad medicine." In fact, elders in Wrigley said that to Pennycook.Jan 08, 2021 3:03 PM CT