What the Navajo Nation’s successful COVID vaccine rollout can teach the rest of the country

Rachel Grumman Bender
·8 min read

The Navajo Nation is one of the hardest-hit populations in the U.S. when it comes to COVID-19 — at one point reporting the country's highest number of cases per capita. To date, the Navajo Department of Health reports more than 1,000 confirmed deaths from COVID-19.

But a bright spot has emerged: The COVID vaccine rollout in the Navajo Nation has been highly successful, already surpassing its original goal to have administered 100,000 shots by the end of February. It’s an impressive number, given that there are an estimated 175,000 people living in the Navajo Nation.

This is a far cry from the grim situation the Navajo Nation found itself in at the start of the pandemic last year. By May, CNN reported that the Navajo Nation — which spans 27,000 square miles and borders Arizona, New Mexico and Utah, making it the largest reservation in the country — had “surpassed New York state for the highest Covid-19 infection rate in the United States.” In August, Dr. Robert Redfield, then the director of the Centers for Disease Control and Prevention, said that “American Indian and Alaska Native people have suffered a disproportionate burden of COVID-19 illness during the pandemic.”

Medical staff at the Northern Navajo Medical Center were among the first in the Navajo Nation to receive their Pfizer-BioNTech vaccinations, on Dec. 15 in Shiprock, New Mexico. What's followed has been a successful rollout to Navajo Nation residents. (Photo: Micah Garen/Getty Images)
Medical staff at the Northern Navajo Medical Center in Shiprock, N.M., were among the first in the Navajo Nation to receive their Pfizer-BioNTech vaccinations, on Dec. 15. What's followed has been a successful rollout to Navajo Nation residents. (Photo: Micah Garen/Getty Images)

The latest data (updated Feb. 4) from APM Research Lab’s Color of Coronavirus project, which looks at COVID mortality rates in the U.S., found that “Indigenous Americans have the highest actual COVID-19 mortality rates nationwide.” In fact, the COVID-19 death rate for Indigenous Americans, as well as Pacific Islanders, Latino and Black Americans, is “double or more” that for white and Asian Americans. The report also found that one in 475 Indigenous Americans has died since the start of the pandemic.

But the Navajo Nation has managed to turn things around thanks to strict protocols, consistent health messaging and the efforts of leaders to build trust in the vaccine.

Why the vaccine rollout was so successful

In an effort to save lives during the pandemic, Navajo area health facilities made multiple changes to their public health and hospital operations to “slow the spread of COVID-19 and maximize resources available to deal with a surge of COVID-19 patients,” according to a statement provided to Yahoo Life by the Indian Health Service (IHS). That included closing or limiting nonessential health care services in many outpatient clinics, conducting most routine appointments by telemedicine and canceling all elective surgical and dental procedures. Staff in these departments were then “re-assigned to assist in the public health response as contact tracers and case managers and monitor the active COVID-19 cases in the service unit,” and additional physicians, nurses and other staff were hired to “ensure adequate staffing.”

In addition, strict protocols were put in place — from mandating face masks in April 2020 to daily curfews, which are still in effect, and 57-hour weekend lockdowns — which Jonathan Nez, president of the Navajo Nation, tells Yahoo Life helped to flatten the curve. “We took our sovereign ability to govern ourselves very seriously,” says Nez. “We went as far as banning non-Navajo residents from staying on the Navajo Nation or visiting our points of interest. Because of that, our economy was hit hard. But the health and well-being of our Navajo citizens is of the utmost importance.”

President of the Navajo Nation Jonathan Nez stands in the Monument Valley Tribal Park, which has been closed due to the Covid-19 pandemic in Arizona on May 21, 2020. - Weeks of delays in delivering vital coronavirus aid to Native American tribes exacerbated the outbreak, the president of the hard-hit Navajo Nation said, lashing the administration of President Donald Trump for botching its response. Jonathan Nez told AFP in an interview that of the $8 billion promised to US tribes in a $2.2 trillion stimulus package passed in late March, the first tranche was released just over a week ago. (Photo by Mark RALSTON / AFP) (Photo by MARK RALSTON/AFP via Getty Images)
Navajo Nation President Jonathan Nez in May in Monument Valley Tribal Park in Arizona, which was closed due to the pandemic. (Photo: Mark Ralston/AFP via Getty Images)

Unlike in several pockets of the U.S., there wasn’t a backlash in the Navajo Nation against wearing face masks or having curfews and lockdowns. “Wearing a mask wasn’t about politics or limiting freedoms,” says Nez. “Wearing a mask showed that you are a warrior and you are being equipped.” As far as curfews and lockdowns go, Nez explains that for the Navajo, “home is the safest place to be in times of difficulties. So we messaged that. That, I think, really helped us with having our citizens understand that these strict protocols were put in place because of this war and these battles that we’re fighting with COVID throughout the Navajo Nation.”

Once vaccines became available, Navajo area IHS facilities were ready to hit the ground running, since they had been “preparing since August to receive the vaccines and have strategic plans in place to carry out vaccine administration quickly and efficiently,” the IHS tells Yahoo Life. “All service units have held and are planning more vaccination events to vaccinate the Navajo Area population as quickly as possible.”

Distributing COVID vaccines has been a coordinated effort led by the Navajo Department of Health and in collaboration with the IHS, tribal health organizations and local tribes, as well as federal, state and regional partners. In addition, an emergency response system was implemented throughout the Navajo Nation to “provide oversight of the Navajo Nation COVID pandemic response,” says the IHS.

The IHS says “exceptional vaccination administration teams” at all health care facilities throughout the Navajo Nation are providing vaccinations by appointment, at walk-in events and at large community vaccination events. “Some service units are taking the vaccines to home-bound patients or elders,” adds the agency.

A sign warning non residents to stay out in the Navajo Nation town of Tuba City during the 57 hour curfew, imposed to try to stop the spread of the Covid-19 virus through the Navajo Nation, in Arizona on May 24, 2020. - Weeks of delays in delivering vital coronavirus aid to Native American tribes exacerbated the outbreak, the president of the hard-hit Navajo Nation said, lashing the administration of President Donald Trump for botching its response. Jonathan Nez told AFP in an interview that of the $8 billion promised to US tribes in a $2.2 trillion stimulus package passed in late March, the first tranche was released just over a week ago. (Photo by Mark RALSTON / AFP) (Photo by MARK RALSTON/AFP via Getty Images)
A sign in May warns nonresidents to stay out of the Navajo Nation town of Tuba City, Ariz. (Photo: Mark Ralston/AFP via Getty Images)

Tribal leaders have also shown flexibility. In an effort to get more citizens vaccinated, Nez says weekend lockdowns were lifted recently “so we can have all seven days to vaccinate,” adding, “This past Saturday, over 5,000 people of the Navajo Nation got vaccinated in one day.”

Getting the message out

Another key contributing factor to the rollout’s success: getting consistent vaccine information out to the Navajo people, which Nez says was “critical.”

Information was shared through biweekly virtual town hall meetings with tribal leaders (one such meeting in September included Dr. Anthony Fauci, who praised the Navajo Nation for its handling of the virus), as well as through press releases, radio and newspapers, which were translated into the Navajo language. “A lot of this was getting our people to understand the science and even the technology in getting a vaccine,” says Nez. “One of the challenges was trying to develop new Navajo terms for some of the English terms.” For example, he says, they needed a Navajo word for “variant” in order for citizens to better understand what health experts and leaders were explaining to them.

Leaders also made an effort to build trust in the vaccine. “I rolled my sleeve up so my elders would be OK with taking the vaccine,” says Nez. “It brought confidence to have the shot being administered.” Navajo health care professionals helped get the message out, “strongly” recommending that Navajo citizens get vaccinated, says Nez.

“Consistent health messaging to the communities, building trust and leadership serving as role models in getting their vaccines have also contributed to the successful COVID vaccine rollout,” the IHS tells Yahoo Life. All those efforts helped the Navajo area vaccine initiative become “a great success.”

As of Feb. 11, the IHS says, a total of 113,345 COVID vaccinations had been administered in the Navajo area. Nez says going “well beyond” the goal of 100,000 shots by the end of February is a “tremendous feat.” He adds, “I applaud the health care facility teams throughout the Navajo Nation for giving out these shots.”

'Follow the experts'

So what can other areas in the U.S. learn from the Navajo Nation’s handling of COVID-19? Above all, Nez says, “you have to take the virus seriously.” In addition, “leaders have to surround themselves with experts in the field. And that’s what we’ve done. We took the CDC protocols and went as far as incorporating them into our laws — and we’re a sovereign nation, so we have that ability.”

He continues: “We’re doing everything in our power to protect our citizens. But other government agencies, states, were not doing the same thing we were doing. What I would tell people out there is to follow the experts and not yield to politics. Wearing a mask is not restricting your freedom. Wearing a mask is to protect those around you, those you love.”

Despite the Navajo Nation mask mandates and strict lockdowns, “there was no uprising, no resistance, no protests,” says Nez, “because our elders stepped up to the plate and told our younger generation to honor and respect the leaders and public health professionals. And because of that we managed to see some low numbers that we haven’t seen in a very long time.”

To stop this pandemic, “we need to use all of our prevention tools,” says the IHS. “The COVID vaccines are a tool, along with continued social distancing, frequent handwashing, and mask wearing, to control the pandemic.”

For the Navajo Nation, it’s also about working together to get through the crisis. “The strength and resilience of our people is magnified through these trying times,” says Nez. “We’re not going to get defeated by COVID-19. We’re actually going to be stronger than before COVID because of how we all helped each other out and worked together to get through this public health emergency.”

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