Oklahoma tribes prepare to pivot to booster shots in COVID-19 battle

Patients get COVID-19 vaccine at the Chickasaw Nation Emergency Operations Facility in Ada, Oklahoma. The tribe planned to begin offering booster shots to immunocompromised patients in August. (Photo by Michael Scott/Courtesy the Chickasaw Nation)

WASHINGTON – Formal guidance from the Indian Health Service on how and when to give COVID-19 vaccine booster shots still are in the works, but some tribes in Oklahoma aren’t waiting.

Armed with the news that booster shot guidelines are on the horizon, tribal nations in Oklahoma are continuing their fight against COVID-19 in a state with a low vaccination rate as another surge pushes health care systems to their limits.

Chickasaw Nation Department of Health locations in Ada, Ardmore, Purcell and Tishomingo began administering booster shots on Aug. 25 to those who are immunocompromised. The Choctaw, Cheyenne and Arapaho, Citizen Potawatomi, Absentee Shawnee and Wyandotte nations are likely to begin offering boosters shots later this month, following guidelines from federal health agencies.

They are just the latest steps by tribes in Oklahoma, which have managed to keep a step ahead of some of their neighbors in the fight against COVID-19.

“The local Native community is probably vaccinated at a higher rate than their non-Native neighbors, just because we, Indian health care in general, have made it extraordinarily easy for them to get vaccinated,” said John Bearden, clinic compliance officer at the Wyandotte Nation’s Bearskin Health and Wellness Center. “No portal to have to sign in to make an appointment somewhere. We’ve been available as a walk-in vaccination clinic since very early on, and continue to do so.”

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As the delta variant has driven a rise in cases, Oklahoma tribes have adopted other measures. Some have shut down all Labor Day activities while mask mandates remain in place for some tribes, despite the lack of a statewide mandate.

Oklahoma has fully vaccinated 1.73 million residents, or 43.6% of the eligible population. The Cherokee Nation of Oklahoma, the state’s largest tribe, reports that 70% of its employees have been vaccinated, nearly doubling vaccination rates in some Oklahoma counties.

The upcoming use of booster shots was announced this summer by President Joe Biden before the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices met to approve boosters or formalize guidelines. That committee met Monday to discuss booster protocols, but until it acts, Bearden said, the Indian Health Service cannot give tribal nations any formal guidance.

The Food and Drug Administration released a statement Aug. 18 that the Moderna and Pfizer-BioNTech vaccine would be evaluated for safe and effective use for booster shots, pending CDC approval. IHS also anticipates that booster shots may be needed for the Johnson & Johnson vaccine, consistent with approved FDA and CDC guidelines.

But IHS also is getting ready for the booster shot.

Following CDC and FDA guidelines as they become available, Dr. Loretta Christensen, IHS chief medical officer, said her agency is preparing to offer booster vaccines in the fall for those who have had two Pfizer or Moderna vaccinations, starting eight months after a patient’s second dose.

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“At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster,” Christensen said.

Oklahoma City’s IHS Area Office is expected to be the primary booster vaccine provider and distributor for many tribes in Oklahoma, said Dr. Adam Vascellaro, chief medical officer of the Citizen Potawatomi Nation’s Health Service.

Vascellaro said the OKC-IHS vaccine supply appears to be “much higher than before,” and booster vaccine distribution will be through in-clinic appointments, strike teams and mass vaccination events. Other tribes will be administering boosters alongside their preexisting COVID-19 vaccination programs.

The Cheyenne and Arapaho and Absentee Shawnee tribes said they are working with IHS to ensure they receive enough booster doses for their tribal and community members that the CDC has deemed a priority for booster shots.

Bearden said his tribe plans to continue providing vaccinations to non-tribal citizens as well.

“Our stance has been and will continue to be that the COVID pandemic isn’t just a tribal, county, state or national problem,” Bearden said. “It would do us little good to limit our COVID vaccination and COVID testing to just tribal members, if the folks that they work with, go to school with and worship with are still susceptible. The healthier our communities are, the healthier our tribes are.”

Gaylord News is a Washington, D.C.-based reporting project of the University of Oklahoma Gaylord College of Journalism and Mass Communication. Cronkite News has partnered with OU to expand coverage of Indigenous communities.