Region reaches 40 percent vaccination, although challenges remain

Close to two months since the region’s first COVID-19 vaccination shot was administered to an Elder in Nome,  Norton Sound Health Corporation is about halfway to its goal of 80 percent vaccination in the region, the ballpark figure that scientists estimate is needed to achieve herd immunity to the coronavirus. While the coming months may bring new challenges, NSHC Medical Director Dr. Mark Peterson hopes they can reach their goal in the next two months.
As of Monday, NSHC had delivered a total of 6,005 individual doses of COVID-19 vaccine in the region, including both Pfizer and Moderna. Of that total, 3,604 were first doses, and 2,401 were second doses.
In Nome, of the 2,931 vaccine doses delivered, 1,745 were first doses and 1,186 were second doses. In Nome and the greater region, about 40 percent of eligible adults have received at least one dose.
Last week, very few first doses were administered, partially because bad weather prevented vaccine deliveries to villages and partially because a large shipment of new doses was delayed. “Second doses are really catching up,” Dr. Peterson said.
But he added that he’s been pleased with how consistently people are keeping their appointments at the hospital and clinics. “Almost everybody is showing up for their second doses,” he said. “That first wave of people, they’re really committed.”
Last week, NSHC was expecting a box of 400 Moderna vaccines and 975 Pfizer vaccines, including first and second doses. Due to a logistical slipup on the part of the state, both boxes were delayed.
The Moderna shipment finally made it in late last week, and new first doses will be distributed to villages this week. The Pfizer box is still on its way and is expected no later than this Thursday, Dr. Peterson said.
He expects another uptick in vaccine deliveries once first doses are widely available again and he said some communities may soon be in a situation where the supply of vaccines exceeds the demand.
 “The first group of people who really, really wanted it have gotten it,” he said. “Now, for some villages, it’s getting a little harder to convince the second 40 percent. Getting that last group is going to take a little more work, a little more convincing, talking, education, and spending time answering questions.”
 To help with that education campaign, Peterson said village-based health aides and mid-level providers are working to reach out to people in their local communities and alleviate concerns. NSHC also hosts an open conference call Monday through Thursday to answer questions about the vaccine.
On top of that, they’ve instituted an incentive program to encourage vaccine uptake. Those who get the vaccine can enter a raffle, and prizes will be announced every week. Top prizes include a free trip to Hawaii for four and $8,000 towards a new four-wheeler. Ten percent of participants will receive $100 checks, and participants can also win $500 vouchers toward fuel or groceries.
NSHC is also working with Sitnasuak Native Corporation to facilitate leadership meetings in villages with lower levels of uptake, Dr. Peterson said. While some villages have embraced the vaccine – 75 percent of adults in White Mountain have gotten at least one dose – other villages have stagnated as low as 15 percent. Convincing holdouts to get the shot will be critical to protecting the entire region, Dr. Peterson said. “I am trying to get people to understand that there are new variants that are developing,” he added. “They’re already in the U.S.” He said as long as we get fully vaccinated up here before the variants arrive here, the region is much better protected.
Some vaccine hesitancy derives from fear of bad side effects. About 30 percent of people will have mild to moderate symptoms from the vaccine, which usually involve soreness in the arm, sometimes include headaches and body aches, and can even include fever and chills.
Within 48 hours, though, the side effects generally subside, and although people may feel like they’re sick, the symptoms are totally natural. “It’s just your body doing the work that it needs to,” Dr. Peterson explained. “It’s your body reacting and building antibodies.”
Symptoms are usually stronger after the second dose and tend to be more severe in younger patients. “When you’re younger, you have a stronger immune system and you exhibit a stronger response,” Dr. Peterson said.
While the possibility of falling ill for a few days may discourage some people, Dr. Peterson emphasized that getting a little sick and then being protected from the virus is much better than leaving yourself vulnerable and putting your own life and the lives of those around you at risk.
“It’s a very small price to protect yourself,” he said. Education efforts have convinced 77 percent of NSHC staff in Nome and 78 percent of staff in the villages to get the shot, and that number continues to climb, so Dr. Peterson said he was confident that people would decide to take the vaccine once they were properly informed.
Allergic reactions to the vaccine can be more dangerous, but they’re extremely rare – no more common than allergic reactions to any other medication – and generally occur within half an hour of receiving the shot.
Dr. Peterson said that only those with a history of allergies to medication should be worried, and any allergic reaction can be treated with epinephrine, which clinic and hospital staff always have on hand.
NSHC’s goal is 80 percent vaccination throughout the entire region, although anything above that would be even better. Dr. Peterson said they hoped to reach that point, among adults at least, in the next two months.
Currently, no vaccines are approved for children, so the region’s vaccination rate is less if those under 16 are included. But vaccines for younger people may be on the way.
Last week, Johnson & Johnson submitted its vaccine data to the Food and Drug Administration for approval. Clinical trials for their single-dose vaccine included participants as young as 12-years-old, although the FDA may choose to only approve the vaccine for an older age group.
Dr. Peterson said he expected the FDA to make a decision in the next two or three weeks, and he hoped it would include everyone 12 and older. Once it became available, he said delivery would be swift, and vaccines for even younger age groups would likely come later.
“Once we get the childhood vaccination program going, I think we’ll have a lot of kids ready to get it,” he said. “I’m not too worried about bringing the kids on board to get that herd immunity status.”
Barriers to that sought-after herd immunity remain. Regional residents have to choose to get vaccinated, and the vaccines have to be effective against new and unstudied viral variants.
Dr. Peterson said it will still be a while before the region can do away with masking, social distancing and restrictions on travel and gathering. But he emphasized how much progress has already been made and was optimistic about the months to come.
“We’ve come so far with this from a year ago, or even six months ago,” he said. “We’re so much better off now than we were, we just need to hang in there a while longer.”
Anyone with questions about the vaccine is encouraged to join NSHC’s daily conference calls, Monday through Thursday at 11 a.m., where Dr. Peterson and other medical staff respond directly to community members’ concerns. The number is 1-800-315-6338, with the access code 03286.

Reporting for this project was supported by the Alaska Center for Excellence in Journalism