As people decline COVID-19 vaccine, more doses become available to general public in Yukon-Kuskokwim

A shipment of COVID-19 Pfizer vaccinations lands in Bethel, Alaska and is transferred to a deep freezer at the Yukon-Kuskokwim Health Corporation on December 16, 2020. (Katie Basile/KYUK)

The Yukon-Kuskokwim Delta is one of the few places in the nation where, across most of the region, the general public is eligible for a COVID-19 vaccine. The tribal health corporation has been able to rapidly expand vaccine eligibility for two reasons. First, it received more doses than expected. Second, many people declined to take it.

During a virtual town hall hosted by the Yukon-Kuskokwim Health Corporation on Jan. 10, President and CEO Dan Winkelman shared an ambitious hope.

“I hope as many people as possible get vaccinated in our region and throughout the nation and the world,” Winkelman said.

The virus that causes COVID-19 has had an outsized impact on the Yukon-Kuskokwim Delta. Since last October, the region has had the highest case rate in Alaska, and one of the highest case rates in the nation. But even with the virus so widespread in the region, fewer people than expected are willing to get vaccinated.

“We have seen a fairly high declination rate throughout our region for the vaccine,” Winkelman said.

YKHC is working to combat that high declination rate with education about the vaccine, using social media posts, virtual information sessions, media interviews and public service announcements. Both the Pfizer and Moderna vaccines are 95% effective at preventing recipients from developing COVID-19, and the vaccine is one of the health corporation’s main tools to suppress the virus outbreak in the region, which has infected nearly 4,000 people and killed 19 residents.

The health corporation received more vaccinations than initially planned. It received an allocation from the State of Alaska and an unexpectedly large allocation from the Indian Health Service. The number of people declining the vaccine has created a surplus for YKHC to widely expand eligibility for vaccinations. Beginning this week in villages, anyone age 16 and older can receive it. That’s as young as federal guidelines allow. During the town hall, YKHC Chief of Staff Dr. Ellen Hodges said that villages have priority because they are more vulnerable.

“Villages have poorer access to care, requires, generally speaking, an airplane ride to be seen in a hospital, and they have less access to water and sewer. So we know that poor access to sanitation has been associated with a risk of respiratory infections,” Hodges said.

Also, many people in villages live in crowded multi-generational homes.

“Which could be considered to be congregant living settings,” Hodges said. “So that’s another reason to expand access in our villages first.”

By the end of this week, YKHC expects to distribute initial doses of the vaccine to 36 village clinics. That will leave only five clinics that have yet to receive the vaccine within the first month of it arriving in the region.

In Bethel, the vaccine is not yet available to the general public. Currently, it’s available to anyone age 50 or older, as well as frontline essential workers and people living in congregant settings. Hodges said that the health corporation may expand eligibility in Bethel in the next week or two. It will depend on how many people who are currently eligible sign up for an appointment.

Even if you are not currently eligible, Hodges encourages everyone in the region who wants to receive a COVID-19 vaccine to complete this online form on YKHC’s website.

“It doesn’t guarantee you an appointment, but it lets us know that you want to have it. And so if you fit into our current criteria, we will call you and get you scheduled as soon as we can. And if you don’t fit into the current tier that we’re on, we will add you to a list and call you as soon as you are eligible to receive the vaccine,” Hodges said.

As of Jan. 8, the COVID-19 case rate was 81 cases per 100,000 people in the Yukon-Kuskokwim Delta; 671 cases per 100,000 people in the Kusilvak Census Area; and 305 cases per 100,000 people in the city of Bethel.

Ten to 15 villages in the region have active COIVD-19 outbreaks, and widespread community transmission in Bethel continues.

Fifteen percent of people in the region receiving COVID-19 tests are testing positive for the virus. This is an indication, according to Hodges, that many people are unaware that they have the virus, but are able to spread it to others.

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