Urban Indian Organizations: Key Partners for COVID-19 Vaccination Equity

The COVID-19 pandemic has spread for about two years in the United States since the first case was detected, and it has seriously harmed those most vulnerable in our communities ever since. American Indian and Alaska Native (AI/AN) communities have borne an especially severe burden, with disproportionately high cases and deaths.  Thankfully though, these communities have been strong and resilient, enthusiastically seeking measures to protect their respected elders and communities.  Over the past year, vaccination against COVID-19 has has emerged as the best protection we have against severe disease and death, and AI/AN people have had the highest vaccination rate in the country by race according to the Center for Disease Control (CDC).  Many reasons contributed to this success, including the Indian Health Service distribution of vaccines to facilities, as well as an acute appreciation of the impact of the pandemic that some AI/AN communities have felt.  A year into the vaccination campaign, we see signs both of triumphs and opportunities.  Urban Indian Organizations (UIO) have been instrumental in the success of vaccinating AI/AN populations in 38 urban areas, and are key beacons for outreach, resources, and care to a growing urban population that is sometimes labelled “hard-to-reach”.

Nevertheless, there remain stark differences in vaccination coverage between cities. In Figure 1, the percent of the general population fully vaccinated against COVID-19 in each UIO service area is displayed, showing how these cities have evolved over the past year. By clicking on service areas in the legend, viewers can hide service areas for clearer reading. The figure also includes a tool tip, showing the date and vaccination coverage in each area at any time.

Thirty-two percentage points separate the UIO service area with the lowest COVID-19 vaccine coverage and the city with the highest vaccine coverage (Wichita at 48% of the population, compared to San Jose at 81% as of January 1st).  Around June 1st of 2021, vaccination coverage in many cities began to plateau – after which most UIO cities experienced much slower vaccination rate increases due to the fact that the most enthusiastic citizens were quickly vaccinated in March and April.

Figure 1: Percentage of the General Population Vaccinated Against COVID-19 in Different Urban Indian Organization Service Areas

Some cities still have ground to cover reaching those who remain not fully vaccinated, and cities with a larger percentage of unvaccinated individuals still run the risk of outbreaks and mass hospitalizations which creates a heightened risk for all patients regardless of their vaccination status.  Two years into a global pandemic, we need to  remember the value of  “hyper-localized” strategies based on personal connections with trusted community leaders. UIOs are well-situated to be that source for urban AI/AN people that remain unvaccinated. As the COVID-19 pandemic continues to evolve, local investment remains as vital as ever to improve equitable distribution and administration of the vaccine and ultimately blunt the effect of this virus.

This post is part of an ongoing series of  COVID-19 Data Tools, so sign up for our newsletter and mailing list. Remember, you can always ask NCUIH for data analysis or technical assistance via our website.

By Alexander Zeymo and Andrew Kalweit, posted on Wednesday, January 26, 2022

This post is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (NOFO OT18-1802, titled Strengthen Public Health Systems and Services through National Partnerships to Improve and Protect the Nation’s Health) funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Data Notes for Dallas and Denver

*Texas did not send vaccination information to the CDC by county until 10/22/2021. Dallas service area vaccination percentage does not start until 10/22/2021.

**Denver area progress was abnormally low for many months, being only 13% until 08/02/2021 where it increased by 45 percentage points in one day. Data prior to 08/02/2021 is suppressed.