Doctors work to gain trust for COVID vaccine in northern Canadian Indigenous communities

Just a little jab is no big deal for most of us, but getting COVID-19 vaccines into the arms of the most vulnerable took a trio of St. Michael’s Hospital doctors way above and way beyond — 1,200 kilometres above and beyond to the fly-in community of Neskantaga First Nation in Northern Ontario.

Dr. Alun Ackery, Dr. Laura Hans and Dr. Suzanne Shoush managed to vaccinate about 90 per cent of the eligible population in the Oji-Cree speaking community of about 400. It took a week of daily flights back and forth to Thunder Bay, 450 kilometres to the south, to get first doses of the delicate Moderna vaccines into arms.

The complex logistical operation, co-ordinated by the air ambulance company Ornge, had to ensure it didn’t waste any doses of the precious vaccine. This is complicated by the unstable nature of Moderna’s vaccine once thawed. It can’t be transported in anything that vibrates, unless it’s still frozen.

But the doctors’ worries going in weren’t just about the physical properties of the vaccine. They also worried about vaccine hesitancy among people who have little reason to trust outsiders or the health-care system.

“There are some communities that vary in their ability, their hesitancy to get the vaccine,” said Ackery. “They have questions and lots of unknowns. To be honest, in those communities there’s lots of hesitancy to engage with health care because of previous experiences.”

Neskantaga is known for its 9,532 days (as of March 8) of boil water advisories. The community’s brand new water treatment plant broke down in the mid-1990s and a parade of politicians, engineers, contractors and others haven’t been able to fix the problem.

The doctors went through cultural sensitivity training before going on the trip, “to make sure we were doing it the right way and the most efficient way, so we maximize our chances of getting those communities vaccinated,” Ackery said.

“There is a lot of mistrust. I spent a lot of my time up there talking to people, giving them time to think about whether they wanted to get the vaccine,” said Ackery.

Things went smoothly when the first patient to be vaccinated was Chief Chris Moonias, who got his jab on FaceTime. Moonias’ leadership made a world of difference, Ackery said.

For St. Mike’s doctors, there’s a natural draw to efforts like Operation Remote Immunity, which as of March 7 had administered 15,324 vaccine doses in 31 fly-in communities and Moosonee, said Ackery.

“I think what draws us to initiatives like this is we can see where there’s impact,” he said. “St. Mike’s has a longstanding history of trying to do our best to help those who are in need and those who are vulnerable. … What you have are people engaged with vulnerable populations at St. Michael’s Hospital, who are interested in contributing to initiatives and endeavours that are worthwhile to a vulnerable population.”

Working with Indigenous Canadians is not out of the ordinary for St. Michael’s. It is daily work for Shoush who practices medicine out of the Sumac Creek Health Centre, an Indigenous-focused family medicine practice in Regent Park.

Operation Remote Immunity has now completed first doses in all 31 fly-in communities and has so-far administered 2,664 second doses.