Results from a National COVID-19 Vaccination Survey: Strengthening Vaccine Efforts in Indian Country
Background
American Indian and Alaska Native people continue to be disproportionately impacted by the COVID-19 pandemic. And with the emergence of several COVID-19 vaccines, there has been an urgent need for information on the knowledge, attitudes, and beliefs among American Indians and Alaska Natives regarding the vaccines.
Urban Indian Health Institute (UIHI) conducted a survey with 1,435 American Indians and Alaska Natives across the United States, with participants representing 318 different tribes across 46 states. The survey asked 49 questions ranging from an individual’s willingness to receive a COVID-19 vaccine to the people they trusted most when making informed decisions.
The analyses and recommendations presented in this report can be used to inform the development and delivery of culturally attuned COVID-19 vaccination campaigns, education materials, and programs tailored to American Indian and Alaska Native communities.
Indigenous communities have unique perspectives and needs. They make decisions for the health of their communities and rely on trusted messengers, which this data shows. As COVID-19 continues to devastate Native communities, data-informed education is needed in order for people to make decisions about their participation in a COVID-19 vaccine.
The primary motivation for participants who indicated willingness to get vaccinated was a strong sense of responsibility to protect the Native community and preserve cultural ways.
Key Findings
All Participants
74%
of all participants believe getting vaccinated is their responsibility to their community
39%
of all participants reported difficulty traveling to their clinic for an appointment
Participants Willing to Get a COVID-19 Vaccine
75%
of participants were willing to receive a COVID-19 vaccine
2 out of 3
participants willing to get vaccinated were confident that COVID-19 vaccines were adequately tested for safety and effectiveness among Native people
75%
of those willing to get vaccinated had concerns about potential side effects
Participants Unwilling to Get a COVID-19 Vaccine
25%
of participants were unwilling to receive a COVID-19 vaccine
90%
of those unwilling to get vaccinated recognized COVID-19 as a serious disease
89%
of those unwilling to get vaccinated had concerns about potential side effects
Key Recommendations
1
Center vaccination campaigns on the cultural values of Native peoples by tailoring messaging on community responsibility and by drawing connections between getting vaccinated and the preservation of Native traditions, cultural pride, as well as love and respect for family, Elders, future generations, and the broader Native community.
2
Support tribal and urban Indian health clinics in leading COVID-19 vaccination efforts, given their position in the community as a trusted, safe, and familiar spaces, with cultural knowledge and expertise.
3
Utilize effective ambassadors, such as healthcare providers, Elders, and tribal leaders, to provide accessible and clear information about the COVID-19 vaccines, including the process of vaccine development, vaccine safety and effectiveness, potential side effects, cost, and personal and community benefits of vaccination.
4
Acknowledge how historic and current harms perpetrated by healthcare institutions and the US government have contributed to skepticism of vaccines. This can be accomplished by holding a public forum with Native community leaders on vaccine hesitancy or by utilizing resources developed by Native-led organizations to build trust in vaccines.
5
Ground vaccination campaigns in community participation and community voice to ensure vaccine messaging is culturally relevant. As evidenced by the high completion rate of this survey and interest in participating in future surveys, the community is willing to share their knowledge and experiences to benefit American Indian and Alaska Native communities.
6
Recognize that vaccine acceptance is a spectrum and those unwilling to get vaccinated may change their opinions once concerns of safety, effectiveness, and accessibility have been addressed. Conversely, acknowledge vaccine acceptance does not mean hesitancy is not present, as those willing to get vaccinated voiced similar concerns around safety for Native people.