Some Americans worry about potential unknown side effects of coronavirus vaccines after expedited approval processes.
The Navajo Nation reported 160 new cases of COVID-19 on Thursday, as public health authorities continued the first round of vaccinations among the hard-hit Indigenous population in the southwestern United States.
A first shipment of roughly 3,900 doses of the Pfizer-BioNTech vaccine that arrived on Monday and Tuesday was being administered to front-line healthcare workers and staff in long-term care facilities, Dr Loretta Christensen, chief medical officer of the Navajo Area Indian Health Service (NAIHS), told Al Jazeera.
“All of our major facilities in Navajo received a portion of vaccines, and all of them have been administering vaccines, with the anticipation of finishing all vaccines by this weekend,” Christensen said.
The vaccination effort is under way after the Navajo Nation, an area larger than West Virginia that stretches across four states and effectively serves as a reservation for its population of roughly 170,000 people, reported a spike in COVID-19 infections in October.
On December 8, amid the second wave of the pandemic, it recorded a record-high 230 seven-day average of new infections, according to state data compiled by the Navajo Nation. Its highest seven-day average during the first wave of the pandemic was 132, reported on May 19.
Since the crisis began, the Navajo Nation has reported more than 20,000 COVID-19 cases and 731 deaths linked to the virus, including four additional deaths reported on Thursday.
The Navajo Nation began curfews in November as cases rose, and there were a three-week shelter-in-place order and 57-hour weekend lockdowns that began on December 7 and will last until December 28.
Christensen said that pending approval from the US Food and Drug Administration (FDA), the health service hopes to receive another shipment of about 7,800 Moderna vaccines by next week. The final number of doses will be confirmed the day before shipment, she said.
The Navajo Nation was one of the US’s first COVID-19 hotspots earlier in the year.
At the peak of its outbreak in May and June, it registered 2,304.41 cases per 100,000 people, while New York, the other early US hotspot, had a rate of 1,806 per 100,000, according to Johns Hopkins University data cited by CNN.
The first COVID wave occurred when the rest of the US was not experiencing a peak in cases, Christensen explained, so there was a greater availability of resources for the Navajo Nation.
More volunteers also were deployed to work to contain the spread of the virus, as tribal leaders called on Washington to send funds.
Christensen told Al Jazeera that some of the infrastructure set up during the first outbreak is being used to try to curb the second wave, including two alternative care sites (ACS) used to monitor and treat patients who have been discharged from hospitals but are not fit to go home.
An ACS in Chinle, a community on Navajo Nation land inside present-day Arizona, “is very actively being used”, Christensen said, while another site near Shiprock, the Navajo Nation capital on its land inside present-day New Mexico, is not currently in use, though it is available when needed.
“We first began using it as an isolation centre about six weeks ago, and it’s been very busy and helpful,” Christensen said about the Chinle site, but as infections increased, officials have “been slowly converting 10 beds at a time” to serve the functions of an ACS.
“It’s half isolation, half ACS, but we can expand to 50 beds of the alternative care site if we need to,” Christensen said.
The federal government is providing help for this wave, too, as are volunteers, but with infections so high across the country, Christensen said the Navajo Nation is competing with other states for resources to fight the virus.
“We are competing with California with, you know, Montana – other states that are also in desperate need of help and a lot of it is nursing shortage,” she said, adding that fewer volunteers are available, as well.
“It’s a little more challenging this time but we have laboratory scientists, we have nurses on the ground. We have public health care nurses that have been helping us, and we have two big teams of [Department of Defense] nurses coming in this week, so we are grateful and fortunate that we’re still able to get that assistance.
“There’s such a critical nursing shortage across the country and so that obviously is one of our challenges as well.”
Harley Jones, the US COVID response lead for international healthcare NGO Project HOPE, agreed with Christensen that the need for nurses “continues to be strong”.
Jones, whose team of volunteers is working at Shiprock, said one of his volunteer nurses is working 12-hour days, six days a week, in the intensive care unit at the Northern Navajo Medical Center.
“I’ve got a critical care [doctor] who’s coming in this Sunday and so his [schedule] is going to look the same: six days a week, 12 hours a day, providing critical care,” Jones said.
These healthcare professionals are working alongside others to help with COVID-19 testing and contact tracing, and in some cases, delivering food and medical supplies, Jones said.
He said he expects his team to reach 24 volunteers by January.
While the situation is currently difficult, he said he was “hopeful from a mental health perspective that this light at the end of the tunnel – of starting to see vaccine roll-out – will help in the long run”.