Mi'kmaw leaders call for tailored COVID-19 vaccine plan

Mi'kmaw leaders in Nova Scotia are calling for a vaccine rollout plan that is tailored to their communities' unique demographics and reflects their marginalization. 

Prototype clinics are in the works for elders in some Mi'kmaw communities during the province's first phase of vaccine administration, but beyond that, Chief Medical Officer of Health Dr. Robert Strang said vaccine supply is currently too precarious to set concrete plans.

With changes afoot at Pfizer's manufacturing facilities in Europe, Nova Scotia's shipments are guaranteed only for the next two weeks.

"But we're making all the connections, having the discussions with the First Nations communities to have things planned as much as possible so when we're able to start the vaccination, we can do so very promptly," Strang said Tuesday at a COVID-19 briefing.

Concerns from the Mi'kmaq were first voiced this week by Assembly of First Nations Regional Chief Paul Prosper. In a statement, Prosper said he was worried that not all Mi'kmaw communities would get shots in arms in the first round.

Nova Scotia's first phase is expected to run until the end of April and is focusing primarily on health-care workers and long-term care staff, caregivers and residents.

Mi'kmaq want all communities to get shots 1st phase

"The province needs to appreciate what is at stake if our elders get sick. Our old people hold knowledge, language and traditions that we are struggling to protect and maintain. They are at very high risk from COVID-19 and as a result, our very future as a people is at risk," Prosper said.

The National Advisory Committee on Immunization, the outside body that provides advice to the Public Health Agency of Canada, has been clear that the first batch of shots should be earmarked for the most vulnerable in society, including Indigenous populations. Prosper said that point "has gotten lost" in Nova Scotia.

Strang has said Mi'kmaw communities are a priority for vaccination — but aside from the prototype clinics for elders that are slated for the first phase, Public Health has not listed the general Mi'kmaw population for phase-one shots.

Prosper also flagged concern with the makeup of Nova Scotia's expert panel on COVID-19 vaccines, which does not include any representation from Mi'kmaw communities.

Strang said that panel is not the place for community stakeholders.

"Our vaccine expert panel are people who are there for their expertise in vaccinology and immunology," he said, adding that he and the vaccine team have been engaging with Mi'kmaw chiefs and elders by other means.

Strang meeting biweekly with Mi'kmaw leaders

Leaders from the province's 13 Mi'kmaw bands have been meeting biweekly with Strang since the early days of the pandemic. As the health director of Eskasoni — the largest Mi'kmaw community in the province — Sharon Rudderham has been part of those meetings.

While she stands by the concerns raised by Prosper, she said she thinks the province is doing its best to follow the National Advisory Committee's guidelines and that eventually, Strang and the Mi'kmaq will find a plan everyone can agree upon.

"We're all aware of the vaccine shortage that's going on across the world and Canada specifically, so it's my belief that we all have to be patient, we all have to wait until we can obtain an adequate supply within Nova Scotia and we will work together with the province … to develop a plan," Rudderham said in an interview.

Like Prosper, Rudderham highlighted the importance of vaccinating Mi'kmaw elders — the keepers of language and culture.

But there are concerns the age-wise approach to vaccine rollout may not be suitable for Mi'kmaw communities. Strang has emphasized that age will be the primary driver of Nova Scotia's general vaccine rollout.

"The demographics are different with our population," Rudderham said.  

"The general populations of Nova Scotia are a lot of baby boomers, a lot of elderly populations, whereas in Indigenous communities, our population demographics are the complete opposite.

"We have a large population of young people and a large population of under the age of 21."

Because of that, she said Mi'kmaw vaccination schedules may have to look different than they do in the general population.