Covid-19 vaccination is being received in rural Alaska. Here the rest of the U.S. Here’s what you can learn

In many ways, Alaska was already preparing for a massive vaccine rollout – they have used similar methods to deliver the flu vaccine statewide. But most of its success comes from learning on the fly, coming up with creative ways to bring vaccines into the arms and prioritizing the most dangerous residents of the state.

What works in Alaska won’t work everywhere – it’s more than 660,000 square miles, and then every state health care worker doesn’t have to travel by dog ​​to carry vaccines. But the rest of the U.S. Could signal the state’s unique approach to its unique problems.

Alaska’s public health structure was built for height complications – its size and its propensity for extreme weather are essential. So when it came time to start vaccinating residents, the state didn’t need to build a strong public health system from scratch like some others, Alaska’s chief medical officer, Dr. Ann Zink said.

Zinc attributes the state’s success to its “hub-and-spoke” healthcare model, Dell: The “hub” – Alaska’s Department of Health and Social Services – gives local health care providers or “spokespersons” the resources they need. . But since Alaska is such a diverse state, it’s up to local providers to figure out how to use those resources to best serve its residents.

Alaska's public health system was designed to deliver the vaccine to remote parts of the state.

The localized approach to vaccination may not have worked everywhere, but it has worked in Alaska, Zinc said. The state distributes the vaccine in different regions but does not give directions, he said – the community has to decide how to carry the vaccine based on their needs.

“If you provide communities with the tools they need to defend themselves, they are always really capable of doing that,” he said.

As trusted healthcare providers in different regions of Alaska and those areas have been given so much power, healthcare workers “will be able to find people wherever they are”, Zinc said: meaning they will deliver boats to vaccinate as many community members as possible. , By dog ​​sled, by helicopter and small planes or by going from house to house in small communities.

“It’s really different across the state,” he said. “It depends a lot on local communities who know their system … we work better than (the state health department).”

It expanded the eligibility criteria

Vaccine eligibility in Alaska is currently more extensive than most other states: the vaccine is available to anyone 55 years of age or older, people with certain underlying conditions, essential workers, multidisciplinary household residents, anyone who helps seniors to get vaccinated, and anyone who lives in the community Where 45% of households do not have a pipe or septic tank.

Expansion of who qualifies for the vaccine is another strategy that helps them vaccinate Alaska native and low-income residents who are disproportionately susceptible to Covid-19.

The first round of Alaska's Covid-19 vaccine is open to young people who are vaccinated with an older person, as well as to residents of multicellular homes.

In areas where the population is mostly Alaskan, the number of people living in multicellular housing is higher. The administrator of the Alaska Native Medical Center in Anchorage, Dr. “It’s a qualification for young people who can be vaccinated with an at-risk adult,” Bobnders said.

And while 25% of rural Alaska does not have running water or sewage, which increases the risk of residents’ respiratory illness, there is no point in excluding rural residents from the first phase of vaccination.

“With more vaccines and faster eligibility for Alaskan Natives, it’s also starting to reduce the risks of high-risk covid, covid, hospitalization and mortality.”

Sovereign tribes received separate vaccines from the state

People of Alaska descent have suffered the effects of Covid-19 in the state – the Kaiser Family Foundation’s Covid-19 data tracker shows that people of Alaska descent have more than a quarter of the cases of Covid-19, but 15% of the population compared to White residents. , Who made% cases% cases, but% 68% people.
Debra McCarthy, director of a medical clinic in Fort Yukon, Alaska, administers the COVID-19 vaccine in February.  Sovereign tribes were vaccinated by the Indian Health Service.

Tribal health systems had the option of receiving the vaccine dose by state or through the Indian Health Service – Alaska’s tribal health system opted for the latter. This option gives tribes more freedom in distributing vaccines as well as the specific allocation of vaccines taking into account the remoteness of the tribes where they are, the rate of infection in the tribes and the reins to providers that are already native communities in Alaska. Confidence.

Instead of a top-down mechanism, where someone from Alaska or rural Alaska is giving orders on how things are going, it’s more about giving them supplies, Ndnders said.

The state gets its dose monthly

Alaska asked the federal government to treat it “like a region rather than a state” so that it would receive a monthly or monthly allotment of vaccines against bilateral lots. This made it easier to plan ahead and deliver the vaccine “creatively”.

Zinc said it can be expensive to carry the vaccine to some remote places in Alaska – more than 15,000 for a single trip, Zinc said. To make vaccination more cost-effective, some areas with fewer populations receive their vaccine allocations, making it possible for entire communities to be vaccinated in one place.

Alaska’s state health department also does not have to handle vaccinations itself. 229 Sovereign Tribes of Alaska, U.S. Department of Veterans Affairs and U.S. The Department of Defense has a separate federal allocation for each vaccine, which means more vaccines are being distributed simultaneously in Alaska.

The state has done this before

The huge movement of vaccines is fairly standard for ALSA.

Alaska’s chief medical officer, Dr. “We have been redistributing the vaccine for years,” said Ann Zink. “It simply came to our notice then [public health] Composition. ”

Health care activists, such as pharmacist Tori Valerie in Ketchikan, often vaccinate residents' homes instead of creating vaccination sites - the state is too far away for large sites to remain effective.

Some areas of the state are so remote that items are not sent directly there – instead, they are sent to central reassessment centers in population centers across the state, such as Anchorage and Juneau. There, vaccines can be distributed on a large scale and distributed in appropriate amounts to the community they are going to so that no area is more or less than they need, Zinc said – something that is not possible if the vaccines are sent directly. . Statewide.

So when it came time to distribute the Covid-19 vaccine, the state benefited from years of preparation.

The rest of the U.S. What can be learned

Elaine Karmark, director of the Brookings Institution’s Effective Public Management Center, has studied vaccination rate trends in states since the vaccine rollout began. He said once again the gaps between states ’vaccination rates are narrowing.

What works for Alaska will not work in more populous states or states with more urban centers, and certainly not every state will get its monthly allotment of doses, but some of its successes can be replicated in other states as well.

Invest in the protection of minority communities. Alaska has increased its eligibility for the first-stage vaccine to include Alaska natives and low-income residents of the state who are more vulnerable to Covid-19. It still has work to do to eliminate the disproportionate risk, while Nnders said it is working.

“If we want fair results, we have to invest disproportionately in the most vulnerable communities,” Andro said.

Covid-19 sends black, Latino and Native Americans to hospital 4 times more than anyone else
Another way to alleviate that burden is to prioritize zip codes over age and health status, Carmark said. Vaccinating residents in low-income neighborhoods or areas where the majority of residents are black, indigenous, or colored may reduce the disproportionate effect of Covid-1’s, although the reaction is likely: in Dallas, The plan has been disabled. The Texas Tribune reported in January that the codes came after the state threatened to reduce its vaccine allocation.
Enter to educate trusted members of communities. Karmark said that in communities where residents are reluctant to receive the vaccine, especially among blacks and Latino Americans, it is crucial to share information about vaccine admissions to address the Covid-19 racial disparities.
America's largest cities face racial disparities in vaccine distribution

Alaska has done that, Zinc & nders said, relying on health care workers to live and work in the communities they serve to educate residents. Zinc leads daily zoom calls with Alaskan, and it holds Q&A sessions to address ambiguity about the vaccine. In Alaska native communities, it feels like calling young populations to inform their elders.

Customize the approach. States that were moving to vaccination are catching on, Carmark said, as they formalize the approach to vaccination that best fits their state. In Massachusetts, for example, more vaccination sites are open at Fenway Park and Gillette Stadium to accommodate more people and store vaccines as needed. That state’s vaccination rate has improved, he said.

That approach may work in a relatively small state like Massachusetts, but the opposite is true in a state like West Virginia, where the U.S. The more rural part of the state, led by, became first available through the assignment of local pharmacies to vaccinate the residents of Carmark. Said.

Alaska’s unique approach to vaccination has worked because the state has always had to adapt to deliver health care services to residents. He said that as soon as other states customize their vaccination process, the difference between the vaccination rates of the states will be as small as possible, she said.

Correction: What was shown in the photo in the previous caption on this story is incorrectly described as having a top spot in this story. It has been updated to say it shows a charter plane in Birch Creek, Alaska, preparing to take residents to get the Covid-19 vaccine.