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Meghan Sullivan
Indian Country Today

As millions across the nation await details about the Pfizer coronavirus vaccine, remote Western Alaskan villages prepare to be among the first to get it. The operation, coined Project Togo after the sled dog who led a life-saving antitoxin delivery to Nome in 1925, recalls memories of that year’s infamous diphtheria outbreak which plunged rural Alaska into quarantine. Almost a century later, officials are hoping the current vaccine delivery will mirror the success of its namesake.

On Monday, Alaska received 35,100 doses of the COVID-19 vaccines, making it one of the initial states to obtain a shipment of the long awaited vaccine. Around 1,000 doses will go straight to the Yukon-Kuskokwim region, which serves 56 tribes, said Dr. Ellen Hodges, Chief of Staff for the Yukon-Kuskokwim Health Corporation. Elders, health care providers and frontline workers are first in line to receive it.

Southwest Alaska has one of the nation’s highest rates of infection from COVID-19, resulting in its early vaccine acquisition. Yukon-Kuskokwim delta’s 56 villages have an infection rate of 172.6 cases per 100,000 people. The spread of the virus can be intensified by rural Alaska’s tight-knit nature, while treatment is complicated by the area’s remote location. Some villages have been hit harder than others — in four Western Alaskan communities, more than a quarter of the residents have tested positive for the virus.

The state received a large batch of the vaccine upfront in comparison to the rest of the nation due to unique logistical challenges that would make a weekly delivery more difficult, explained Dr. Robert Onders, Medical Director at the Alaska Native Tribal Health Consortium and interim administrator of the Alaska Native Medical Center in Anchorage. Over the past 10 months, the tribal healthcare organization has been a key component of the coronavirus response among Alaska Native communities, and will be instrumental in delivering the vaccine throughout the state’s 230-plus villages in the weeks to come.

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While health officials aren’t relying on dog sleds anymore, the rural delivery process is still complicated. To start, the vaccine will be stored in Bethel at the required conditions of minus 94 degrees Fahrenheit, in a freezer space that can reach the extremely low temperature.

But the vaccine’s safe arrival to Bethel is only half the journey. The unique storage specifications prevent it from being shipped out to the villages from the regional hub like other cargo typically is. Instead, a team of trained vaccinators and bush pilots will hand deliver the vaccine to impacted areas, hopping from village to village until the operation is complete.

During the heart of winter in remote Alaska, the delivery teams will have to brave tough weather and potentially extreme flying conditions — meaning flights could easily be cancelled and shipments could be delayed.

Adding to the challenge, the vaccine requires two doses, administered as close to 21 days apart as possible. Recipients of the first dose will have a card that states the necessary date for their second dose. Health care providers are working to ensure the second batches will arrive by the scheduled dates.

“The state has been involved in the transport of vaccines to regional clinics and even villages for a long period of time,” said Onders, who praised the creativity and tenacity of the state’s tribal health care providers. The intricate distribution conditions are nothing new to rural Alaska — tribal health care organizations already have a logistics system setup to track vaccine deliveries. Onders believes the existing medical structure will help overcome the rural delivery obstacles.

(Previous story: First COVID-19 vaccine hits Indian Country)

On Monday, state officials expressed their excitement at the vaccine news, but warned that there were still health risks ahead.

“This is a big step #Alaska - as the CDC said - ‘this is a huge turning point in this pandemic.’ Much more to come soon,” said Alaska’s chief medical officer, Dr. Anne Zink, in a tweet.

“If we can get through the next two weeks, it could be really important for the healthcare workforce.. and for the patients at the highest risk for hospitalization,” Onders said. “And that could be something that changes dynamics here in four to six weeks. So that portion I'm optimistic about.”

Out of the 12 Indian Health Service regions, only 11 will receive the vaccines from IHS. The Alaska IHS region opted for state distribution of the vaccines. The shipment includes 11,700 doses allocated by the Indian Health Service to Alaska tribes, reported the Associated Press. The state is working with the Alaska Native Tribal Health Consortium to coordinate shipment of the vaccine, including to rural villages. 

National correspondent Joaqlin Estus contributed to this story.

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Meghan Fate Sullivan, Koyukon Athabascan, is a writer for Indian Country Today. She grew up in Alaska, and is currently reporting on her home state from Anchorage.

Like this story? Support our work with a $5 or $10 contribution today. Contribute to the nonprofit Indian Country Today.