As demand for COVID-19 vaccinations drops, one Iowa community nears herd immunity

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Meskwaki Tribal Council Members Delonda Pushetonequa (left) and Judith Bender have voted to put COVID-19 restrictions on the tribe. They say it's helped curb the spread of the virus. (Side Effects Public Media)

Genesis Ramirez grips a digital timer, her legs swinging in a chair in the waiting room of the Meskwaki Tribal Health Center in Tama County, Iowa.

The 17-year-old just got her second dose of the Pfizer COVID-19 vaccine. But she didn’t do it just to keep herself safe.

“My family is very high risk, and I don’t want to bring anything back to them where I can’t help them,” Ramirez said.

Ramirez isn’t a member of the Sac and Fox Tribe of the Mississippi, also known as the Meskwaki Nation.

But she is one of the 2,600 people who live or work on the tribe’s 8,000-acre settlement west of Cedar Rapids. 

The Meskwaki Health Center has been hosting COVID-19 vaccination clinics since December. It offer those who get vaccinated a free t-shirt, mask and reusable shopping bag. (Side Effects Public Media)

She’s now one of the many members of her community who’s fully vaccinated against COVID-19.

“I’ve been waiting and I’ve been wanting to get a vaccine just so I can know that there’s — I did something to help,” she said.

According to state data, less than half of adult Iowans have been fully vaccinated. That’s far short of what experts say is needed for herd immunity.

But that number is much higher for the Meskwaki Nation, where officials estimate more than 70 percent of those eligible who live and work on the settlement are fully vaccinated. 

“I’m actually a little surprised to be honest,” said Rudy Papakee, the health director of the Meskwaki Tribal Health Center. “I didn’t expect our numbers to be this high this quick, I thought, eventually we’d start, you know, we’d hit a plateau, or we’re trying to build upon those numbers. But we actually had a pretty, in my opinion, a pretty substantial number from the very beginning.”

As Iowa’s only federally-recognized tribe, Meskwaki Nation leaders faced a unique choice last fall. They could get the vaccine through the state of Iowa or the federal government’s Indian Health Service.

The tribe chose the feds, Papakee said.

Sara Augspurger, the clinic nurse manager at the Meskwaki Health Center, said most of the community knows and trusts the center’s staff. They’ve used this to spread accurate vaccine information. (Side Effects Public Media)

“I just thought the connection with Indian Health Service was going to get much stronger. They made some promises right from the beginning that once we get it, we’ll get it to your hands as quickly as we can,” he said.

That’s just what happened, Papakee said. Doses started coming slowly in December. They vaccinated elders and health care workers first, and quickly moved on.

But vaccine hesitancy was prevalent at the start. Even tribal leaders like Delonda Pushetonequa initially turned down the vaccine in December.

“I was one of the people who said no, you know, like, I don’t trust the government to be able to give us a vaccine,” Pushetonequa said.

But Pushetonequa said the Meskwaki Nation is a close-knit community with many multi-generational homes. This is what ultimately persuaded her to change her mind, she said.

“I don’t want to be that person who, you know, gets my dad sick, or, you know, any of my uncles, you know, who might not fare as well, if they were to get COVID,” she said.

Pushetonequa said she believes this has pushed others to get vaccinated as well.

But officials say it’s taken more than that.

Sara Augspurger is the clinic nurse manager at the tribe’s Health Center. She says the center’s staff works hard to spread accurate vaccine information and address concerns.

And Augspurger says she’s careful not to push anyone who’s not ready.

“And I also tell people, if you’re not comfortable, then it’s not time. You know, once you get comfortable with it, that’s when you should get vaccinated. And I’ve had four or five people be like,’ nobody’s ever said that to me. You know, I feel like everybody’s forcing me, but that makes sense,’ and have actually turned around and gotten vaccinated,” said Augspurger.

Health center director Papakee said he posts updates regularly in Meskwaki Facebook groups to address ongoing hesitations. He answers questions directly and tailors the experience of getting vaccinated to the community, he said..

“We created a post on social media that said, ‘if you’ve had the vaccine, what were your reactions?’ So — and it’s, it’s no longer ‘I read this on the news,’ or ‘I saw it on the internet,’ it’s, it’s your friend, your neighbor, your cousin, your relative,” Papakee said.

But Papakee said demand for the vaccine has started to decline. Meskwaki leadership launched a program three weeks ago for the settlement’s 500 tribal operations employees. It offers them a $100 Visa gift card for each COVID-19 shot they get.

That’s pushed their group’s vaccination rate to nearly 80 percent. It’s a program Papakee said he hopes to extend to all tribal members soon. So he can reach his goal of getting 85 percent vaccinated.

This story was produced by Side Effects Public Media, a public radio collaborative covering healthcare. It is based at WFYI in Indianapolis and has partner stations in six Midwestern states, including Iowa Public Radio. Natalie Krebs works out of Iowa Public Radio.