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B.C.’s top public-health officials are apologizing for mishandling the distribution of COVID-19 vaccines in a remote Indigenous community, exacerbating tensions about systemic racism in the health care system.

Remote Indigenous communities such as the Nuxalk Nation at Bella Coola were promised prioritized access to the COVID-19 vaccine, according to the plan administered by Dr. Penny Ballem, executive lead for the province’s immunization program. It is a policy that recognizes the higher health risks, and greater barriers to health care, facing Indigenous communities.

Kirsten Milton, health director for the Nuxalk Nation, said the initial plan was to vaccinate 110 elders in her community, but when the public-health team from Vancouver Coastal Health arrived in Bella Coola on Jan. 21, they announced they had secured additional supplies – a welcome surprise that she expected would be used to help the Nuxalk respond to active COVID-19 cases in their village.

She said the pandemic has put scarce health resources under stress. “We have less access to primary health care and a lot of overcrowding and poverty in our community,” she said. But the visiting public-health officials and the Nuxalk leadership did not see eye-to-eye on who should receive the vaccine after the elders. As well, Ms. Milton said the health authority put pressure on her to submit information by e-mail, despite internet connection problems. Finally, the public-health officials announced they were withdrawing the remaining vaccines when their terms were not met.

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Kirsten Milton, health director of the Nuxalk Nation in Bella Coola, B.C.Kirsten Milton/The Canadian Press

Nuxalk Chief Wally Webber, in a statement, said the conduct of the Vancouver Coastal Health (VCH) team was shocking. “This issue could have been resolved in a simple phone call, but instead VCH referred to the initial vaccines as a ‘gift’ and used an RCMP escort to take the remaining vaccines to the airport.”

Of the 580 Moderna vaccine doses delivered to Bella Coola, 350 were administered, with the majority going to health care workers and long-term care residents off-reserve. The team returned to Metro Vancouver with the remaining 230 doses. Those doses were later administered at a hospital in Vancouver that was experiencing a COVID-19 outbreak.

Ms. Milton described the crushing disappointment when the Vancouver Coastal Health team departed with spare vaccines that the Nuxalk had wanted for front-line health workers and those who are immunocompromised on the reserve. “They failed us,” she said. “We were notified that these [vaccines] would be for reserved for our people, and people knew that the vaccine clinics were happening. So it was just really disappointing to have to let everybody know, we don’t have access to that anymore.”

B.C. has recognized that the pandemic presents higher risks in remote Indigenous communities, and committed to use its reserves of the Moderna vaccine to ensure those communities are protected. But since the vaccine plan was announced on Jan. 22, the province has had to scale back as Canada’s promised shipments of both the Pfizer and Moderna vaccines have stalled. Those supply shortages are undermining the province’s mass vaccination program.

Dr. Ballem would not respond to interview requests. In a written statement, she acknowledged there is systemic racism in the province’s health care system and said she has apologized directly to the Nuxalk leadership. She also appointed a liaison “to support the collective efforts to rebuild trust and repair relationships with the Nation and ensure that a culturally safe, respectful and partnership-based vaccine distribution process is established with the Nation going forward.” B.C. Health Minister Adrian Dix and Provincial Health Officer Dr. Bonnie Henry also offered apologies.

Mary Ellen Turpel-Lafond, who delivered a report to the provincial government in November that found Indigenous-specific stereotyping, racism and discrimination in British Columbia’s health care system, said the way the vaccine distribution was handled with the Nuxalk has deepened the fault lines between the province and Indigenous peoples about health care services in the pandemic.

“This is a public-health measure, it’s not a gift,” she said. “We’ve had this profound history of systemic and individual racism, and it is an impediment to actually addressing the health care issues on the ground in an emergency. So we’ve got to tune up, we have to learn from this experience. And they have to do better.”

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