Navajo Nation will receive monkeypox vaccine as part of preparedness efforts

The Navajo Nation hasn't yet reported a case of monkeypox, but the tribe has activated its preparedness team and requested the White House to prioritize Native American communities by distributing vaccines through the Indian Health Services.

A supply of the approved Jynneos vaccine will be shipped to the Navajo Nation this week, said Capt. Brian Johnson, Navajo Area Indian Health Service acting deputy director.

"We know how important it was when vaccines arrived for COVID-19," said Johnson. "Although we don't have cases on the Navajo Nation, we know we will have that protective measure of having the Jynneos vaccine here on site.”

The Navajo Nation is preparing for monkeypox much the same way it geared up to fight COVID-19, officials said. Tribal leaders implemented the COVID-19 preparedness group in February 2020, three weeks before the first cases were reported. The group was formed to monitor, plan, prepare and coordinate precautionary efforts to address the coronavirus.

This current preparedness team includes Navajo Area Indian Hospital Services, Navajo Health Command and Operations Center, Community Outreach and Patient Empowerment and the Navajo Department of Health. Within these entities, according to Jill Jim, executive director for the Navajo Department of Health, there have been meetings to receive updates, training and to identify the leaders who will be co-leading the group.

“With President (Jonathan) Nez’s support by sending out the letters to Washington, I'm glad we are making the connections to get vaccines through Indian Health Services rather than the state,” Jim said. “We have an existing surveillance through the Navajo epidemiology center where we communicate with health facilities if possible cases are identified. Those mechanisms are more alerted to the fact that we will be addressing monkeypox."

In the letters to President Joe Biden and Health and Human Services Secretary Xavier Becerra on Aug.10, Nez said the Navajo Nation has demonstrated efficiency in administering COVID-19 vaccinations. The Navajo Nation was successful with vaccine distribution because the tribe bypassed the state public health agencies and instead utilized the IHS for vaccine distribution.

The vaccine proved to be the quickest way to prevent the spread of diseases such as COVID-19 on the Navajo Nation, Nez wrote.

“We have been hearing about this for quite some time, but now it's more elevated to an extent,” Jim said. “But messaging will still be more important and preventative.”

Since monkeypox was declared a global emergency in July, there have been 14,115 reported cases in the country. The Navajo Nation spans three states: Arizona, which has 220 cases; New Mexico, with 16 cases; and Utah, with 77 cases, according to the U.S. Centers for Disease Control and Prevention.

Since monkeypox is surrounding the Navajo Nation, the preparedness team was activated.

Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. It can spread to anyone through close, personal, often skin-to-skin contact such as direct contact with a monkeypox rash, scabs or bodily fluids from a person with monkeypox; touching objects, fabrics (clothing, bedding or towels) and surfaces that have been used by someone with monkeypox; or contact with respiratory secretions.

On Aug. 9, the U.S. Food and Drug Administration issued an emergency use authorization for the Jynneos vaccine to allow health care providers to use the vaccine for individuals 18 and older who are determined to be at high risk for monkeypox infection.

“They are recommended for people who have been exposed,” said Dr. Laura Hammitt, director of infectious disease programs at Johns Hopkins University's Center for American Indian Health.

She noted the CDC recommends the vaccine be administered to people identified as a close contact, or someone whose sexual partner in the past two weeks was diagnosed with monkeypox, or someone with multiple sex partners in an area with known monkeypox.

Nez wrote in the letter that the ongoing COVID-19 pandemic has highlighted the inequities tribal communities have faced due to a history of oppression and inadequate federal funding of tribal health care systems. He said access to safe and effective vaccines can prevent a second pandemic from occurring in a time of continued public health crisis.

“A greater proportion of Native Americans who had contracted COVID-19 had experienced more hospitalization and death,” Nez wrote in the letter to Biden. “We have every reason to expect similar impacts from monkeypox, and disparity gaps will widen without vaccine distribution proportional to the rates and vulnerabilities of Native Americans to infectious diseases.”

Aside from working to get monkeypox vaccines sent to the Navajo Nation, tribal leaders are working on a Navajo interpretation of monkeypox. Before COVID-19 had been reported on the Navajo Nation, leaders interpreted it into Navajo as Diko Ntsaaígíí-Náhást’éíts’áadah (big cough-19 or big cold-19).

“As we did with COVID-19, we are in the process of developing a more Navajo medical term for monkeypox,” Nez said. “The reason why we name these viruses in Navajo is so that our Navajo health care professionals can also use this for scientific research and data and everyone will know what the terminology is.”

While the Navajo Nation has not had a confirmed case of monkeypox and is awaiting the supply of Jynneos vaccine, the Phoenix Area Indian Health Service has had confirmed cases and also will be receiving a supply of Jynneos vaccine. Currently, the vaccine will be reserved for those at highest risk for severe disease.

The Phoenix Area IHS consists of two acute care hospitals, two critical access hospitals, four outpatient facilities and a youth regional treatment center. The total patient population served by the Phoenix Area IHS is about 170,000 American Indians and Alaska Natives in Arizona, Nevada and Utah.

The Phoenix Area IHS is hosting updates for federal, tribal and urban facilities regarding the most current monkeypox guidance from public health authorities.

"As with any public health emergency, the Phoenix Area IHS is very concerned. However, the monkeypox virus differs from the other public health emergency, COVID-19," said a Phoenix Area IHS representative in an email to The Arizona Republic. "Monkeypox virus infection is very serious; however, education, situational awareness, and access to testing, contact tracing and treatment can contain the spread of this disease. IHS remains committed to this public health approach."

Arlyssa Becenti covers Indigenous affairs for The Arizona Republic and azcentral. Send ideas and tips to arlyssa.becenti@arizonarepublic.com.

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This article originally appeared on Arizona Republic: Navajo Nation awaits the first shipment of monkeypox vaccine