Answering the ‘spiritual call to action’: How the NATIVE Project brought vaccines to Spokane’s communities of color

Toni Lodge founded the NATIVE Project from the ground up, investing in the urban Indian community in Spokane for decades.

For all her accomplishments, 2021 marked a milestone for Lodge.

After a year of lockdowns, sickness and death, bringing lifesaving vaccines to not only the Native population but to other communities of color, which were hit hardest by the virus, was “the best thing I’ve ever done in health care,” Lodge said.

Starting in mid-December, the NATIVE Project staff began a vaccination marathon of sorts, hosting Saturday clinics every three weeks, first for their patients and tribal members and then for the broader community, working with organizations that represent and advocate for communities of color.

The result of the outreach, collaboration and relentless work of the NATIVE Project staff has led to 4,156 people getting vaccinated from many different communities by mid-June.

The planning began early, with the NATIVE Project’s pharmacist keeping a close eye on COVID-19 vaccine candidates in late fall 2020, ultimately asking Lodge and clinic manager Dylan Dressler to make a big leap of faith and purchase an ultra-cold freezer. The Pfizer-BioNTech vaccine looked to be the most promising.

That gamble paid off just a few months later.

Behind the scenes, the NATIVE Project also made another choice that proved pivotal in getting vaccine doses out to American Indians in Spokane and other communities of color. Instead of waiting for doses from the federal government, clinics and advocates asked the Department of Health to be included in statewide distribution of vaccine doses. The American Indian Health Commission and other tribal leaders helped secure doses for a handful of Indian health clinics in the state, including the NATIVE Project. When the Pfizer vaccine was approved, the clinic was ready.

Because of tribal sovereignty, the doses given to NATIVE Project would be used differently than the state’s tiered vaccine eligibility guidelines.

“We’re way more at-risk because of underlying health conditions and way more at-risk because of (mortality rates),” Lodge said.

The NATIVE Project prioritized health care staff and those who would be administering vaccines first, along with elders, and those living in multigenerational households and teachers came next. Age-based eligibility used by the state did not apply to the doses at the NATIVE Project, in part due to life expectancy data in the Native community and other communities of color.

This equity lens was recognized by other community partners that the NATIVE Project opened clinics to.

“They understand the data that says if you’re making this vaccination available only to elderly in the general community, you may not qualify for that until you’re 65 and 70 years old,” said Kiantha Duncan, president of the Spokane NAACP. “In communities of color, our lifespan for us is shorter; elderly for us is in their 50s.”

The color of your skin and in what neighborhood you live can mean the difference in lifespan of up to 15 years in Spokane County, according to data from the Spokane Regional Health District.

Less than a year after the first case of COVID-19 in Spokane County was diagnosed at the NATIVE Project, the first doses of the Pfizer vaccine were administered to clinic staff and community elders on Dec. 17, 2020.

At a time when doses were hard to come by, the NATIVE Project worked quickly to vaccinate tribal members, patients, volunteers and even some health care staff from around the community. Then, Lodge and her staff turned their attention to other communities of color.

These communities were hit much harder by the virus statewide, in part due to systemic racism and lack of access to care that existed long before the pandemic.

Pacific Islanders, Native Americans, Black and Latinx Washington residents have higher case, hospitalization and death rates from COVID-19 than white residents.

Lodge, who served on the statewide Safe Start committee, knew this and knew how she could help. She started making phone calls.

“I think the partnership was lifesaving, and I do not say that lightly,” Duncan said. “There were people and seniors from some of the local Black churches who came to get their vaccination, and they definitely would not have gone somewhere else to get it, so I think it was lifesaving for people of color in this city.”

Lodge reached out to the NAACP, Latinos en Spokane, the Asian Pacific Islander Coalition and other community groups to host vaccine clinics. The NATIVE Project provided the vaccine doses, the clinic space and the staff, but the organizations brought their own people.

Ryann Louie with the Asian Pacific Islander Coalition recalled going to restaurants and businesses, reaching out to friends and acquaintances and getting translators to come help on a Saturday. Louie and the APIC team did three to four weeks of outreach before their clinic, ensuring they could get food donated and offer people resources when they came to get a shot.

Latinos en Spokane began hosting webinars with bilingual doctors in anticipation of the community clinics. The organization’s comadres (outreach volunteers) made phone call after phone call, inviting people to the clinic.

The NAACP used social media and advertised through the Carl Maxey Center, and team members made a lot of phone calls out to households in anticipation of their clinics.

Every three weeks, from January to mid-June, there was a community clinic at the NATIVE Project. Each community organization had specific dates for their clinics, so culturally appropriate food, entertainment and translation was available. The turnout was so staggering that some days, they had to turn people away when they ran out of doses.

The NATIVE Project was not the only group arranging community clinics with organizations. The MLK Center and the Pacific Islander Community Association were coordinating clinics with the Spokane Regional Health District at the same time.

The NATIVE Project allowed each community group to tailor their vaccine clinic to what their community needed most. Latinos en Spokane brought in El Mercadito, the free farmer’s market, for their vaccine clinics. Translators and a welcome environment, free of doctors asking for insurance or potentially intimidating police or National Guardsmen, were vital.

“When you don’t have the language skills and don’t know the people there, it’s not a safe environment,” said Jennyfer Mesa, executive director of Latinos en Spokane.

The NATIVE Project inverted the whole narrative, Mesa said, creating a welcome and safe space where Latinx community members were not worried about being turned away or not having access to a doctor to ask questions.

With the inherent racism that nonwhite communities experience regularly, seeing community members, hearing information in your first language and feeling comfortable at the clinics was vital to their success.

Duncan, with the NAACP, said the clinics were an example of soulful leadership, with the NATIVE Project extending community trust, and community groups in turn offering that trust to those who showed up to get their shots.

“Communities of color do better when they receive resources and access to resources from people of color,” she said.

The efforts made by not only the NATIVE Project, but all the community groups is at least partially evident in Spokane County’s current vaccine data. The overtime of the NATIVE Project doctors, nurses, medical assistants and every staff member who could vaccinate someone or help with the clinics paid off.

“It was more of a spiritual call to action than work,” Dressler said, reflecting on the last six months.

There is still work to be done.

Lodge and her team anticipate ramping up the clinics again when children younger than 12 become eligible for the vaccine.

Mesa and the Latinos en Spokane team continue to host clinics. Last week, they hosted a late night clinic with Range Community Clinic specifically for construction workers and got 50 people vaccinated, Mesa said.

While local race and ethnicity vaccine data is not comprehensive or granular enough to capture details, overall percentages show that white and Hispanic populations in Spokane County are disproportionately not getting vaccinated against COVID-19.

Hispanic residents who are eligible for the vaccine make up 5% of Spokane County’s population but just 4% of the population that has received at least one dose.

White Spokane County residents, however, make up the lion’s share of those who are not getting vaccinated. White residents 12 and over make up 86% of the county’s population but just 80% of those who have received at least one dose of a vaccine, according to Department of Health data.

Statewide and in Spokane County, Hispanic populations have lower vaccine rates than other racial groups.

Mesa thinks it’s an access and assistance issue.

“COVID has highlighted the many inequities that immigrants and people of color and undocumented families face in Washington state,” Mesa said. “We can’t expect people to come to the party when they’ve never been invited to the party before.”

The NATIVE Project vaccination clinics created a sense of solidarity among communities of color in the county, Duncan said.

“What it showed and proved is: We’re capable of taking care of ourselves when we’re given the resources to do so,” she added.