Sarah Stanley of the Passamaquoddy Tribe at Pleasant Point stands on her porch on Friday, May 22, 2020. She is one of the hundreds of tribal members who has been vaccinated against the coronavirus in an effort running parallel to the statewide vaccine push. Credit: Courtesy of Wabanaki Public Health

Throughout the coronavirus pandemic, Passamaquoddy elder Sarah Stanley has worried about getting her grandchildren sick if she ends up being exposed to the virus. She now feels “100 percent safer” but still worries about venturing beyond home.

The difference now is that the 61-year-old from Pleasant Point was vaccinated at the tribe’s health center. The clinic had her on file as a patient with underlying health conditions and called her directly. There was no need to jockey for an appointment or navigate a website for hours, as many other older Mainers did when eligibility opened up.

“I would have done anything to get vaccinated,” Stanley said. “I’m really grateful that I did not have to try and go anywhere for it. I’m grateful to them.”

That close connection to their communities may be one of the reasons why three of the five tribal clinics in Maine have opened up doses to all people over age 16 while largely following a similar age-based strategy that the state has used. At least two are outpacing the state now and their effort could be a preview of Maine’s move to universal eligibility planned for April 19.

The Penobscot Nation, the Passamaquoddy at Pleasant Point and Indian Township and the Aroostook Band of Micmacs had collectively gotten 6,750 doses as of Tuesday with over half going to the Penobscots. They get their doses from the federal Indian Health Service. The Maliseets are supplied by the state and have gotten enough doses for 400 people, the Maine Center for Disease Control and Prevention said.

The efforts are now in high gear. The Micmacs have fully vaccinated 40 percent of the populations served by their health clinics, which includes tribe members and non-members alike, while the Penobscots are around 20 percent. Nearly 16 percent of Mainers were fully vaccinated as of Friday, according to the Maine CDC.

Tribes are coordinating as well. The Penobscot Nation announced on Wednesday it would be opening daily clinics up to members from any tribe or non-natives of an eligible household after receiving 600 more doses than expected. An agreement with the Passamaquoddy tribes and the Micmac allows them to store Pfizer vaccine in an ultra-cold freezer at the Penobscot Nation’s health center and access the doses as needed.

The tribes have mostly followed federal CDC guidelines, vaccinating health care workers and older people first. Candy Henderly, director of the Penobscot clinic, said they have made small adjustments as necessary and felt it was important to think of their community as those who interact with the tribe regularly, rather than just registered members.

“It would not make sense to exclude a rather large portion of the community who could potentially expose the Penobscot tribe to COVID,” she said.

Tribes in Maine avoided seeing large numbers of cases for months as the pandemic disproportionately affected American Indians and Alaskan Natives. That was likely due to a couple of factors: Tribes had their employees work from home for a period of time and the Penobscot and Passamaquoddy tribes closed reservations to outsiders. Local health providers began delivering goods to vulnerable elders to limit outings.

Like other tribes, their populations have high rates of comorbidities that make them more vulnerable to the virus. Many often live in multi-generational households with elders. In June, only three positive cases among people who self-reported as American Indian or Alaskan Native people had been recorded in the state. As of Thursday, that was up to 142, state data showed.

It is difficult to say how many of those cases are on tribal lands, as not all tribal members get their health care through the Indian Health Service-affiliated clinics or live on reservations. A person is also not required to report their race to get tested, and not every provider asks for it, something that is challenging Maine’s ability to gauge racial disparities in vaccine access.

The Micmacs have received all the doses they needed to vaccinate the population the clinic serves, said Theresa Cochran, the tribe’s health administrator. Natives are the priority, but the tribe is also offering vaccines to daycare providers for the tribe and caretakers of families who are not members. The tribe has a call list of people interested in getting vaccinated.

“The ultimate goal is to not waste doses,” Cochran said.

There are still hurdles. Tribes are seeing some vaccine hesitancy among younger members. Elizabeth Neptune, the health director for the Passamaquoddy Pleasant Point Health Center, said concerns range from misinformation about vaccines affecting fertility to conspiracies, as well as how quickly the vaccines were developed. She was not sure how to counteract those myths, but hoped hesitancy would be outweighed by the greater good vaccination could do for the community.

“We want to encourage people to come in and get vaccinated because it’s the right thing to do,” she said. “We want them to protect the folks who cannot be vaccinated.”