Senior health officials in British Columbia have apologized to the Nuxalk Nation after a medical health officer withdrew more than 200 COVID-19 vaccine doses that Indigenous leaders had been told were intended for their people.
Following a succession of technical and communication problems during a vaccine rollout in remote Bella Coola, B.C., by Vancouver Coastal Health in January, medical health officer Dr. John Harding promptly removed his team from the community after fewer than 100 doses had been administered, according to internal emails and an audio recording obtained by CBC News.
Nuxalk leaders were also shocked when Harding referred to the vaccine as a “gift” to the nation.
The planned inoculation drive in Bella Coola was part of the B.C. government’s aim to roll out the Moderna vaccine across the province’s remote Indigenous communities, which have been disproportionately affected by COVID-19 and often have poor access to health care.
In the audio recording, Dr. Jeffrey Peimer, a medical director with Vancouver Coastal Health (VCH), is heard telling Nuxalk leaders that Harding was upset over what he called an “aggressive” and “shocking” email sent to him by Nuxalk executive director Wilma Mack, and as a result, Harding took the vaccine back to the Lower Mainland.
Harding left the community with an RCMP escort on Jan. 22, five days after arriving, because he thought people were going to “stick him up,” Peimer also says in the recording.
But in emails to the Nuxalk Nation health team, Harding states that he withdrew his team because he was “deeply saddened” that the Nuxalk hadn’t created a vaccine rollout plan overnight.
VCH confirmed that Harding took 230 vaccine doses meant for Bella Coola back to Vancouver, but the health authority would not disclose why.
“For it to unravel so quickly was just so disheartening,” said Nuxalk director of health Kirsten Milton, who was part of the vaccine rollout in her community.
Milton said she felt guilt-ridden telling elders and health-care workers they would no longer be inoculated.
Technical, communications troubles
Harding and a team from VCH arrived in Bella Coola on Jan. 17, a day earlier than planned, to avoid a snowstorm.
At least one VCH nurse and two Nuxalk nurses were distributing the vaccine together.
Emails exchanged between Harding’s team and the Nuxalk show a plan was put in place to provide the first dose of the vaccine to 110 members of the on-reserve community, starting with elders over the age of 65, followed by those 55 and up and then immunocompromised people.
There was also a separate plan to vaccinate 110 off-reserve health-care workers at the Bella Coola General Hospital.
On Jan. 19, about 75 elders, aged 65 and older, who live on the reserve received a first dose of the vaccine from the Nuxalk health team. But the next day, the team started to face serious technical difficulties.
A VCH nurse sent an email to the Provincial Health Services Authority stating that the team was struggling with “very inconsistent Wi-Fi” and that she was tethering internet service from her cellphone, which posed security issues.
The nurse also said the First Nations Health Authority and VCH computer systems were not compatible, creating further issues — a fact that was confirmed by Nuxalk health leaders.
As a result, they were unable to add information into the system about who would be getting the vaccine — something Harding said he needed prior to anyone getting vaccinated.
The nurse’s email concluded that she didn’t see “a feasible option” to work out the technical issues.
Plan deadline missed by 2 minutes
On top of technical difficulties, the community and Harding were facing a communications breakdown.
At a ceremony to welcome Harding and the vaccine, the medical officer stated he brought up more vaccine than expected — 360 doses — to inoculate the entire community, said Milton, Nuxalk’s director of health.
But in numerous emails sent on Jan. 19 and 20, Harding gives unclear recommendations about how to “best protect the community” — suggesting it should include elderly and immunocompromised people in the entire Bella Coola Valley, not just those on reserve and health workers, as initially discussed. According to census documents, the population of the region is about 2,000.
With Harding’s email suggesting priority was moving to off-reserve individuals, Wilma Mack sent him a short email on Jan. 21 outlining her concerns that the most vulnerable people in her community would not get vaccinated.
She ended by saying: “The Nuxalk Nation demands that 250 of the 360 Moderna vaccines be released immediately to our Nuxalk Nation Registered Nursing team.”
About 30 minutes later, at 5:21 p.m., Harding replied, telling the Nuxalk that if a “plan” was not provided by 10 a.m. the next morning, “the vaccine will no longer be available.”
The community provided a plan at 10:02 a.m., but Harding said it missed the deadline.
Harding left the community shortly after with the vaccine and an RCMP escort.
Before he left, Harding sent the Nuxalk health team an email saying, “VCH will honour its promise to gift a total of 110 doses to Nuxalk,” and added: “As 10 vials in total were already gifted since arrival, one remaining vial has been left at the Bella Coola hospital.”
“That was unbelievably unacceptable,” Milton said.
“No one would ever call public health a gift. That to me showed the privilege we do not have.”
Iris Siwallace, a Nuxalk cultural leader who heads up the nation’s Emergency Operations Centre team, said she believes systemic racism was at play.
“It really made me feel disheartened,” she said.
Health officials apologize to Nuxalk
VCH would not respond to specific questions nor grant CBC News an interview with Harding.
But in a statement, VCH board chair Dr. Penny Ballem said she “deeply regrets that we failed to provide a culturally safe and respectful experience for Nuxalk Nation members while providing COVID-19 vaccine to vulnerable elders in their remote community.”
She also said she sincerely apologizes to Chief Wally Webber, the Nuxalk Nation and its members.
B.C. Health Minister Adrian Dix and Provincial Health Officer Dr. Bonnie Henry said they failed the Nuxalk.
“We sincerely apologize to the people of the Nuxalk Nation,” a statement read.
“We can and must do better … and [we] recognize the need for prioritized access to the COVID-19 vaccine to ensure cultural continuity and to counter the impacts of long-standing racism and discrimination.”
Both have asked Dr. Danièle Behn Smith, deputy provincial health officer, to ensure “a culturally safe, respectful and partnership-based vaccine distribution process is established with the [Nuxalk] Nation going forward.”