First Nations leaders in B.C. say the province's updated COVID-19 immunization plan deviates from national guidelines that priority should be given to all Indigenous adults within the first two stages of vaccine rollout.
The current guidance from the National Advisory Committee on Immunization states adults in Indigenous communities should be prioritized in stage one and adults in or from Indigenous communities, including those living in urban centres, should be prioritized in stage two.
Charlene Belleau, chair of the First Nations Health Council, the political leadership and advocacy arm of the health governance structure for First Nations in the province, said the provincial plan was published "with no explanation or engagement by our people at all."
"I was in a call yesterday where chiefs are very upset about this new direction."
Isolated and remote communities given priority
Richard Jock, CEO of B.C.'s First Nations Health Authority, which is responsible for health services in B.C.'s First Nations, said the approach to vaccinations in First Nations communities has been one that takes a "whole of community" approach.
Belleau said this approach was advocated for by First Nations leadership and agreed to with the province in the initial vaccine rollout.
Documentation from the authority said this means vaccine is provided to all adults living and working in a community, including people who may not be First Nations such as family members, health care and community workers serving the community.
"This includes individuals who live off reserve, but close to community, due to housing challenges," states the authority's toolkit for First Nations receiving COVID-19 vaccine.
Then on Monday, the First Nations Health Authority learned the B.C. Ministry of Health was taking a different direction. The province committed that the whole community approach would continue for isolated, semi-isolated and remote communities identified for phase one rollout.
But according to a document shared with CBC News, all other First Nations communities (that aren't isolated) will receive vaccines for those who are 65 years and older, elders, recipients of long term home support/home care and related staff in First Nations. The province said it will consider a whole community approach in situations where a community is experiencing ongoing clusters and outbreaks.
To date just over half of the 204 First Nations in the province have received allocations of vaccine, according to the latest figures from the First Nations Health Authority.
The authority reported to chiefs on Thursday they're aware of just under 5,000 cases of COVID-19 among First Nations people in B.C. as of Feb. 24. There have also been 83 deaths.
Concern for off-reserve members
For the off-reserve population, First Nations people 65 or older will be eligible for vaccine in phase two of B.C.'s immunization plan.
In a Union of B.C. Indian Chiefs meeting on Thursday, Coun. Sherry McIntyre (Nlaka'pamux from the Skuppah Indian Band) said it's problematic to limit vaccines to elders and people over 65.
"Many elders live in multi-generational homes and need the entire household immunized at minimum in order to protect the health of that elder," she said.
Tsartlip Chief Don Tom said it's also problematic to have inequitable access between community members who face the same kinds of risk factors regardless of where they live.
"Crowded homes, chronic health conditions, kidney problems — these are not limited to on-reserve. These are very much factors that come into play off-reserve as well," he said.
"Tsartlip will be having vaccines available on Monday for my community and it just breaks my heart to know that my aunts and uncles who live off-reserve, who are elders, that they just aren't afforded the same opportunity and somehow their lives are less important than mine," he said.
'No room for exceptions'
Leadership at UBCIC passed a resolution calling for a revision to the B.C. immunization plan on Thursday. They're advocating for a plan that will see equitable and accessible delivery to all First Nations people in the province.
They also called on Indigenous Services Canada Minister Marc Miller, who was at the meeting, to step in.
Miller acknowledged that the national guidelines "clearly and squarely" state that all adults living in Indigenous communities should get a vaccine under stage one, and that all other Indigenous adults should be able to get their shot in stage two.
"There's no room for exceptions here, with the exception of some of the logistical challenges, that I must acknowledge," said Miller.
Some of the logistical challenges Miller acknowledged come down to jurisdictional differences for on and off-reserve populations.
Belleau said the First Nations Health Council has requested a meeting with B.C. Provincial Health Officer Dr. Bonnie Henry and B.C. Health Minister Adrian Dix to discuss their concerns.
The province did not respond to questions by the time of publishing.