“Knowledge is medicine”: Indigenous health care experts tackle community COVID-19 vaccine hesitancy

Building trust between Indigenous communities and health care providers is a monumental feat — yet one that will also help save lives. The rate of reported COVID-19 cases among First Nations people living on reserve is currently 74% higher than in the general Canadian population, according to the latest government data.

“There are people who don’t trust COVID-19 vaccines. I have heard some people worry that they are being treated like guinea pigs,” said Dr. Lisa Richardson, an internist and strategic lead in Indigenous health at Women’s College Hospital in Toronto. “Vaccine hesitancy is not about the individual.  It is part of the larger systemic mistreatment such as forced experimentation, coercion or mistreatment in medical decisions and also racist assumptions that have led to poor outcomes for Indigenous people.”

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Understanding this colonial history and how it contributes to the ongoing mistrust of the medical establishment, Dr. Richardson and her team set out to collaboratively develop a culturally relevant program to address the safety of COVID-19 vaccines amongst First Nations, Inuit and Metis communities. Helping people make informed decisions, without any coercion, was essential.

The end result: the virtual hub Maad’ookiing Mshkiki, meaning “Sharing Medicine” in Anishinaabemowin, features a series of short videos, on everything from how vaccinations work to the intersection of traditional healing with western medicine. Presented as “fireside chats,” the approach is deliberately informal, featuring a range of voices — from health professionals providing advice to grandmothers explaining why they are reluctant to get the shot.

“It’s about allowing someone to make an informed choice, and never forcing someone to do something.” — Dr. Lisa Richardson

Final-year medical student Elisa Levi explained the approach. She has supported the project by developing fact sheets translating evidence-based information into concepts and language that are meaningful to the Indigenous peoples to improve accessibility. 

“In our communities we share information when we gather and Maad’ookiing Mshkiki embodies this virtually. Knowledge is medicine.”

Dr. Richardson said since its launch in February, the hub has not only filled a need in Indigenous communities, but it also seems to be accomplishing its goal.  

“It is about informed decision making. Every person I have spoken to had the vaccine once they had their questions answered.”

On the basis of her experience with the hub, Dr. Richardson advises all physicians and health care providers to embrace the opportunity for thoughtful conversations with their patients. In the meantime, the hub continues to add new material, including infographics, fact sheets and links to culturally relevant resources.

Maad’ookiing Mshkiki was developed by the Centre for Wise Practices in Indigenous Health at Women’s College Hospital in partnership with the Indigenous Primary Health Care Council, Anishnawbe Health Toronto, the Indigenous Health Program at University Health Network (UHN) and Shkaabe Makwa (CAMH).

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The CMA unites the medical profession in Canada to improve the health of Canadians and strengthen the health care system.

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