NOEL KING, HOST:
The federal Indian Health Service, or IHS, has successfully delivered coronavirus vaccines to some of the most remote parts of this country. But for many Native people who live in cities, getting the vaccine hasn't been that easy. Here's Savannah Maher from the Mountain West News Bureau.
SAVANNAH MAHER, BYLINE: Fifty-five-year-old Jonathan Concha of Albuquerque has been searching for a vaccine since early February. That's when the shot became widely available at his tribal clinic in Taos Pueblo. He was willing to make the 2 1/2-hour drive home to get one. But Taos Pueblo was on strict lockdown.
JONATHAN CONCHA: I had called. And they said, since I live outside the county that I was ineligible to get it.
MAHER: So he tried for an appointment at Albuquerque's two federally funded urban Indian health centers.
CONCHA: I wasn't able to register. And they said it was only eligible to patients.
MAHER: As in patients who are already enrolled at the Indian Health Service clinic or hospital. But Concha has private health insurance through his job. So he hadn't needed to enroll.
CONCHA: If you don't visit IHS, then you're basically out of the loop.
MAHER: He finally got his shot in mid-March at a state-sponsored event for Albuquerque's urban Native population.
UNIDENTIFIED PERSON: Things going? OK. Let's have your sleeve up then. OK. Here comes the poke. Ready? Poke.
CONCHA: For the most part, everybody's - in my family's been vaccinated already. I'm the last one (laughter).
MAHER: Concha was initially left out of a nationwide effort to mass vaccinate Indigenous people, who, according to the CDC, are more vulnerable to COVID-19 than anyone else in America. And he's not alone. Abigail Echo-Hawk, director of the Urban Indian Health Institute, says many Native people living in cities across the country are having the same trouble getting vaccinated as non-Natives.
ABIGAIL ECHO-HAWK: They're going to the same hospital systems, same clinics, the same grocery store pharmacies that other people are trying to go to to get the vaccine. And they're not getting it even though they are the most at risk.
MAHER: And even though the federal government has a legal responsibility to provide health care to Native people regardless of their zip code. According to the IHS, most Indigenous Americans live away from tribal land. But less than 1% of the agency's budget goes to urban Indian health programs, like Denver Indian Health and Family Services. Director Adrianne Maddux says decades of underfunding has driven patients away from her clinic.
ADRIANNE MADDUX: Historically, our Native population in the Denver area has always thought of our clinic as the clinic that takes care of people that can't afford to go anywhere else.
MAHER: But the clinic has seen an influx of urban Natives seeking coronavirus vaccines. And it's been hard to keep up.
MADDUX: Probably, the majority of who we're vaccinating probably will not come back.
MAHER: The IHS is approaching 1 million patients vaccinated and announced this week that vaccine demand is on decline on many reservations. That means the agency can start targeting its supply to clinics like Denver Indian Health. But Maddux says it's not just supply that's holding the clinic back.
MADDUX: We need the staff. And we need the storage of these vaccines. So a lot of it has to do with what we're able to do within our infrastructure.
MAHER: And many other American cities don't have any IHS-funded clinics, as Ani Auld can attest.
ANI AULD: I'm working in D.C. where IHS headquarters are. And there's nothing available for us.
MAHER: Auld is a citizen of the Navajo Nation. She's watched many urban Natives in her circles travel hundreds of miles home to get the shot.
AULD: But then you put yourself at risk of exposure for having to travel. And that being the option is pretty ridiculous.
MAHER: She's lobbying the IHS to provide a vaccination clinic in the city. For now, she and other urban Natives are on their own. For NPR News, I'm Savannah Maher in Albuquerque.
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