American Indians and Alaska Natives continue to “lead the way” in COVID-19 vaccinations, according to federal officials, even as President Joe Biden and the rest of administration are warning the rest of the nation about becoming too complacent.

The Indian Health Service is on track to have administered 1 million doses of the vaccine by the end of March, Dr. Matthew Clark said on a media call on Monday. That accounts for 60 percent of the agency’s user population, meaning the number of patients who have recently received care within the IHS system.

With the target in sight, the agency is transitioning to a new phase in its COVID-19 efforts. The IHS is the first in the nation to start distributing the vaccine based on the need at the community level, Clark said.

“We are committed to working with the administration and our tribal and urban Indian organization partners to continue increasing equitable access to vaccines a day,” said Clark, who is one of the team leads on the IHS COVID-19 Vaccine Task Force.

“For the first time, we are announcing that the IHS is the first jurisdiction to begin distributing vaccines based on orders from facilities, rather than based on centralized allocation,” Clark added.

The Navajo Nation has been among the hardest hit by COVID-19. Over the past year, the tribe has lost more than 1,200 to the virus. At one point, the reservation had the highest positive case rate of any jurisdiction in the U.S.

But Dr. Loretta Christensen, the chief medical officer for the Navajo Area of the IHS shared some promising developments from the the largest reservation in the nation. She said about 70 percent of the population has been vaccinated since the COVID-19 vaccine became available in late December.

“We are shooting for at least 80 percent of our population to be vaccinated,” said Christensen, who is a Navajo citizen.

“We feel that we would like to get to 80 percent and that is our immediate goal,” she said of a reservation that spans the states of Arizona, New Mexico and Utah.

Despite the seemingly good news in Indian Country, the rest of the nation doesn’t appear to be living by the same goals. With COVID-19 case rates rising once again, the director of the Centers for Disease Control and Prevention is fearing a return to the days when the Navajo Nation and other regions were at the center of the pandemic.

“I’m going to pause here. I’m going to lose the script. And I’m going to reflect on the recurring feeling I have of impending doom,” Dr. Rochelle Walensky said on another media briefing on Monday, one that place a couple of hours before the IHS call.

Walensky said Americans are moving too quickly to return to normal, as if COVID-19 has already been eradicated. While President Biden has promised to ramp up vaccinations — 200 million by the end of April — only 16 percent of the population has been inoculated so far, according to CDC figures.

“I so badly want to be done,” Walensky said on an update hosted by the White House. “I know you all so badly want to be done. We are just almost there but not quite yet. And so I’m asking you to just hold on a little longer, to get vaccinated when you can so that all of those people that we all love will still be here when this pandemic ends.”

Within a couple of hours, Biden was sharing the same message as the one pushed by the CDC. He too warned of a lapse in vigilance, one that resulted in American Indians and Alaska Natives suffering the highest COVID-19 cases rates, hospitalization rates and death rates than any other racial or ethnic group.

“This is not the time to lessen our efforts. That’s what she said,” Biden said in reference to Dr. Walsneky. “We could still see a setback in the vaccination program. And most importantly, if we let our guard down now, we could see a virus getting worse, not better.”

5 new cases, 16,359 recoveries, and no recent deaths related to COVID-19 pic.twitter.com/Yb2TKpTU7r

— Navajo Nation President Jonathan Nez (@NNPrezNez) March 29, 2021

Later on, President Jonathan Nez of the Navajo Nation sounded the alarm as well. Although the tribe has maintained a stay-at-home order for more than a year, some nearby jurisdictions — mainly the entire state of Arizona — have already lifted restrictions they had in place.

“According to public health officials, parts of the country are now seeing a rise in new COVID-19 infections due to increases in travel and some states lifting restrictions too soon,” Nez said on Monday evening.

“We are doing everything we can to help reduce the number of new infections, hospitalizations, and deaths,” Nez added.

According to IHS data from March 28, only 2.7 percent of coronavirus tests reported to the IHS have been positive in the last seven days. That’s a far cry from early January, when the 7-day positivity rate spiked as high as 16.5 percent. Last year, during the holiday season, rates were consistently high for weeks on end.

Even now, some regions of the IHS appear to be experiencing upticks. The 7-day positivity rate in the Great Plains Area, which includes Nebraska, North Dakota and South Dakota, rose from 3.3 percent to 5 percent, according to the most recent data. The Navajo Area is seeing an increase as well.

“We must remain vigilant,” Dr. Clark said on the IHS call. “Regardless of vaccination availability and the total number of COVID-19 cases, we continue to advocate that people who exhibit symptoms consistent with COVID, and those who suspect that they’ve been exposed to someone with the disease, should continue to get tested.”

“Testing is still an indicator of where COVID is and where it is going,” Clark said.

Nicholas Boudreaux, a member of the Chitimacha Tribe of Louisiana, talks about why he felt it was important to get the #COVID19 vaccine to protect his community. Contact your local IHS, tribal or urban Indian health facility to #getvaccinated! https://t.co/WhjZSTjlGZ pic.twitter.com/G2hfwomR46

— IndianHealthService (@IHSgov) March 29, 2021

The IHS updates its COVID-19 testing and results data every day, with figures based on what’s reported from tribal, urban and federally-managed sites two days prior. However, the information is incomplete, as facilities run directly by tribes, as well as those that are part of the urban Indian health program, are not required to disclose their figures.

According to the IHS, only 33 percent of tribal facilities and 44 percent of urban Indian organizations have been reporting COVID-19 data to the public since the start of the pandemic a year ago.

The IHS updates COVID-19 vaccination data once a week, showing how many doses have been distributed and administered across the IHS areas. But no data is being kept about urban Indians, an official from the Albuquerque Area of the agency said on the media call on Monday.

“I don’t have urban Indian clinic specific data,” said Dr. Julianna Reece, the chief medical officer for the region, which is home to four urban Indian organizations in the states of New Mexico and Colorado.

“But we do work very closely with our urban health centers and support their initiatives,” said Reece, who cited a recent COVID-19 vaccination event that took place at the Indian Pueblo Cultural Center in Albuquerque, New Mexico, where about 4.7 percent of the population is Native.