SANTA FE, N.M. (AP) — The first doses of the coronavirus vaccine are being administered in Native American communities from the desert highlands of New Mexico to a coastal fishing tribe outside Seattle as the federal government and states rush to protect one of the most vulnerable U.S. populations.

The two-pronged effort includes a massive logistical operation by the federal government's Indian Health Service focusing on vaccinating health care workers at sovereign Indigenous nation clinics across the country and urban clinics serving off-reservation Native Americans.

The agency's initial allotment of about 22,000 vaccine doses from Pfizer and Germany’s BioNTech arrived Monday at distribution centers on vast portions of the Navajo Nation in Arizona and New Mexico and in urban places like Phoenix, where hundreds of health care workers who care for Native Americans got vaccinated on Thursday.

But many tribes selected a separate route to receive vaccine deliveries through state health agencies that in some cases have more enduring and trusting relationships with tribal communities. That system is spiriting vaccinations to small tribes like the Acoma Pueblo, known for its mesa-top “sky city” in the New Mexico desert.

Native Americans have been disproportionately sickened and killed by the pandemic — despite extreme precautions that have included curfews, roadblocks, universal testing and the suspension of business at casinos and artisanal trading posts.

The Lummi Nation, a tribe of 5,000 members living on an oceanside Washington state peninsula, began vaccinating Thursday with 300 doses as it fights surging cases with a shelter-in-place order.

Tribal elder James Scott, a facilities worker at the reservation's community clinic was the first to be vaccinated. In coming days, shots will go to tribal police, food program workers, long-term care residents and health care workers.

“We are so happy I can’t even describe it,” said Dr. Dakotah Lane, medical director of the Public Health Department and a Lummi Nation member, as he stood in line to get his shot.

The Lummi Nation managed to keep the virus at bay with broad testing and quarantine housing with food provided for those who tested positive, Lane said. There have been 133 cases of COVID-19 on the 20-square mile (52-square kilometer) reservation, with four hospitalizations and no deaths.

The tribe decided to get vaccines through the Indian Health Service to avoid competition with hospitals and nursing homes that would be vying for the state’s allocation. Lane called the decision “a calculated gamble.”

The Indian Health Service has said about 68,000 doses from Pfizer and an approval-pending shot from drug maker Moderna should be enough to protect front-line health workers at the 338 facilities serving Native Americans across the U.S. that signed up to work with the agency.

Pfizer vaccinations began Tuesday among health workers at clinics across the Navajo and Hopi nations in portions of Arizona and New Mexico, where 3,900 doses were escorted by police to clinics.

COVID-19 has roamed relentlessly among the Navajo Nation’s multi-generational rural households. Navajo health officials have confirmed 20,000 coronavirus cases across the reservation and at least 727 deaths since the pandemic began.

Navajo Nation President Jonathan Nez in a statement called the vaccination delivery effort "a blessing for all of our people, including the doctors, nurses, and many other health care warriors.”

Three Indigenous pueblos in New Mexico with populations as small 250 are getting doses of the vaccine through trusted relationships with state health officials.

At Acoma Pueblo, the first round of shots Wednesday went to health care personnel, the elderly and workers on the front lines of food distribution and mental health visits to tribal members living in self-imposed isolation to protect against infection.

The pueblo has funneled millions of dollars in federal relief toward its lockdown strategy for enduring the COVID-19 pandemic — closing its casino, installing 24-hour road blocks and stepping up food deliveries and virus contact tracing among homebound residents.

Since the pandemic began, there have been 16 virus-related deaths at the pueblo of about 3,000 residents, said pueblo Gov. Brian Vallo.

The infections happened despite pandemic precautions including near-universal pueblo virus testing and roadblocks to prevent tribal members from unauthorized travel and to keep visitors away.

Vallo has left the pueblo only once since March, to help deliver food to tribal members living in Albuquerque.

Vallo said Acoma Pueblo leaders doubted the local health care unit overseen by Indian Health Service would have enough medical personnel to administer the vaccine because of a recent reorganization that reduced local health services.

Many tribes, federal and state health officials are contending with a legacy of distrust among Native Americans linked to routine frustrations with health care services and historical events dating back to the arrival of deadly diseases carried by European settlers.

But the vaccine’s arrival at Acoma this week was greeted with gratitude and voluntary participation was enthusiastic, Vallo said.

“The community also realizes or understands that there are limited quantities and so that it will take time to get everyone fully vaccinated," he said.

Kailee Fretland, an Indian Health Service hospital pharmacist at the Red Lake Nation in Minnesota, helped design distribution to Native Americans across the U.S. keeping in mind vaccination access gaps during the 2009 H1N1 influenza virus outbreak.

“We went back and we reflected on what happened with H1N1,” she said an interview with the Native America Calling program broadcast on public radio stations. “The tribes were often not prioritized and we wanted to make sure that that did not happen with COVID.”

Derrick Lente, a New Mexico state legislator and tribal member at Sandia Pueblo on Albuquerque's outskirts, said his neighbors are eager to get vaccinated.

“Most people have said spike me, give it to me, I will take it,” Lente said. “They’ve seen the ugliness of what this pandemic has done to our community. They want a sense of security — if not for them, for their elders.”

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Johnson reported from Washington state.