How is Alaska leading the nation in vaccinating residents? With boats, ferries, planes and snowmobiles.

Alaska, the state with the largest land mass in the nation, is leading the country in a critical coronavirus measure: per capita vaccinations.

About 13% of the people who live in Alaska have already gotten a shot. That’s higher than states such as West Virginia, which has received a lot of attention for a successful vaccine rollout and has inoculated 11% of its people.

But the challenge for Alaska has been how to get vaccines to people across difficult, frigid terrain - often in remote slivers of the state?

“Boats, ferries, planes, snowmobiles - Alaskans will find a way to get it there,” said the state’s chief medical officer, Anne Zink, 43.

Alaskans are being vaccinated on fishing boats, inside 10-seater planes and on frozen landing strips. Doctors and nurses are taking white-knuckle trips to towns and villages across the state to ensure residents are protected from the coronavirus.

Contributing to Alaska’s quick speed in getting the vaccine to its residents is a federal partnership that allows the state, which has more than 200 indigenous tribes, to receive additional vaccines to distribute through the Indian Health Service.

Other reasons include the state’s small population of 732,000, as well as a high number of veterans, Zink said. The U.S. Department of Veterans Affairs is working with the Centers for Disease Control and Prevention to ensure that high-risk veterans receive priority for the vaccine.

But one big reason is the state is practiced in delivering precious cargo by transport not often used in the Lower 48. Sometimes that even means adventures by sled.

[Alaska rises to No. 1 among states for per-capita coronavirus vaccinations]

One all-female medical crew of four in December used a sled pulled by a snowmobile to deliver vaccine to the village of Shungnak in the state’s remote Northwest Arctic Borough.

“It’s just an easier way to get around when you don’t have a lot of roads,” said Kelli Shroyer, public communications director for the Maniilaq Health Center in Kotzebue, Alaska, where the crew started their journey.

Shroyer added that people sometimes get picked up from the airport in a sled, and high school sports teams will at times travel to one another’s gyms by sled, too.

Zink was so impressed by the sled crew’s delivery in December that she posted about it on her Facebook page.

“I love the pictures of vaccination distribution in Alaska,” she wrote. “Recipients expressed how grateful they were that even though they are so remote, they are getting this vaccine. They are not forgotten.”

Elders from some tribes recall stories about the 1918 flu pandemic, which decimated entire villages, she said.

“The stories have lived on,” Zink said. “One chief told me how his grandmother took his mother out to the wilderness for a year so that she would be safe. When they returned, they learned that most of their village had died.”

“We are stronger as a state because of that history,” she added. “For me, the way that villages were able to recover from that trauma speaks to what we need to do to keep moving forward.”

Thousands of Alaskans are playing a role in getting people vaccinated, Zink said.

Curt Jackson used to employ his water taxi, the Orca, to shuttle tourists from the small city of Homer to villages across Kachemak Bay that aren’t accessible by roads.

In late December, Jackson received a request to take three nurses across the bay to Seldovia, a town with about 450 residents, including members of the Seldovia Village Tribe. Planes couldn’t fly that morning because of weather, and the water was rough.

When the women climbed aboard his 32-foot aluminum landing craft and took seats in the windy darkness, Jackson said, he noticed that the woman in the middle, Candace Kreger, was clutching a bright blue cooler.

That was when he realized that the women were traveling with the precious doses.

“I asked them, ‘Is that the vaccine?’ and they told me that it was,” said Jackson, 46. The nurses were going to vaccinate the first group of medical workers in the village.

Although the harrowing 15-mile trip across the bay took more than an hour instead of the usual 30 minutes, Jackson safely piloted his boat through strong winds and choppy, four-foot waves.

At the end of the journey, he posed for a photo with the medical crew, who thanked him profusely for getting them there.

“With a strict time frame [for the Pfizer vaccine], there was no option for us to postpone vaccinations,” said Kreger, 40, a licensed nurse care coordinator from Homer.

“On any other day, the rough ride would not have been as nerve-racking if [the] vaccine hadn’t been involved,” she said.

For Ellen Hodges, a doctor from Bethel, Alaska, the coronavirus vaccination effort is the most rewarding project in which she has been involved, she said.

Hodges, 46, has flown to several villages in a six-seater plane to vaccinate medical workers and elders, who meet her on the runway.

“We land in the isolated tundra, and they’ll be lined up waiting,” she said. “Some places have up to 30 people, and some have only one.”

Even if there’s just one person, the trip is worth it.

When the weather is especially cold, said Hodges, medical crews often upgrade to 10-seater planes so people can climb aboard and get inoculated inside.

“If you turn around the last two seats in the plane, it works out perfectly,” she said

Tribal leaders say they are appreciative of the creative approach the state has taken - resorting to planes, sleds and snowmobiles.

“You have to be resilient and self-sufficient to live in Alaska,” said Crystal Collier, president and CEO of the Seldovia Village Tribe. “We have a lot of multifamily households, so we’re extremely grateful to see these vaccines arrive.”

Collier, 61, was not at all surprised to learn that Jackson had piloted his boat through heavy seas to get the first vaccines to her village.

“People here look out for each other,” she said.

Jackson has a new nickname since his turbulent voyage across the bay, he said. Some of his friends are now calling him “Captain Balto.”

Balto was a lead sled dog for a team in 1925 that made a heroic transport of diphtheria vaccine across nearly 700 miles of Alaska, from Nenana to Nome. The Iditarod Trail was the only accessible route at the time during winter.

“I was glad I didn’t have to go that far,” Jackson said. “But when we made it across [the bay], I got a little choked up, happy that I helped play a part in it.”