This Doctor Who Just Got the COVID-19 Vaccine Has a Message for Black and Latinx Patients

Photo credit: By Alexa Mieses Malchuk
From Oprah Magazine
Alexa Mieses Malchuk, MD, barely sleep from the excitement on the night of Friday, December 18. She had been selected as one of the first people in North Carolina - and the United States - to receive the recently approved Pfizer BioNTech vaccine for COVID-19, and she was scheduled to receive her shot at 1 p.m. the next day. People don't usually feel dizzy before being pricked with a needle, but that day had been a long time for Lousy Malchuk.
"I was so excited about this vaccine," she told "I see this has the ability to get us back to normal and change the course of the pandemic."
Lousy Malchuk is a family doctor who provides regular and practical care to people of all ages at the UNC Family Medicine Center in Durham and two hospitals. She was extremely frustrated that she had been forced to video care for patients for months.
"At the beginning of the pandemic, I felt very guilty for not being able to come into contact with my patients," she says. Lousy Malchuk grew up in Queens, New York, the epicenter of the pandemic last spring. From a distance, she watched the virus devastating her hometown.
“I've heard horror stories from colleagues about the mobile morgues outside the hospital. I had a good friend in their residence who got COVID in March; My closest friends and relatives in NYC just had a radically different experience than me. "While she was still able to safely and effectively deliver virtual care, she wanted to do more to help.
Time passed, however, and Mieses Malchuk, who is also an assistant professor in the Family Medicine Department at UNC-Chapel Hill, saw the value of her role. “Even though I'm not in intensive care and taking care of people intubated with COVID, there are still thousands of patients in my practice who need primary care. Not only do I teach patients how to protect them and how they should have access to primary care, but many people suffer from worsening depression and anxiety, and I was able to virtually help them cope with it. “These days she's practicing a mix of inpatient and outpatient medicine.
Many of Mieses Malchuk's patients have raised concerns about the speed at which the vaccine is being developed. The doctor, who identifies as multiethnic - Afro-Latina and white - felt deeply committed to learning about the vaccine and sharing knowledge with patients in person, on a screen, and through her social media account. “In our facility, we take care of everyone, regardless of whether they are insured or not. My patient population is extremely diverse and as I am one of the few Spanish-speaking providers in my clinics, I take care of many Spanish-speaking people. "
While public confidence in the vaccine increases in all segments of the population, including people of color, there are still significant numbers of black and Spanish people who fear the safety of the vaccine. According to a recent survey by the Kaiser Family Foundation, 48 percent of black adults say they are not sure that developing a COVID-19 vaccine will address blacks' needs. (It's worth noting, however, that this percentage has declined from 65 percent of black adults surveyed in September.) Among Hispanic adults, 36 percent say the same thing about the needs of the Hispanic population. In addition, 52 percent of black and 43 percent of Hispanic respondents say they want to wait before getting the COVID vaccination, compared to 36 percent of white respondents.
#ThisIsOurShot #CovidVaccine SO HAPPY !!!!! While the pandemic was a historic tragedy for our globe, there is light at the end of the tunnel. Today I feel like part of history. I urge everyone to get your vaccine ASAP!
- Dr. Alexa Mieses Malchuk (@DrAlexaMM), December 19, 2020
"Research has shown that people of color in general have a greater distrust of the medical facility," says Mieses Malchuk. "And when you think about how African Americans have been treated in this country, and especially by our scientific community and health system, it makes perfect sense that there would be this suspicion."
As one of the most notorious examples of racist abuse, Mieses Malchuk cites the 1932 Tuskegee Syphilis Study, in which 600 black men (399 with the disease, 201 without) were misled and then were not allowed to die. "These experiments lasted until 1972!" says lousy Malchuk.
"There is discrimination and bias in medicine to this day," she adds. "I think it's really important that providers take this into account and help patients make decisions about their health while considering their own situations, history, and beliefs."
She emphasizes the importance of diversifying the medical field. "We know that when patients can identify similarities between themselves and their doctor - in terms of race, language, or cultural background - there is an extra level of confidence that leads to better health outcomes."
Because of this, Lousy Malchuk has been talking about the vaccine non-stop (and tweeted and answered questions from the media). "A patient might be in the office for a Pap smear and I'll tell her about my plans to get the vaccine and ask her when she'll have hers."
Although the doctor believes the vaccine is safe, effective, and non-negotiable, she understands why many of her patients feel hesitant or unsafe. "As a woman of color who also wants to get pregnant in a few years time, I would be lying if I said I didn't share some of her concerns," she says. "We just don't have much of long-term safety data. We have other key data, however. I can safely tell you that if you get the COVID-19 virus, you will get sick. In some cases, you will get very sick and end up in the hospital. And there have been records of deaths from this virus. With the vaccine, the data shows you cannot get COVID and the side effects of the vaccine are minimal. The chance of a serious allergic reaction is small. "
Pfizer's two-dose vaccine has been shown to prevent 95 percent of COVID-19 cases, and a two-dose vaccine from biotech company Moderna appears to be similarly effective at 94.5 percent. "What I am telling people is that if you don't get vaccinated you are playing with COVID and you are hoping you won't get seriously ill or die from it. I care about my patients and I don't." I don't want them to take that risk. "
Lousy Malchuk had read that common side effects of the vaccine include pain and swelling around the injection area, as well as possible flu-like effects (which suggest the body is providing protection). So she scheduled her appointment for a Friday in case she needed a weekend day to recover.
After receiving Dose 1, she told that it felt like your typical needle clamp, but caused even less sore muscles than her last flu shot - and admitted that it could be because of her sky-high adrenaline levels or because she was distracted from joyful selfies. (The second dose of the vaccine is the one that experts say is more likely to cause side effects like fever, chills, fatigue, and headaches. Crappy Malchuk's follow-up appointment is scheduled for January 9th and she'll be reporting to us then like that goes.)
After the injection, she was asked to sit in a waiting room for about 15 minutes, where she was monitored for possible signs of an allergic reaction, which has so far been reported in very few cases. But she only felt joy and excitement. "I called my whole family right after that to tell them all they need to do is get their shot!"
It is not yet clear whether people who have been vaccinated can pass the virus on to others.
Lousy Malchuk realizes the irony in the fact that the groups hardest hit by the coronavirus are often those who are most reluctant to get vaccinated. "It is so important to highlight that it is racial and ethnic minorities who are hardest hit by COVID-19. This has nothing to do with genetics, it has nothing to do with the social determinants of health that we interact with on a daily basis. Our ability to Getting access to the health system, implicit and explicit prejudices within that system, the kind of jobs we might be forced to work to when we are undocumented immigrants in this country ... many things put us at risk of getting seriously ill with COVID That is why we need the vaccine the most. "
Despite her boosted immunity, Mieses Malchuk says she will continue to follow CDC recommendations by wearing her mask in public and practicing social distancing - even after receiving her second dose of the vaccine. "It's not yet clear whether people who have been vaccinated will be able to pass the virus on to others. So it is best that we all play it safe. I am relieved and grateful for this vaccine - but I am I'm still gonna be careful. "
Lousy Malchuk wants everyone to feel empowered to get vaccinated. “If I want my Black and Latino patients to know one thing, this vaccine is safe and it will help you be safe. There are many things we cannot control, but making the decision to vaccinate is one Decision that you can make yourself. "
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