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

Corrie Pikul
·9 min read
3
Photo credit: By Alexa Mieses Malchuk
Photo credit: By Alexa Mieses Malchuk

From Oprah Magazine

Alexa Mieses Malchuk, MD, could barely sleep from excitement on the night of Friday, December 18. She had been chosen to be one of the first people in North Carolina—and in the U.S.A.—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 giddy before getting jabbed with a needle, but this day had been a long time coming for Mieses Malchuk.

“I’ve been looking forward to this vaccine so much,” she tells OprahMag.com. “I recognize that this has the ability to get us back to normal and change the course of the pandemic.”

Mieses Malchuk is a family medicine doctor who provides regular, hands-on care to people of all ages at the UNC Family Medicine Center in Durham, and also at two hospitals. She was extremely frustrated at being forced to tend to patients via video for months at a time.

“At the beginning of the pandemic, I felt a lot of guilt at not being able to come into contact with my patients,” she says. Mieses Malchuk grew up in Queens, New York, which was the epicenter of the pandemic last spring. From afar, she watched the virus wreak havoc on her native city.

“I heard horror stories from colleagues about the mobile morgues outside the hospital; I had a good friend in their residency who got COVID in March; my closest friends and relatives in NYC were just having a radically different experience than I was." Although she was still able to safely and effectively provide virtual care, she wanted to do more to help.

Time wore on, though, and Mieses Malchuk, who is also an assistant professor at in the Department of Family Medicine at UNC-Chapel Hill, realized the value of her role. “Even though I’m not in the ICU taking care of people intubated with COVID, there are still thousands of patients in my practice that need primary care services. I’m not only educating patients about how we’re keeping them safe and how they should be accessing primary care, but a lot of folks are experiencing worsening depression and anxiety, and I’ve been able to virtually help them deal with that.” These days, she practices a blend of both inpatient and outpatient medicine.

Many of Mieses Malchuk’s patients have expressed concerns about the speed at which the vaccine was developed. The doctor, who identifies as multiethnic—Afro-Latina and white—felt a deep responsibility to educate herself about the vaccine and share knowledge with patients in-person, on a screen, and through her social media account. “At our institution, we take care of everyone, whether or not they have insurance. My patient population is extremely diverse, and since I’m one of the few Spanish-speaking providers at my clinics, I care for a lot of Spanish speakers.”

While public confidence in the vaccine is increasing among all demographics, including people of color, there remains a sizable number of Black and Hispanic people who are wary of vaccine safety. According to a recent poll by the Kaiser Family Foundation, 48 percent of Black adults say they are not confident that the development of a COVID-19 vaccine is taking the needs of Black people into account. (Though, it's worth noting that this percentage is down from 65 percent of Black adults polled in September.) As for Hispanic adults, 36 percent say the same about the needs of Hispanic people. What’s more, 52 percent of Black and 43 percent of Hispanic respondents say they want to “wait and see” before getting the COVID vaccination, compared to 36 percent of white respondents.

“Research has shown that people of color have a greater level of mistrust in the medical establishment in general,” says Mieses Malchuk. “And when you think about the way African Americans have been treated in this country, and more specifically by our scientific community and health care system, it makes perfect sense that there would be this mistrust.”

As one of the most notorious examples of racist mistreatment, Mieses Malchuk cites the 1932 Tuskegee syphilis study, in which 600 Black men (399 with the disease, 201 without) were misled into participating and then were not offered proper treatment—in effect, they were allowed to die. “These experiments went on until 1972!” says Mieses Malchuk.

“There’s discrimination and bias that goes on in medicine still today," she adds. "I think it’s really important for providers to keep that in mind, and to help patients make decisions about their health while taking into account their own situations, history, and beliefs."

She stresses the importance of diversifying the medical field. "We know that when patients can see similarities between themselves and their physician—in terms of race, language, or cultural background—there’s an extra level of trust, and that leads to better health outcomes.”

That’s why Mieses Malchuk has been talking (and tweeting, and answering questions from the media) about the vaccine nonstop. “A patient could be in the office for a Pap smear, and I’m telling her about my plans to get the vaccine and asking her when she intends to get hers.”

Although the doctor believes the vaccine is safe, effective, and non-negotiable, she does understand why many of her patients feel hesitant or uncertain. “As a woman of color who also wants to get pregnant in a few years, I’d be lying if I said that I didn’t share some of their same concerns." she says. "We just don’t have a lot of long-term safety data. However, we do have other key data. I can tell you with certainty that if you get the COVID-19 virus, you will become sick. In some cases, you will become very sick and end up in the hospital. And there have been record cases of death from this virus. With the vaccine, the data shows that it can prevent you from getting sick with COVID, and the side effects of the vaccine are minimal. The chance of a severe allergic reaction is low."

The two-dose Pfizer vaccine has been shown to prevent 95 percent of cases of COVID-19, and a two-dose vaccine from the biotech company Moderna appears to be similarly effective, at 94.5 percent. "What I tell people is that if you don’t get vaccinated, you’re gambling with COVID, and you're hoping that you won’t get severely ill or die from it. I care about my patients, and I don't want them to take these chances.”

Mieses Malchuk had read that common side effects of the vaccine include pain and swelling in the injection area, as well as possible flu-like effects (which are evidence that the body is building protection). So she scheduled her appointment for a Friday, in case she needed a weekend day to recover.

After getting dose 1, she reported back to OprahMag.com that it felt like a typical needle pinch, but it involved even less muscle soreness than her last flu shot—acknowledging that this could be because of her sky-high adrenaline levels, or because she was distracted by taking joyful selfies. (The second dose of the vaccine is the one that experts say is more likely to cause side effects such as fever, chills, tiredness, and headache; Mieses Malchuk's follow-up appointment is scheduled for January 9, and she'll be reporting back to us then on how that goes.)

After the injection, she was asked to sit for about 15 minutes in a waiting room, where she was monitored for any possible signs of an allergic reaction, which have been reported in a very few cases so far. But she felt only joy and excitement. “I called my entire family right afterwards to tell them they just had to get their shot!”

It's not clear yet whether people who have been immunized are able to pass the virus on to others.

Mieses Malchuk recognizes the irony in the fact that the groups most impacted by the coronavirus are often those who are most hesitant to get vaccinated. “It’s so important to highlight that it’s racial and ethnic minorities that are being hit hardest by COVID-19. That has nothing to do with genetics, and everything to do with the social determinants of health that we interact with on a daily basis. Our ability to access the healthcare system, implicit and explicit bias within that system, the type of jobs we may be forced to work if we are undocumented immigrants in this country...a lot of things put us at risk for becoming severely ill with COVID. For those reasons, we need the vaccine the most.”

Despite her boosted immunity, Mieses Malchuk says she will still follow CDC recommendations by wearing her mask in public and practicing social distancing—even after getting her second dose of the vaccine. "It's not clear yet whether people who have been immunized are able to pass the virus on to others. Therefore, it's best that we all err on the side of caution. I'm relieved and grateful for this vaccine—but I'm still going to be cautious."

Mieses Malchuk wants everyone to feel empowered to get immunized. “If there is one thing that I want my Black and Latino patients to know, it’s that this vaccine is safe, and it will help keep you safe. There are a lot of things that we can’t control, but making the choice to get a vaccine is one choice you can make for yourself.”

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