Juleyka welcomes Dr. Eva Galvez, a family physician working primarily with immigrant communities, to get advice on how to talk with parents and loved ones about the need to get vaccinated. Dr. Galvez offers strategies for addressing concerns, building trust, and navigating barriers to access for certain populations.
Featured Expert:
Dr. Eva Galvez is a board certified family physician at Virginia Garcia Memorial Health Center in Hillsboro, OR. She is a native Oregonian and the daughter of Mexican immigrants. She obtained her undergraduate degree from Oregon State University and her medical degree from the University of Washington School of Medicine in 2004. She serves as the Board Chair for Migrant Clinicians Network, a non for profit national organization focused on health justice and on the board for Oregon Academy of Family Physicians. Dr. Galvez is passionate about health equity. She regularly speaks on panels to educate the public around root causes of poor health and health disparities. During the COVID-19 pandemic she became a vocal advocate for mitigating health risks for Oregon’s seasonal farmworkers and she has addressed the Select Subcommittee on the Coronavirus Crisis in the US House of Representatives. Dr. Galvez also serves as a teacher for family medicine students. She believes that she has a responsibility to help train the future generation of family physicians and most importantly, in bringing awareness to future doctors regarding the barriers and social determinants affecting immigrants. Learn more about the health center and its work, here.
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Juleyka Lantigua-Williams:
Hi, everybody. In a way, COVID-19 was the catalyst for this show. My friend’s story about dealing with her mom, who was being reckless during the initial days of lockdown in 2020, really got me thinking about the major gaps and the deep pitfalls in our communication with our parents. A year later, as vaccines become more available, I’ve been thinking a lot about how we should speak to our loved ones about getting vaccinated. There’s a lot of confusion. There’s a lot of misinformation. So, of course, we found someone who’s been having these conversations and who’s earning the trust of many in the immigrant community.
Let’s get into it.
Dr. Eva Galvez: My name is Dr. Eva Galvez, and I am a family physician, and I work at Virginia Garcia Community Health Center in Portland, Oregon. I work primarily in a community health center that serves Latino patients. The patients that I serve are usually low-income patients, they’re immigrants from different areas of Latin America. Most of my patients prefer to speak Spanish. Many of my patients are working in essential jobs. And they’ve really been hit hard by this pandemic. We’re seeing a lot of not only problems with physical health, but there’s also been a huge financial and emotional impact that the pandemic has had on the community that I serve.
Lantigua-Williams:
So, Dr. Galvez, I imagine that you’ve been talking to your patients about getting vaccinated. What are those conversations like? What are their fears? What are their hesitations?
Dr. Galvez: Well, I’ve been talking a lot about the vaccine since we began to roll it out, and my patients do have a lot of concerns. I think primarily the concerns that they have have to do around safety about the vaccine. So, many of them want to know is the vaccine safe? What are the long-term side effects of the vaccine? Is it possible that I will get sick after I get the vaccine? You know, some people have other concerns about whether or not maybe the vaccine is injecting the virus into their body. I’ve had people tell me, “Is this a way to try to reduce the number of people of color in the community?”
I’ve had people who told me that they’re worried about it causing infertility and long-term health problems, so we’ve been having a lot of conversations about the vaccine. And usually what I do is I start out by asking people, you know, what do you know about the vaccine? What are your concerns? And then from there, it’s really nice to be able to have a conversation and I really do my best to try to address all of their concerns.
Lantigua-Williams:
So, let’s talk specifics. Talk me through how you explain and answer the question of is the virus being injected into my body.
Dr. Galvez: Well, the first thing I always tell people is it is normal and it’s okay to have these kinds of concerns. A lot of people have concerns about vaccine safety. It’s not just Latinos. I think in general, what we’re seeing in the community is that people are worried about how quickly the vaccine was rolled out. So, I first acknowledge that these concerns are completely normal, and then what I do is I really try to give them a really basic idea about how the vaccine was developed. And you can do this in a way that is in a language and at a level that my patients can understand. And I find that that’s really effective, talking a little bit about the science, and how it works, and I tell them that this is a testament to our technology and how much science has advanced, and that we have a way to inject a copy of the COVID-19 virus that is RNA and that it goes into the body, it makes our body make antibodies, and then it disappears, and it doesn’t integrate or alter our DNA, and that when we do see that virus later on if we’re out in the community, we have the antibodies or the immunity to fight off the virus.
And it doesn’t have to be complicated. It can be really simple. I think most people understand that. And that really, really does provide a lot of comfort for people.
Lantigua-Williams:
And what about the question around the fear of it causing infertility? Because we’ve seen some horrible news coming out of the ICE detention centers, where women were allegedly operated on, you know? And so, how do you answer that fear?
Dr. Galvez: Once again, I validate those concerns, and I think it’s important to acknowledge when we’re talking to the community is that there is good reason for us to have some mistrust and hesitation because of the way communities of color have been treated in the past, especially when it comes to science and doing experiments. And I go back to the science and I also think that humility is very important, because we as a medical field do have to acknowledge that there is still a lot that we don’t know about the vaccine. The vaccine is very new. Usually when we have medications or vaccines, we have the privilege of having two to three years, if not more, of prospective data. We don’t have that privilege with this vaccine, and so we have to acknowledge that.
But at the same time, we have to let people know that COVID is real. People are dying. People are being impacted. And we know that we have a tool available to us at this moment that can not only begin to get our lives back to normal, but it can save our lives. And so, we have to also put some of our faith into our scientific bodies and have faith that they are doing this with the intention of making people healthier. But going back to what I said, I think acknowledging that fear, acknowledging that trepidation, we must do it, and especially me, as a Latina who comes from a community that has been historically underrepresented and has been impacted by policy that has often been hurtful, I think I have a responsibility to really acknowledge that.
Lantigua-Williams:
So, there is a lot of misinformation being spread like wildfire, especially among communities of color, because you know, we’re on WhatsApp, we’re on Facebook, the tía network is in full effect. What are some of the things that you’re hearing from the networks and how do you counter some of that misinformation that is being spread?
Dr. Galvez: Well, it is funny, because I would say that when my patients come to me with a concern about safety, again, something like infertility, or altering DNA, I would say that nine times out of 10 it is coming from a social media platform. And so, what I do then is I acknowledge that oftentimes when we’re dealing with social media, we don’t really know the source. And what happens is in the Latino community, when you don’t have access to medical journals, when you don’t have access to things like newspapers, what you do is you tend to get your information from friends, and family, and social media. It’s the easiest.
And so, those are often not reliable, and I tell them that it’s oftentimes not… It’s not our fault. We just don’t have enough information that is in Spanish, or that is at a level that we can truly understand, so we compensate by going to other sources of information. And those are often not reliable. I think point blank, your tía in Mexico who told you that the vaccine is bad, I don’t think she’s trying to trick you, or that she’s trying to hurt you. She’s really concerned, and she means well, but she is probably not getting her information from a valid source, so it’s really teaching the community to think about where they get the information and to question what they’re reading. And if they have a question, they need to feel that they can actually talk to a professional like a doctor about it.
And I think that’s what happens, is so many people are fearful, or are embarrassed to tell a doctor, “This is what I’m hearing. Is it true?” And so, one of my jobs is really to try to open those lines of communication, build that trust, because if they feel restrained with me, then they’re going to get their information from another source. It doesn’t matter how crazy it sounds, I want them to tell me so that we can have a conversation about it.
Lantigua-Williams:
Yeah. I completely agree. But I want us to zero in on what is probably a really common situation, which is a first gen daughter or son is trying to convince their immigrant parent to go get vaccinated, to sign up for it. What are the key points that this first gen can make to their parents to try and convince them that this is something they absolutely should do?
Dr. Galvez: I have to say that in my experience, much of the hesitation is I’m seeing it more in the younger community. My patients who are older seem to be more accepting, but with that said, I think that it’s important for them to… The young community has a world of information. They have access to social media. Many of them speak English. Many of them know how to get onto the computer. And so, they can really be a link between the older generation and the medical community, and that’s how I see the younger generation and their role, is really trying to be a link between people that might have difficulty accessing the information because of language barriers or barriers with technology, linking them to the scientific community so that they can get that information. That would be my main thing.
But once again, I just really want to emphasize that maybe it’s because of the patients that I serve who have a strong connection with my clinic, older folks who have chronic medical conditions are much more familiar with me and our organization, and so I think there’s a trust that they have. Many of the younger Latinos are essential workers, they’re busy, they are out in the community, they often are not coming into the doctor, and so I don’t think they often have this relationship with a physician or with the medical field, and I think that that has actually increased the distrust.
Lantigua-Williams:
So, I want us to broaden out from that sort of one-on-one conversation at home to talk about the factors, because we know for example that Filipino nurses have been disproportionately impacted, both in the infection rate and in the death rates, because they over-index among the nursing ranks. We also know that Black first responders have also been disproportionately impacted because again, they over-index in the support roles in the healthcare system. So, can you talk to us a little bit about the conditions that can exacerbate the rates of infection, the mortality, in communities of color, and why it is that all of us bear a responsibility to protect ourselves and thereby protect our larger community?
Dr. Galvez: Well, COVID has taught us a lot, but one of the things that COVID has really unmasked are the conditions of many people who are considered essential. Those people who are on the front lines, whether it’s in food or healthcare. And absolutely what we’re finding is that there are many factors that are driving the disparity. Number one, they have no choice, they have to leave their home in order to go to work, so we know that that in itself increases your risk of getting the virus. Many people are also forced to travel in public transportation, also increasing that risk, because they can’t afford a car. Many of these what we call essential workers also have very little worker protections. Many times, there are some worker protections, but they’re not being enforced. People are having to work next to other people and many of them are not wearing masks, they’re not following the guidelines, and people are often afraid to speak up. There’s concern about losing a job, so what you do is you continue to go to work in these conditions, even if you know that they’re unsafe.
The other thing that is also contributing is that in many of these jobs, worker benefits that a lot of essential workers enjoy, like nurses or doctors, such as sick leave and unemployment, many of these workers don’t have access to those benefits. For a number of reasons. Many of them because they are undocumented. And so, when you’re living day to day, you’re not making a lot of money, and you have to take a day off of work because you’re sick or because you’ve been exposed to the virus, or let alone two weeks, it’s gonna be tough to do that.
Again, we don’t have the support systems in place to incentivize people to stay home if they’ve been exposed or if they’ve been sick, and so oftentimes you have people minimizing their symptoms, going to work, because they feel the need to, but they’re exposing their coworkers.
And then you have exposures at work, and what happens? People come home, oftentimes to these crowded living conditions, because low wages force us to live in multigenerational housing, and then once again this also increases the risk of spreading the virus. So, one of the things that has been really important for me to talk about this year is that there are absolutely health inequities. And absolutely not having healthcare is another huge factor that is driving the disparity. But we can’t forget all of the social inequities, right? And that has also been a huge driver.
You know, COVID is not going away even when we get vaccinated. We need to start thinking about these variants. And so, we need to begin to really invest in the communities and making sure that they have access to unemployment and sick leave, maybe even hazard pay. We need to increase the minimum wage so that people can actually afford to live in an apartment with their own family, not have to room with another family. You know, we really need to begin to look at how these conditions are driving the disparity and we have to begin to address them.
Lantigua-Williams:
Dr. Galvez, you are a gift. Thank you for coming on the show today.
Dr. Galvez: It has been my pleasure. Thank you so much for taking the time and thank you for the work that you do.
Lantigua-Williams:
All right, let’s recap what we learned from Dr. Galvez. Validate their concerns. Let them know that it’s normal and even logical to be hesitant and to have questions. Listen and address their concerns, but do not dismiss them and please do not judge them. Explain the science. Use clear, accurate, and accessible language to talk about the science behind the vaccine and how it actually works. And remember, you are the missing link. You can bridge the gap by providing scientific information, sharing reliable sources, and encouraging them to build trust and open up to a doctor or a medical provider.
How to Talk to [Mamí and Papí] About Anything is an original production of Lantigua Williams & Co. Virginia Lora produced this episode. Michael Castaneda mixed it. Manuela Bedoya is our social media editor. Cedric Wilson is our lead producer. Jen Chien is our executive editor. I’m the show’s creator, Juleyka Lantigua-Williams. On Twitter and Instagram, we’re @TalktoMamiPapi. Please follow and rate us on Apple Podcasts, Amazon Music, Spotify, everywhere you listen to your favorite podcasts. Bye, everybody. Same place next week.
CITATION:
Lantigua-Williams, Juleyka, host. “How to Talk to Your Family About Getting the COVID Vaccine”
How to Talk to [Mamí & Papí] About Anything,
Lantigua Williams & Co., March 15, 2021. TalkToMamiPapi.com.