For most Americans in 2024, COVID-19 has receded into the background. But for many people who are high-risk or marginalized, it remains a constant worry.
To better understand some of the challenges that immunocompromised families face, Public Good News spoke to Alex Wood, a doula from Michigan. She focuses on helping families who are disabled, have chronic illnesses, or have compromised immune systems.
Alex shared her work and what she has discovered while supporting families who need to wear high-quality masks and take other measures to protect themselves from COVID-19.
Here’s what she said.
[Editor’s note: The contents of this interview have been edited for length and clarity.]
PGN: Can you tell us more about the work you do as a doula? What services do you provide?
Alex Wood: I do postpartum and abortion doula work. I support people when they’re not pregnant anymore.
For my in-person work, it looks like me showing up after the baby is born and doing things like helping with meal prep. One of the things that’s really common for people to be really nervous about is giving a first bath. So I help with that.
I like to focus more on the person who gave birth and making sure that their physical needs are met.
Like, everybody wants to focus on the baby, right? Everybody wants to hold the baby. Everybody wants to do stuff for the baby. And, it seems like the person who just built a human being is a second thought.
So, I get to focus fully on them and make sure that their recovery process is smooth, and they’re getting what they need to then have a full cup to provide for their child.
I also do abortion doula work, which is similar in that it focuses on the physical needs of the person who’s not pregnant anymore.
Some people need someone to just listen and talk through the process of how things went and what it felt like.
Sometimes people just need someone who’s going to listen deeply.
PGN: How do you incorporate vaccines into your approach?
A.W.: This changed pretty dramatically five years ago with COVID-19. I was always really clear on my website that I wouldn’t work with families set on choosing not to vaccinate. I think we have a societal and moral obligation where anyone who’s medically able to be vaccinated should.
There’s always that middle ground of people who have had enough people in their lives fear mongering them about vaccines that they’re scared about, and they need reassurance. I’m happy to have that conversation, but I think the way I have worded things on my website, it kind of weeded out a lot of those families that needed more than a gentle encouragement.
My daughter is immunocompromised. And we had our foster license at the time when COVID-19 first happened.
We’d taken an emergency placement of two medically fragile babies, and it was supposed to be temporary. So, then, COVID-19 happened, and everything got pushed back with the courts. And by the time things started moving again, they’d been with us over a year.
Those were our babies at that point. So we ended up adopting the twins. And, because they came into our care in the first place having a significant amount of medical needs, including some base immune issues and some autoimmune disorders, I really couldn’t work with anyone in-person anymore who wasn’t being very cautious.
So, that shifted my policy of who I could work with in-person. And, over time, as people have sort of relaxed their precautions and kind of moved on from even thinking about it, it’s left a certain portion of the population without anyone to seek care or support from.
So, at this point, I really only work with other families that are still always masking in public, always taking precautions.
I don’t have any issue working with families who can’t vaccinate for medical reasons. That’s part of the reason why the rest of us have an obligation to get vaccinated when we can.
Those families deserve the same level of care.
PGN: Based on the time you spent with people and families who take these precautions, what important lessons can you share with health workers who are trying to encourage the importance of vaccinations to high-risk groups, like pregnant people and parents?
A.W.: The marginalized group that I don’t hear talked about enough are disabled and immunocompromised people, and their access to vaccines. The hesitancy I see in this group is not, ‘Do I get the vaccine?’ but, ‘How do I access it safely?’
The idea that someone with little to no immune system is expected to sit in close quarters while someone sits right there, breathing in their face and refusing to mask, that poses a real question for people. Is it worth the risk of getting the disease [from exposure at the appointment] that I’m trying to mitigate harm from by vaccinating?
The biggest problem I see is that when people directly ask for access, for support, they’re turned down.
If someone asks, ‘Hey, can you mask for me for this visit?’ Say yes. It’s 10 minutes of your time. You can make a visit more accessible to people.
When people say things like, ‘Oh, we can’t require masking at our events because people won’t come.’ Well, then you’re making a clear choice about who you don’t want to come. Either way, a group of people won’t come, and so you’re choosing who you would prefer to be there. I don’t think people understand that they’re making that choice.
PGN: What about messaging? What has resonated most in the conversations you’ve had with parents and people who are immunocompromised?
A.W.: I wish there was more honesty and clarity around what [COVID-19] vaccines actually do. They don’t [fully] prevent infection, and they’re being presented as if they did. So, when people get their vaccine and then they get COVID-19 anyway, their reaction is, ‘Oh, well, the vaccines don’t work. Why would I get another one?’ And that calls in other questions like, if this vaccine that was hyped up so much doesn’t work, do the other vaccines work?
In not being really clear about what they can and can’t do, we’re creating more vaccine hesitancy.
[We need to] make sure that people understand that it is going to reduce your risk of being hospitalized and your risk of death for a short period of time, but it can’t [fully] prevent infection and the protection doesn’t last a whole year.
People have these negative outcomes, [like breakthrough infections], and they assume it was a waste of time to have gotten vaccinated. But in reality, maybe it kept them out of the hospital, or maybe they would have been a statistic of people who passed that year if they hadn’t been vaccinated.
But there’s still real value in getting these vaccines, it’s just not the value that is being stated, and that’s discouraging to regular people. Not giving them the full information to choose for themselves is unimaginably foolish, especially in communities that have historically and frequently been lied to by doctors and the government.
You’re losing people every time you aren’t honest with them.
Adriana Díaz is senior editorial manager at Public Good News. Adriana writes Community Voices, a biweekly newsletter for health workers responding to relevant health issues within their communities. Please send tips to adriana@publicgoodnews.com
Editor: Claudia Sanchez-Bustamante
This article is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the CDC Foundation totaling $69,392,486 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. In addition, the CDC Foundation does not guarantee and is not responsible for the accuracy or reliability of information or content contained in this article. Moreover, the CDC Foundation expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on any information contained within this article. This article are not intended as, and should not be interpreted by you as, constituting or implying the CDC Foundation’s endorsement, sponsorship, or recommendation of the information, products, or services found therein.