Brad Bigford, a traveling nurse practitioner from Boise, Idaho, jumped at the invitation: spend an afternoon at Fred’s Reel Barber Shop in nearby Meridian, offering the flu vaccine to customers.
“Ladies, send your guys for a trim and a flu shot,” Mr. Bigford posted on Facebook. He added, “Anti-vaxxers need not reply.”
Within hours, his Facebook page was swarmed with hundreds of vitriolic comments, even violent threats from people opposed to vaccines. Vicious reviews on Yelp and Google about his urgent-care business, Table Rock Mobile Medicine, popped up from “patients” as far away as Los Angeles, Texas and Australia. Protesters circulated his cellphone number, hometown and wife’s name.
Then the e-cavalry rode to his rescue. A new group of doctors, nurses and other vaccine supporters, called Shots Heard Round the World, flooded his page with evidence-based vaccine facts, which attracted harassers spoiling for a fight to their own sites and away from Mr. Bigford’s. They taught him how to block some 600 posters and expunge comments.
“They saved me,” Mr. Bigford said. “But it’s a matter of time till I’m attacked again.”
Vaccines used to be embraced almost unquestioningly in the United States as lifesavers. But growing skepticism surrounds them as anti-vaxxers dominate the internet megaphone. Their aggressive tactics on social media have cowed the staid medical establishment into relative silence. They have sown doubt about optional vaccines like those for the flu and HPV, and angst in many new parents facing state mandates.
But now doctors and other health care providers are beginning to link arms virtually in an organized effort to defend not only each other, but also vaccines themselves, which they see as essential to their mission.
On Thursday, they held their most full-throated virtual rally, storming social media platforms with positive vaccine messages and the hashtag #DoctorsSpeakUp, #NursesSpeakUp, #ResearchersSpeakUp, #ParentsSpeakUp and #TeachersSpeakUp. The hashtag and its allies percolated throughout Twitter, many listing diseases they had never seen, because of vaccines. Doctors and nurses posted memes and TikTok videos. The U.S. Surgeon General tweeted it out.
Throughout the day, vaccine resisters used the hashtags to hurl challenges. When anti-vaxxers attacked the Instagram post of an adolescent medicine doctor who wrote about the HPV vaccine, Shots Heard rushed to her aid.
By the next morning, researchers at the University of Pittsburgh’s Center for Research on Media, Technology, and Health, who were analyzing the traffic, noted that the #DoctorsSpeakUp hashtag was retweeted more than 100,000 times.
Such efforts are particularly urgent now, say some medical experts, who fear an imminent perfect public health storm: The coronavirus is spreading not only simultaneously with a severe flu season but also, potentially, measles outbreaks, which typically occur in late winter and early spring.
Until recently, it was rare for doctors to post pro-vaccination messages on social media. Dozens of colleagues quietly reached out to Dr. Steven Ford, an assistant professor of neonatal medicine at the University of South Florida, after he wrote a Facebook vaccine info-post that was intended for parents of his vulnerable premature patients.
“They all said, ‘We appreciate this,’ ‘It’s very brave,’ ‘Great job,’ but very few would repost it or speak up publicly,” said Dr. Ford, who was subjected to a howling anti-vaccination barrage.
The call to arms was conceived by Dr. Zubin Damania, who practiced for a decade as a Stanford University hospital-based internist and now lectures about medical care at conferences and online as ZDoggMD.
“I particularly want to call out my own tribe — doctors,” Dr. Damania said. “They are the biggest cowards when it comes to this stuff because they feel they have so much to lose.”
Shots Heard sprang from the ashes of a scorched-earth cyberattack on Kids Plus Pediatrics, an independent practice whose main office includes the site of a converted Chinese restaurant in a small, tired strip mall in Pittsburgh. The practice has a video studio with podcast equipment. In the summer of 2017, it released “We Prevent Cancer,” a 90-second video spot about the HPV vaccine.
In short order, its social media sites were bombarded by thousands of negative comments. Its online ratings plummeted, with savage reviews by “patients” from anywhere but Pittsburgh. Anonymous supporters, who lurk on anti-vax sites as moles, secretly sent Dr. Todd Wolynn, a high-profile doctor in the practice, and Chad Hermann, the Kids Plus media director, screen shots that read: “Go get them on Yelp!” “Flood the phonelines.”
“It was coordinated terrorism,” Mr. Hermann said.
Dr. Wolynn reached out to colleagues for help. On Facebook, Physician Moms Group and many others came to his defense. Ultimately, the practice blocked some 900 attackers from its online platforms.
Dr. Wolynn, who has been a consultant on vaccine confidence and a clinical researcher for Sanofi and Merck, was alarmed by the attack and the increasing reticence among pediatricians to speak forcefully about vaccines’ benefits. He and Mr. Hermann hit the road, exhorting providers to support each other.
“We’re a horrible mismatch for the
anti-vaxxers,” Dr. Wolynn tells providers. “They have no restrictions on what they can say. We do,” he said, referring to a doctor’s obligation to address evidence-based medicine. “But pediatricians have built up face-to-face trust with patients and that’s what we can work from. ”
Shots Heard grew out of those sessions. Since going online last fall, the group has grown to nearly 600 vetted volunteers worldwide, dedicated to defending other vaccine advocates against online anti-vaccine attacks. Members include clinicians, nurses, lawyers, researchers, medical students, paramedics and state legislative staff members. When an attack is reported, the group’s members are notified by email or through a closed Facebook group.
“We want them to ride to the site and do whatever they feel comfortable doing,” Dr. Wolynn said. “For some, it’s to respond to every bogus claim with a link to an evidence-based study. For others, it’s to push back at the anti-vaxxers.”
Shots Heard recently posted a free 80-page strategy guide, “Anti-Anti-Vaxx Toolkit,” that has been downloaded more than 2,000 times. In the last three months the group’s members have swooped in on about 10 large-scale attacks and about 60 smaller ones.
The cyberattacks seem to be initiated by a relatively small number of extremists, rather than the “vaccine hesitant” — often parents who are scared and concerned about the schedule of vaccines and their impact. “It’s fine to ask questions in good faith,” Dr. Wolynn said. “It’s just not okay to be hostile.”
Educators like Dr. David L. Hill, a pediatrician in Goldsboro, N.C., who lectures about patient communication, says he does not want anti-vaxxers to control the messaging to these families. “Doctors have to talk to parents in a way that doesn’t make them feel belittled or disrespected,” he said. “The conversation should start with the idea that everyone wants what’s best for the child.”
A 2019 study in the journal Vaccine that analyzed the characteristics of anti-vaccine commenters on Facebook found that while most are female and mothers, their differences were significant. Health experts, the authors said, should therefore not presume that a one-size-fits-all pro-vaccine message will be effective.
Resisters often refer to themselves as “vaccine choice” advocates, such as Larry Cook, founder of the popular Facebook site Stop Mandatory Vaccination, who wrote on Mr. Bigford’s haircut-flu shot post, “Vaccines offer zero benefit.”
One prominent anti-vaccine activist is Erin Elizabeth, who runs Health Nut News, a newsletter that challenges many mainstream health concepts and promotes a line of essential oils and products. Her post about Mr. Bigford began: “This nasty group that does mobile vaccinations on your children…”
In response to an inquiry from The New York Times, she wrote in an email that she had over two million followers across several platforms, but denied coordinating attacks.
“I believe the increased traction of the vaccine choice movement may simply be the natural byproduct of consumers becoming more educated about their health,” Ms. Elizabeth wrote.
Dr. Damania, who raps, rants and interviews guests on YouTube and Facebook, has felt the wrath of vaccine protesters. While interviewing Dr. Paul Offit, a well-known vaccine advocate, the two men heard loud thumping. Protesters were pounding on the glass walls of the Las Vegas studio.
But it was after the cyberassault on a Cincinnati pediatrician in January that Dr. Damania called for last week’s action to flood social media with pro-vaccine posts. The pediatrician, Dr. Nicole Baldwin, had posted a 15-second pro-vaccine TikTok video to reach her adolescent patients, linking it to Twitter and Facebook. Anti-vaxxers telephoned her office, labeling her a pedophile and a child poisoner. She received death threats. The police patrolled outside her home for several days.
She, too, reached out to Shots Heard. “They were invaluable,” said Dr. Baldwin, who wound up barring 5,000 attackers from her Facebook page alone.
In Idaho, Mr. Bigford has installed security cameras and alerted neighbors to look out for unfamiliar cars. His wife urged him to stop posting about vaccines.
“But if I stop posting, then the only people talking about vaccines are the anti-vaxxers,” he said. “It’s part of our mission as health care givers to keep talking about this. So I’ll keep going.”