It all started when a Pennsylvania pediatric practice posted a video on its Facebook page urging parents to get their children vaccinated against human papillomavirus (HPV), which can protect them from a variety of cancers.
At first, Kids Plus Pediatrics got the reaction it was looking for, as it got rave reviews for the video and parents called to schedule appointments for their children to get the vaccine, said Todd Wolynn, M.D., a pediatrician who is CEO and president of the practice, in an interview with FierceHealthcare.
In eight days in September 2017, the practice received 10,000 negative comments from more than 800 individuals. Thousands were either threatening (“you’ll burn in hell for killing babies”) or extremist (“you have been brainwashed”).
Wolynn, whose practice is known for its use of social media, said he was familiar with anti-vaccine groups and had heard of such attacks before. But unlike some practices that have reacted by pulling information about the benefits of vaccines from their websites, Wolynn said Kids Plus Pediatrics decided to fight back.
“We decided to take a stand,” he said. The practice wanted to find out who was behind the attack and more about how it was carried out.
A look at the attackers
Practice leaders reached out to researchers at the University of Pittsburgh and its Center for Research on Media, Technology, and Health. Interested in examining the people behind these attacks, researchers analyzed a randomly chosen subset of 197 people who posted anti-vaccinations comments and then reviewed those individuals' public profiles.
Vaccines by the numbers
14—The number of different vaccines recommended for children between birth and age six
1.3%—The number of children born in 2015 who received no vaccinations by age 2 (compared to 0.9% of children born in 2011)
732,000—The number of child deaths in the U.S. prevented by immunizations over the last two decades
$295M—The savings on direct healthcare costs prevented by immunizations
314—Number of measles cases confirmed in 15 states so far in 2019
Source: Centers for Disease Control and Prevention
The results were published in a study in the journal Vaccine. The majority (89%) of the individuals were women and 78% were parents. Among those who divulged their location, they represented 36 states and eight other countries.
After his practice was attacked, Wolynn said he heard of others. In fact, online attacks against those who promote vaccines have become more common.
And given the measles outbreaks that have occurred in five states this year, the anti-vaccine movement is under increased scrutiny. A rising tide of reluctance to vaccinate children is blamed on misinformation spread on social media about the safety of vaccines. The American Medical Association recently added its voice to those calling on large tech giants to combat the misinformation on vaccines on their sites, sending a letter to the CEOs of Amazon, Facebook, Google, Pinterest, Twitter and YouTube urging them to ensure their users have access to “accurate, timely, scientifically sound information” on vaccine safety and efficacy.
Finding themselves under attack, the anti-vaccine activists may step up their efforts. “I do think probably it’s going to get worse before it gets better,” said Wolynn.
To help other doctors and practices that may find themselves threatened, Wolynn and Kids Plus communications manager Chad Hermann have put together a toolkit with specific instructions for how practices should prepare for, defend and clean up after an attack.
“If you’re attacked on Twitter, here’s what you do. If you’re attacked on Facebook, here’s what you do,” Wolynn said. The toolkit has already been revised twice because of changes in policy made by social media companies.
The 80-page toolkit is intended to help practices defend themselves against attackers who can do real damage, Wolynn said. The anti-vaxxers, for instance, posted negative reviews about Kids Plus on sites such as Yelp and Google. The practice, which had consistently earned four-star ratings, saw those ratings plummet after the attack.
Wolynn said the practice is seeking financial support from a nonprofit company or foundation to absorb some of the costs of the toolkit so it can be distributed free to pediatricians and other doctors.
There are certain steps practices will want to take to counter an attack. Kids Plus immediately blocked users posting the anti-vaccine messages on its Facebook page. It shut off the ratings on its own Facebook page and demanded that Yelp and Google take down the fraudulent reviews. Some were obvious, such as the one-star review sent from someone in Sydney, Australia.
“I don’t think a parent from Sydney is going to be bringing a child into my practice for an ear infection,” he said.
He also advises practices not to try and counter the arguments of those who are blatantly anti-vaccine and are there to threaten and scare them. “Disengage. Ban them, get them off your page. Get them off your site,” he said.
When the attack happened, Wolynn was attending a national pediatrics conference, where he was speaking about the benefits of practices using social media to engage patients. He told his audience what he knew about the attack. “This literally just scared the hell out of them,” he said.
He was able to rally other medical professionals at the conference to come to Kids Plus' defense and counter the anti-vaccine posts. And that has prompted him to establish what he calls “The Shots Heard Round the World” virtual social media calvary. He describes it as a pro-vaccine rapid-response network of physicians and others who can post pro-vaccine information to combat anti-vaccine efforts.
“It will be like a virtual cavalry,” he said. Anyone interested can email [email protected] to get on the list. Members will be vetted and the list will be kept private.
Thx! Deeply appreciated being interviewed for this article!— Dr. Todd Wolynn (@DrToddWo) March 3, 2019
We/@kidspluspgh attacked for simply educating our families on the importance of vaccinating.
Weaponized social media including fraudulent reviews must be addressed.
No one likes a bully... especially pediatricians!
Despite the attack on Kids Plus, Wolynn isn’t backing down from his advice that physician practices get involved with social media. “I would say we still strongly support being on social media,” he said.
If physicians aren’t on social media with fact-based information for patients, the internet will be filled with pseudo-science, he said.