People’s willingness to get immunized against coronavirus disease 2019 (COVID-19) continues to shift.1  Vaccine hesitancy remains high in minority communities.2  We do not know how parents will respond when the vaccine becomes available for children. Given these uncertainties and the importance of attaining high levels of immunization, physicians need to encourage people to get immunized. This work will be as difficult and important as providing clinical care for people who have contracted COVID-19. It will require careful communication with individual patients. Furthermore, to fulfill our professional obligations to educate the public, it will also savvy use of social media. If we do this well, it will save more lives than all the ICUs in the world.

Health professionals have a long-recognized obligation to care not just for individual patients but, also, for the health of the public. To fulfill that obligation, we need to help the public understand the safety and efficacy of immunization. Today, the best way to do that is by using digital media platforms. Such public education through digital media is not something we learned how to do in medical school. Not every doctor can do it.

Opponents of immunization are very active on social media. In some cases, doubters raise important questions about the side effects, anaphylaxis, or the duration of immunity. In other cases, however, their posts spread debunked disinformation embedded in true information. For example, a (true) video of a nurse who fainted after receiving her vaccine has been used to (falsely) suggest that she went on to die and that her death was covered up.3  Some popular Web sites suggest (falsely) that COVID-19 vaccines have not been well studied and they can cause DNA mutations and birth defects.4 

The Centre for Countering Digital Hate5  analyzed the techniques that vaccine opponents use to sway people who are hesitant about vaccines. First, they persuade people that COVID-19 itself is not dangerous so there is no compelling reason to get immunized. Second, they highlight the real and imagined dangers of vaccines. With both arguments, they suggest that doctors and scientists cannot be trusted. In the Centre for Countering Digital Hate report, it is recommended that doctors and public health officials speak directly to the people who follow these sites. Experts in communication science agree that doctors need to speak to the vaccine-hesitant population to answer their legitimate questions.6  We cannot just talk to like-minded people in our own communication bubbles.

Doctors have a key role to play.7  People trust their doctors. The most common reason that vaccine-hesitant people decide to get immunized is their “trust in their health care provider’s advice.”8  We have the vital information that patients and parents need to make informed and wise choices. Professional societies maintain numerous Web sites with accurate information (see Table 1). We need to be honest and accurate, acknowledging that COVID-19 vaccines can cause headaches, chills, joint pain, and fever. We need to explain why those symptoms, which may last a day or two, are preferable to getting COVID-19.9  Such facts are crucial. So are powerful stories about personal experiences taking care of patients or getting immunized ourselves.

TABLE 1

Available Online Resources on Immunization

OrganizationWeb Site Section on Immunization Education
Immunization Action Coalition https://www.immunize.org/ 
Immunization Coalitions Network https://www.immunizationcoalitions.org/ 
CHOP’s Vaccine Education Center https://www.chop.edu/centers-programs/vaccine-education-center 
American Academy of Pediatrics https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Pages/Immunizations-home.aspx 
OrganizationWeb Site Section on Immunization Education
Immunization Action Coalition https://www.immunize.org/ 
Immunization Coalitions Network https://www.immunizationcoalitions.org/ 
CHOP’s Vaccine Education Center https://www.chop.edu/centers-programs/vaccine-education-center 
American Academy of Pediatrics https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Pages/Immunizations-home.aspx 

CHOP, Children’s Hospital of Philadelphia.

There are relatively easy and practical ways to get these messages out. We can post about our own vaccination experiences (including posting pictures of getting vaccinated). We can invite patients and families to join us online for discussion. Many social media platforms also facilitate live video sessions. By going “live,” doctors and their audience can have a real-time interaction in which doctors can answer any questions or concerns from the audience regarding the vaccine. Doctors can create or join digital advocacy groups. A list of helpful resources and networks that doctors can join and use, both online and off-line, to communicate with parents and advocate for the vaccine, is provided in Table 1.

For doctors who have a digital media presence but have never shared a live video and are interested in learning how to do so, we provide helpful starting guides in Table 2. All that is required is a camera, access to Wi-Fi, and a quiet space. Live videos can also be recorded and, later, uploaded onto digital media platforms for anyone who missed the live session.

To gain an audience, doctors can create a public Facebook page that is different from their personal page.10  On this, they can hold events for patients, friends, and families.11  They can also post information regarding the vaccine on these public pages and, then, share their public page link with patients (and their families) who may have questions and fears about the vaccine. We recognize that many doctors use social media to communicate with established patients. Messages on such private platforms may be different from those in a public platform.

Some doctors are already expertly engaging in online vaccine education sessions. A hospitalist who goes by the name of “ZDoggMD” has been using these platforms to dispel myths and misinformation. He often hosts experts on immunizations.12  Dr Kristamarie Collman has been addressing minority communities with informative and entertaining videos.13 

Doctors who decide to engage in public education online should be aware that there are risks to doing so. Physicians who develop a digital media presence and gain followers have been threatened with violence.14  Online discussions can become vicious battlegrounds for vaccine proponents and opponents. In many cases, however, the end result is that people who were confused and on the fence about the vaccine changed their minds after getting their questions answered by the doctors.

We recognize that doctors who try to do such online campaigning can become the target of “social media trolls” who deliberately post inflammatory comments to prevent any constructive conversation from occurring. The goal of the doctor should always be to de-escalate conflict, show respect for the opinions of others, acknowledge valid concerns about vaccines, and hammer home the message that it is safer to get immunized than to risk getting the disease.

Most social networks also have established policies around respectful conduct. Doctors can make their own policies for live events and let their audience know in advance.15  This way, if they start getting verbally attacked, they can either warn or block the person from attending the event or submit a report to the social media network, if the comments violate the policies set by the network.

We also realize that not all doctors are accustomed to (or interested in) using social media platforms. Doctors who have not developed a social media presence should not start now. For them, using the more traditional methods of advocacy, like in-person patient education and handing out educational brochures to patients and their families, may be the best way forward because entering the complex world of digital media for the first time can be daunting. But, for those who have experience and skills, this is an opportunity to put those skills to good use.

As physicians, we have an obligation to society to “provide the public (and the news media) with accurate information about health care.”16  We have a responsibility to “advocate for public health policies and programs that reduce disparities in health care access and receipt of quality health care.” Achieving herd immunity to COVID-19 is one of those programs. Let us rise to the challenge.

Drs Raza and Lantos conceptualized and designed the manuscript, drafted the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted.

FUNDING: No external funding.

     
  • COVID-19

    coronavirus disease 2019

1
Desmon
S.
COVID-19 vaccine acceptance falling globally, in US. Available at: https://ccp.jhu.edu/2021/02/22/covid-19-vaccine-acceptance-falling-globally-in-u-s/. Accessed February 23, 2021
2
Sinha
A
. Reducing COVID-19 vaccine hesitancy among racial and ethnic minorities. Available at: https://blogs.bcm.edu/2021/01/22/reducing-covid-19-vaccine-hesitancy-among-racial-and-ethnic-minorities/. Accessed February 22, 2021
3
Reuters Fact Check Team
. Fact check: nurse fainting after COVID-19 vaccine not evidence of potential mass genocide. Available at: https://www.reuters.com/article/uk-factcheck-vaccine-genocide-idUSKBN28S2F5. Accessed January 8, 2021
4
Hay
M
. Wild scheme to sabotage COVID vaccine is too creepy for some anti-vaxxers. Daily Beast. December 26, 2020. Available at: https://www.thedailybeast.com/the-anti-vaxxer-mission-to-promote-nonexistent-covid-19-vaccine-deaths?ref=home. Accessed January 8, 2021
5
Center for Countering Digital Hate
. The anti-vaxx playbook. Available at: https://f4d9b9d3-3d32-4f3a-afa649f8bf05279a.usrfiles.com/ugd/f4d9b9_25e2a7b73e8c4236a53c1002db4017b4.pdf. Accessed January 8, 2021
6
Burki
T
.
The online anti-vaccine movement in the age of COVID-19
.
Lancet Digit Health
.
2020
;
2
(
10
):
e504
e505
7
Abbasi
J
.
COVID-19 conspiracies and beyond: how physicians can deal with patients’ misinformation
.
JAMA
.
2021
;
325
(
3
):
208
210
8
Chung
Y
,
Schamel
J
,
Fisher
A
,
Frew
PM
.
Influences on immunization decision-making among US parents of young children
.
Matern Child Health J
.
2017
;
21
(
12
):
2178
2187
9
Walsh
EE
,
Frenck
RW
 Jr.
,
Falsey
AR
, et al
.
Safety and immunogenicity of two RNA-based COVID-19 vaccine candidates
.
N Engl J Med
.
2020
;
383
(
25
):
2439
2450
10
Newberry
C
. How to create a Facebook business page in 7 easy steps. Available at: https://blog.hootsuite.com/steps-to-create-a-facebook-business-page/#:∼:text=Go%20to%20facebook.com%2Fpages,Next%2C%20enter%20your%20business%20information. Accessed February 12, 2021
11
Facebook
. How do I create or edit a Facebook event? Available at: https://www.facebook.com/help/210413455658361. Accessed February 12, 2021
12
ZDoggMD
. COVID-19: is our cure worse than the disease w/Dr. Paul Offit. Available at: https://zdoggmd.com/paul-offit-covid/. Accessed February 12, 2021
13
Huang
P
. Black doctors use social media to share accurate information about COVID-19 vaccine. Available at: https://www.npr.org/2021/01/01/952716747/black-doctors-use-social-media-to-share-accurate-information-about-covid-19-vacc. Accessed February 12, 2021
14
Bowen
A
. Even before COVID-19, doctors faced online harassment, including death threats. The pandemic makes it worse. Available at: https://medicalxpress.com/news/2021-01-covid-doctors-online-death-threats.html/. Accessed February 12, 2021
15
McCoy
J
. 7 effective tactics to defeat internet trolls. Available at: https://www.searchenginejournal.com/defeat-online-trolls/323439/#close. Accessed February 22, 2021
16
Sulmasy
LS
,
Bledsoe
TA
;
ACP Ethics, Professionalism and Human Rights Committee
.
American College of Physicians Ethics Manual: Seventh Edition
.
Ann Intern Med
.
2019
;
170
(
2_Suppl
):
S1
S32

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.