When I took the final exam after years of pediatric training, hearing my professors say, “You are now qualified and equipped to manage a pediatric clinic; congratulations” was a deeply touching moment for me. I felt fortunate to experience the profound satisfaction of seeing my efforts to help children recognized and appreciated. With eager anticipation, I awaited the assignment to the place where I would begin my journey as a specialist. Luck was on my side again—I was assigned to a small coastal town. Happy people, a peaceful life … and then, bam! I was confronted with some harsh realities early on.
A 4-year-old boy had been diagnosed with atopic dermatitis at six months old. Tests conducted at an external center showed elevated egg-specific IgE. The patient had not received any routine vaccinations since his sixth month. After an elimination diet, his egg allergy had regressed, and egg-containing foods were gradually reintroduced until he could consume them freely. However, the family had been strongly advised against vaccinating him. At this point, the patient came to my clinic with upper respiratory infection symptoms. While taking his medical history, I discovered that his vaccinations were incomplete and learned the reasons behind it. I addressed the family’s concerns and explained the benefits of vaccines. They agreed to proceed with vaccinations. I outlined the catch-up vaccination protocol and referred them to their family physician.
I initially thought this was an isolated incident, but a week later, another case emerged. A 6-month-old boy presented with symptoms of a respiratory tract infection. Upon examining the patient, who was coughing and feverish, I detected fine crackles in the basal regions of both lungs. While taking the medical history before further tests, I learned that the patient had not received any vaccinations, including those scheduled for the second month. When I inquired why, the family explained that they did not trust vaccines and cited anti-vaccine sentiments shared by doctors on social media. Curious, I wondered—who were these anti-vaccine doctors? Perhaps they weren’t real physicians but impostors deceiving the public. After all, no one sees their diplomas; people just believe what’s written in their social media bios. Upon researching the names provided by the family, I was disheartened to find that many were indeed licensed physicians, some even holding academic titles. This revelation left me questioning the sources of misinformation and my own previous assumptions. Had I been living in a cocoon during my education at a well-resourced institution surrounded by scientists? Had I missed out on real-world experiences by believing that everything could be answered scientifically and methodologically? Was the allure of popularity overshadowing the dissemination of truth, or was scientific accuracy being drowned out by the noise of misinformation? With these thoughts weighing on my mind, I explained the scientific facts about vaccines to the family. I spoke of the eradication of smallpox, the near disappearance of diseases like polio and tetanus, and how tuberculosis was no longer an insurmountable problem. The family was convinced, but I could still sense lingering doubts. How could I compete with a popular opinion they encountered daily? Perhaps I could have done more.
At the end of a long day spent helping patients waiting for exams and treatments, I picked up the phone. I called the family physicians in my town, one by one. How prevalent was vaccine refusal among their pediatric patients? I learned that every family physician had at least five patients who refused vaccines, despite being informed about them. Most refusals stemmed from things read online or consultations with anti-vaccine doctors. As the only pediatrician in town, I reviewed my options. I reinforced my knowledge by reading up on active immunization, providing patients with more detailed information about vaccines, and referring patients to other specialists in the same field, steering them away from anti-vaccine doctors while explaining my reasons.
Vaccination is a fundamental right for all children and societies. It should be administered uniformly and without delay due to its numerous benefits: reducing morbidity and mortality from infectious diseases, eradicating diseases, providing herd immunity, decreasing secondary infections, protecting against certain cancers, lowering health care costs, preventing epidemics, ensuring equitable access to health services, and enhancing both the length and quality of life. However, despite these achievements, they can quickly be overlooked due to the power of social media.
As our world has just emerged from the threat of COVID-19, Mark Dredze and colleagues have suggested that we should turn our attention to social media before the next outbreak.
Recognizing the urgency of the situation, I resolved to reach a broader audience by sharing my experiences, hoping to contribute to a wider discourse on the importance of vaccination. On a sunny day—not too hot, with a gentle breeze blowing from the sea and the sound of children playing outside—I sat down at my computer. And I began to write …
Ahmet Alptuğ Güngör is a pediatrician in Turkey.
