Counterfactual examples have proven to be valuable in the field of natural language processing (NLP) for both evaluating and improving the robustness of language models to spurious correlations in datasets. Despite their demonstrated utility for NLP, multimodal counterfactual examples have been relatively unexplored due to the difficulty of creating paired image-text data with minimal counterfactual changes. To address this challenge, we introduce a scalable framework for automatic generation of counterfactual examples using text-to-image diffusion models. We use our framework to create COCO-Counterfactuals, a multimodal counterfactual dataset of paired image and text captions based on the MS-COCO dataset. We validate the quality of COCO-Counterfactuals through human evaluations and show that existing multimodal models are challenged by our counterfactual image-text pairs. Additionally, we demonstrate the usefulness of COCO-Counterfactuals for improving out-of-domain generalization of multimodal vision-language models via training data augmentation. We make our code and the COCO-Counterfactuals dataset publicly available.