Vaccines, Policy, and the Erosion of Trust: A Conversation with Chuck Vega, MD

"Vaccines are science. They're some of the best science we've ever created as human beings, and it's very sad to see that science politicized."

In a recent interview with Patient Care,© family physician Charles Vega, MD, expressed concern—and sadness—over the confusion and partisan rhetoric that surrounds and imbues discussions of vaccination in the US. Vega said he understands that vaccines aren't for everyone and that he respects patients' beliefs, but he doesn't "want to see those beliefs clouded by stories that just aren't true—on either side: that they're the most effective things ever and you'll live forever, or that they're harmful and the devil's work."

When asked if he feels that the trust of US clinicians is being affected by the recent and dramatic shifts in policy and recommendations, Vega said that while the medical community's trust is in science, the undermining of the public's trust makes a day in the clinic harder. Much more time is spent teasing out facts for some patients and explaining the reasoning behind new CDC positions and decisions for others.

Depending on where in the country one practices, there may be regional vaccination recommendations gaining traction as well as states in the Pacific northwest and in northeast form alliances to "stabilize" traditional guidance. Medical professional societies are also stepping in with their own resources. Even if all of the new documents follow the vaccine schedules that were in place in December 2024, the fractured landscape affects clinicians and patients alike.

In this short video above, Vega talks in more detail about these topics.

The following transcript has been lightly edited for flow.

Patient Care: I’m going to start with a broad question on immunization in the U.S. How are the recent, fairly radical shifts in the government’s vaccine recommendations affecting confidence and trust—first among clinicians, and then among their patients?

Charles Vega, MD: Vaccines are science. They’re some of the best science we’ve ever created as human beings, and it’s very sad to see that science politicized. Vaccines aren’t for everybody, and I respect patients’ beliefs, but I don’t want to see those beliefs clouded by stories that just aren’t true—on either side: that they’re the most effective things ever and you’ll live forever, or that they’re harmful and the devil’s work. Really, what it comes down to is me, as a clinician, developing a sense of trust with patients.

Patient Care: I’m curious about the level of trust among physicians in the current environment. How do you think it’s affecting your ability to go to work?

Vega: You know, it’s one thing when patients—who aren’t trained—start having questions. But now, when I have to start questioning these things as a physician, and I’m not sure what’s true myself anymore—goodness, we are really upside down. It does make things harder, because I only have so much time in the day to focus on these things, and I really depend on guidelines. I’m not an independent vaccine expert. I know there are really good people who have spent their whole careers on this, and that’s who I want to hear from. Those are the folks I really trust when it comes to making solid vaccine recommendations, and I’m going to follow those recommendations as best I can.

Patient Care: That brings up the regional and state alliances that are coming together now to fill in the blanks—at least for the 2025–26 respiratory virus season. Do you see this sort of balkanization of recommendations as sustainable, or is it too early to comment?

Vega: It’s too early, but I am concerned. With the politicization, maybe there’s going to be more of a pull from a different source or a different perspective—where instead of really having a fair balance and looking at the science behind vaccines and the public health aspects as well, maybe we get pulled too far to one side. Even for somebody like me, who really believes in vaccines, I’m concerned about that. Every time we weigh down busy clinicians with more decisions to make and more conflicting data to process, that’s going to take away from good patient care.

Charles P Vega, MD is health sciences clinical professor, UC Irvine Department of Family Medicine, assistant dean for culture and community at UC Irvine School of Medicine, and executive director, UC Irvine Program in Medical Education for the Latino Community, UC Irvine School of Medicine.