That Space Still Belongs to Us

If you work in healthcare or public health and believe in the science of vaccines, the spectacle that unfolded in the White House yesterday likely triggered some very strong emotions. For me, they came in waves; first profound sadness and a sense of defeat, then rage, and finally resolve to continue to stand up for what I know is true and to do my best to keep protecting my community and the patients I care for every day.

To recap briefly, the President of the United States signed an executive order seeking major changes to the childhood vaccination schedule in the US. A major focus of the announcement was the MMR vaccine, which protects children against measles, mumps and rubella and is usually given as a multivalent vaccine in two doses. Disinformation was a prevailing theme, with long-debunked claims about vaccines causing autism and assertions about children receiving harmful volumes of vaccines repeated from the highest office in the country.

All of this is happening while the US is experiencing a resurgence of measles, a disease that was declared eliminated from sustained transmission in this country more than two decades ago and that caused deaths during the large outbreaks of 2025.

It is tempting to be dismissive when discussing the impact of this kind of vaccine disinformation. Parents can always discuss their decisions with their pediatrician or another healthcare provider. There is no practical way for an executive order to dictate every conversation happening in physician offices across the country. Doctors will continue to practice evidence-based medicine.

I think this stance is wrong, and potentially dangerous, because it ignores a very basic reality: what leaders say carries weight.

Spreading disinformation and dangerous rumors about safe vaccines is an extremely effective way to attack the trust people have in public health interventions. We saw this repeatedly during the COVID pandemic. At a White House briefing in 2020, President Trump publicly speculated about whether disinfectants could somehow be used inside the body as a treatment for COVID, prompting public health agencies and manufacturers to warn people not to ingest or inject disinfectants.

The misinformation from that period has not disappeared. To this day, I encounter people who refuse lifesaving blood transfusions because they do not want blood products they believe have been “tainted” by mRNA vaccines. We continue to see people refuse vaccines and treatments because of claims that have little or no basis in science. The examples are too many to list in this brief reflection, but the harm is not theoretical. It is reflected in vaccine-preventable diseases returning, outbreaks growing larger, and people experiencing complications and deaths from infections we know how to prevent.

It will probably take me a long time to fully process my emotions about what is happening to public health and how the spread of disinformation is shaping the way people engage with healthcare. So for now, I am choosing to take a more practical approach. As healthcare professionals, I believe we have to reimagine our practice to meet this moment.

I cannot control which executive order comes out of the White House. I cannot control the latest unfounded claim about the safety of a proven vaccine, treatment or drug being amplified by a powerful politician. I cannot control what someone has watched online before they walk into my clinic. But I can control what happens in my daily interactions with people and with my patients, whether in the clinic or the hospital. And I increasingly believe that this is what matters most right now.

I want to share the story of a patient I first met several years ago.

At the time of our first meeting, this person was at probably the lowest point in their life, weathering homelessness, several personal tragedies, job loss and a complete loss of confidence in a healthcare system they felt had abandoned them. They were also in the final stages of advanced HIV and had essentially resigned themselves to dying because, at that point, death felt preferable to continuing to live the life they were living.

I was consulted to help treat an opportunistic infection. From the moment I walked into the room and introduced myself, I immediately sensed that leading with the medical issue at hand would probably be met with frustration and tuning out yet another voice there to tell this person what to do, how to act and how to be well.

So I did something else. I asked for permission to sit next to their bed, and then I asked them to tell me their story.

Their first reaction was surprise, followed by a question.

“Why do you care?”

I responded that I could not help them the best I could if I did not know their story.

Initially, slowly and with a weak voice, they began to speak. Then it was as though I had opened a floodgate. I listened without interrupting, probably spending more time in that encounter than I could reasonably afford to. We did not talk very much about the reason for my consult. I felt that the moment deserved the respect of not being tainted by my own agenda of getting the work done. I promised that I would talk to their medical team about the infection I had been asked to help treat and that I would return the next day.

And I did. The days and encounters that followed allowed me to get to know this person more, to learn about the failings of the healthcare system that had contributed to bringing them to this point and to understand a little better where their mistrust came from. At discharge, I offered to become their HIV primary care physician, with very little confidence that they would actually keep the appointment. Their history of being lost to follow-up preceded them.

To my surprise, they showed up. What followed has now become a patient-physician relationship spanning many years. I have watched this person navigate profound hesitancy about lifesaving antiretroviral therapy to becoming virologically suppressed and living a fully restored, healthy life. Today, they receive long-acting injectable HIV treatment, which sits at the cutting edge of HIV medicine. Last year, they also received their first influenza vaccine under my care.

None of these changes happened overnight. They required time, patience, continued support, non-judgment and, perhaps most importantly, seeing the person in front of me.

I did not get there by winning an argument.

My relationship with this patient is just one tiny illustration of the power healthcare providers still have. We occupy an extraordinary position of privilege in which we meet people while they are navigating illness, information, doubt and fear, often within a healthcare system that has itself failed them in very real ways.

We have the incredible privilege of providing a steady and constant voice in the chaos, anchoring our guidance in science while also pausing long enough to see the person in front of us. I think that distinction matters enormously right now.

The response to vaccine disinformation cannot simply be to repeat the facts more loudly. We have to continue to be rigorous about the science, correct false claims when we hear them and defend evidence-based public health policy. But we also have to understand why the person sitting across from us may be skeptical in the first place.

Sometimes that skepticism comes from misinformation. Sometimes it comes from fear. Sometimes it comes from experiences with healthcare that have given people very legitimate reasons not to trust us. Usually it is more complicated than any one of these things.

And this is where I think healthcare professionals have an enormous opportunity in this moment. Executive orders may dominate the news of the hour, but they do not change what happens in that first interaction when I walk into a patient’s room, shake their hand, look them in the eyes and introduce myself.

They do not change what happens when I sit down and listen.

They do not take away my ability to explain what I know, acknowledge what I do not know, correct misinformation without humiliating someone for believing it, and earn enough trust that perhaps they will come back tomorrow and continue the conversation.

That space still belongs to us.

We have an opportunity as health professionals to do something really special in this season. Yes, our responsibility is to stand up publicly for science when it is being distorted. But perhaps just as importantly, it is to keep showing up in the quiet, ordinary encounters where trust is actually built.

I started yesterday feeling profoundly sad and defeated by what I was watching. I am still angry.

But wallowing in defeat is simply not an option.

Our roles matter.

There is too much at stake.

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I am an infectious diseases physician and scientist writing at the intersection of medicine, global public health, society and justice. If this piece resonated with you consider sharing it and subscribing.