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What We Risk When We Stop Trusting Medical Science
by Robert E. Geise, MD, FIDSA
As I began my medical career in the mid-1990s, the world was As I began my medical career in the mid-1990s, the world was in the middle of an epidemic – the HIV epidemic. HIV caused 16% of deaths among adults ages 25–44 in the US in 1995 and was the number one cause of death in that age group. Between 1981 and 2000, there were 448,000 HIV related deaths. As a medical resident during the early and mid-90’s in Washington, DC, it was not unusual to admit 10–15 patients each call night with HIV related illnesses. As I finished my residency in 1998, those patients began to disappear from the hospital as the promises of effective antiretroviral therapy began to take hold.
During the last decade of my career as an infectious disease doctor, I faced another epidemic – COVID. Prior to the introduction of vaccines, COVID was the 3rd leading cause of death in the US, with over 1 million individuals dying in the US during 2020–21. With the development and implementation of vaccines and pharmacotherapies, we were able to decrease the impact of this disease through natural and vaccine-mediated herd immunity.
Medical science has always been about research, advancements, and the efforts of medical professionals (physicians, nurses, and other allied health professionals) to give patients the latest, most effective, and safest care. We discuss with each patient the risks versus the benefits of each medication, vaccination, and intervention we recommend.
In 2019, HIV was the primary cause for less than 0.2% of deaths in the US (still impacting disproportionately minority and economically disadvantaged groups) and was no longer one of the top causes of death in adults between the ages of 25–44. By late 2021, the COVID vaccine provided significant protection with a 95% decrease in hospital visits in those fully vaccinated, and those same individuals were 14 times less likely to die from COVID. Measles cases fell from one-half million annually in 1960, just prior to vaccine introduction, to 22,231 in 1968. With the introduction of a recommended 2nd dose in 1989, annual cases in the US fell to 86 by the year 2000. A study published in the MMWR in 2024 projected that between 1994 and 2023, over 32 million hospitalizations and 1.1 million deaths from vaccine-preventable illnesses were avoided.
But this is all data.
There are stories, too, such as my good friend Mikey’s. I met Mikey in the fall of my second year of residency, when he was brought in with severe abdominal pain, weight loss, metabolic acidosis, and general failure to thrive. Mikey had been HIV positive for many years and had gone through many medications. He had a prolonged hospitalization, and like many other young men his age, it appeared that he was facing the end of his life. I took care of Mikey for the better part of several months, including significant time in the hospital with many readmissions. At this point in his life, things were looking grim.
Thanks to the advances in HIV care, this was not the end. Mikey has recovered and continues to bring joy to the people in his life, including his wonderful husband, who has been with him for four decades. The world is a better place because of the advances we have made in medicine and because of having Mikey in it.
Yet despite our remarkable victories against HIV, COVID, and measles, medical science is under attack. Whereas six years ago, people were cheering nightly for those caring for the sickest in the COVID epidemic, now they question practices that have been standard for decades. Vaccine hesitancy and misinformation have been circulating for decades, and the policies and statements of the current administration, especially in the Department of Health and Human Services, are accelerating and exacerbating this distrust.
The latest of these are the attacks on the hepatitis B immunizations for infants and state support for HIV therapy.
The CDC's Advisory Committee on Immunization Practices has, for decades, been a well-respected group of experts in the field that enjoys a high degree of public trust and professional respect. Unfortunately, in June of 2025, the 16 members were dismissed by HHS Secretary Robert F. Kennedy Jr. and replaced with less experienced individuals, some with views not supported by medical science.
One of their first changes was to remove the recommendations of a birth dose of the hepatitis B vaccine. For context, the hepatitis B vaccine has been one of the most successful public health interventions, providing 85–95% efficacy in preventing perinatal transmission when given at birth (along with hepatitis B immune globulin if the mother is known to be a hepatitis B carrier), and 98% protection if the full three-shot series is given. The rate of hepatitis B infections in children ages 1–9 decreased from 0.9 infections per 100,000 children in 1986 to less than 0.1 infections per 100,000 children. Children infected with hepatitis B before the age of 1 have a 90% risk of developing chronic hepatitis B, while those aged 1–5 have a 10–50% change. This can lead to lifelong risk of severe liver disease, including cirrhosis and liver cancer. In addition, decreasing the reservoir of chronic hepatitis B carriers can prevent further transmission. The hepatitis B vaccine is one of the safest vaccines available, with almost no side effects.
It is not only the ACIP that is reversing years of public health progress. As of March 1, 2026, the Florida Department of Health imposed an emergency rule that could prevent an estimated 16,000 residents from accessing HIV medications. At the same time, the state's AIDS Drug Assistance Program (ADAP) changed formularies, no longer allowing access to some of the most used and effective antiviral therapies available. A preliminary analysis by the HIV Medical Association estimates these cuts could lead to over 4000 new HIV infections. These changes are not isolated to Florida – over 20 other states have made similar cuts.
The distrust in medical science is further demonstrated by a 2025 Kaiser Family Foundation poll. While 85% of Americans trust their primary care physician or their child's pediatrician, only 65% trust doctors at the National Institutes of Health, 61% trust the CDC doctors, and only about half trust the FDA. Because of what parents are seeing on social media and governmental policy and statements, one in six are choosing to delay vaccines for their children. Although they trust their physicians, in most cases, they do not follow their pediatricians' advice. Much of this distrust has been weaponized in our current social media and political environment.
As a result of parents choosing to delay or skip the MMR vaccine, the United States in 2025 had 2,281 confirmed measles cases, the highest since 1992, and the current outbreak in South Carolina at the end of February resulted in over 1000 cases. Despite this, vaccine laws and regulations continued to be undermined.
As providers, we need to be able to talk to our patients not only armed with facts and science but also with the skills to communicate them with compassion and understanding. Often, patients’ stories may be more powerful than studies, guidelines, and recommendations. As medical science continues to advance, we gain the ability to treat and prevent many dangerous and deadly illnesses. Society needs to take a step back, reconsider how we evaluate and trust medical science, and ensure we get our medical information from reliable, factual sources. It is vital that we turn the current tide of mistrust for the protection of ourselves, our children, and our society.
Robert E. Geise, MD, FIDSA
President, Infectious Disease Society of Washington
Trustee, King County Medical Society
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From Our KCMS Presidentby Amish Dave, MD, MPH | President of KCMS
Looking at the accomplishments of the Washington State legislature, I am struck by how far physician advocates within KCMS have come in the decade since I first joined this remarkable organization. I have heard many physicians voice concern over inequities in our state, the growing influence of pharmacy benefit managers, the consolidation of healthcare systems, and the ongoing challenges facing local, state, and national public health departments. KCMS has worked to bring these concerns to the attention of legislators in Olympia.
Lawmakers have advanced reforms related to prior authorization, firearm safety, access to vaccinations, protection of public health, and safeguarding insurance coverage for medically necessary procedures and clinic visits, among the priorities KCMS delegates have advanced in recent years. In partnership with the Washington State Medical Association, KCMS has also advocated for thoughtful consideration of scope-of-practice legislation, with a focus on patient safety and quality of care.
I continue to be impressed by how a dedicated group of physicians can help shape meaningful policy and improve patient care across our state. There is still more we can accomplish together. Our voices are strongest when we collaborate, find common ground, and engage constructively with policymakers.
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KCMS DELEGATE COUNCIL BEGINS!
First Meeting | 2026
Help shape KCMS priorities for the year ahead. We invite our KCMS Members to serve as delegates on our Delegate Council. We are excited to add new delegates and bring this group together, and begin shaping our priorities for the year ahead.
JOIN US in person
Sunday, April 26, 2026 @ 5:00 PM (Address details to follow for those that RSVP)
WHAT TO EXPECT
- Connect with elected officials and fellow delegates across specialties
- Help shape KCMS legislative and policy priorities
- Engage in meaningful discussion on issues impacting physicians and patients
- Build relationships with colleagues and leadership
DETAILS: Food and beverages will be served.
Please RSVP at 📩 info@kcmsociety.org
We look forward to seeing you and beginning this important work together.
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KCMS Inspires Future Health Professionals at UW “Doctor for a Day”Inspiring the Next Generation
KCMS was proud to participate in the Sound Careers in Healthcare/Doctor for a Day event at the University of Washington. Nancy Belcher, Ph.D., CEO of the KCMS, and Michelle Terry, MD, Secretary of KCMS, spent the day engaging with students interested in careers in science, medicine and health care. The event brought together scientists, physicians, health professionals, educators, and students for a hands-on exploration of what it means to work in health care.
During the event, Dr. Belcher and Dr. Terry spoke with students about the social determinants of health and how factors such as housing, education, environment, and access to resources shape health outcomes in communities.
Hundreds of students rotated through interactive stations. The energy was incredible, and it was inspiring to see so many young people excited about the future of health care.
KCMS is proud to support efforts that strengthen the future health care workforce.
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A Rare Opportunity to Own a Piece of Medical History
KCMS is offering a curated selection of more than 150 historic medical and scientific works, dating from the 1600s through the early 1900s, in partnership with Collins Rare Books of Seattle.
These volumes span the evolution of medicine, from early anatomical studies to foundational advances in public health, and include works by figures such as William Harvey, Robert Koch, Henry Gray, and Herman Boerhaave.
To view available titles or ask about purchasing, contact info@kcmsociety.org. Availability limited.
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Additional opportunities and updates from our partners
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Reference Committee Volunteers Needed
WSMA is looking for volunteers to be on the reference committees at the 2026 WSMA Annual meeting at the Historic Davenport in Spokane on September 26-27, 2026. If you are interested in serving, please complete the form below.
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Register for the 2026 WSMA Leadership Development Conference this May in Chelan | Join WSMA May 15-16 in Chelan for leadership coaching, resort fun, and more
Join your physician and care team colleagues for the 2026 WSMA Leadership Development Conference, May 15–16 at Campbell’s Resort on Lake Chelan. This year’s conference will focus on strengthening leadership skills while also equipping physicians and their teams with timely communication and advocacy tools.
The conference will also feature a discussion around drivers of health and food as medicine, with practical resources to support you in addressing these issues during patient visits. Social drivers of health shape outcomes across every field of medicine and are of growing interest to physicians from all specialties.
Visit the conference webpage on the WSMA website for a full agenda, registration, and accommodation information.
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WSMA Webinars
The WSMA is hosting webinars for the physician community. All are free.
April 3 | Noon (CME) | Expanding Access to High-Resolution Anoscopy
Overview of screening and care for high-risk populations. AMA PRA Category 1 Credit™.
Register: Link
May 1 | Noon (CME) | Immigration Enforcement & Patient Access to Care
Clinical perspectives on barriers to care and patient impact. AMA PRA Category 1 Credit™.
Register: Link
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Volunteer InformationApril 23 – 26, 2026 at Seattle Center.
Event registration is OPEN.
The region’s largest volunteer-driven clinic provides free dental, vision, & medical care to people in need. Since 2014, this volunteer-powered event has provided $30 million in free dental, vision, and medical care to over 33,000 patients. The clinic depends on volunteers like you.
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Thank you for being part of the KCMS community and for your continued commitment to patients and public health.
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