Narrative Dx #006: Trust Didn't Disappear. It Relocated.
On vaccine makers, providers, and where public trust actually lives now.
Vaccines.
Not the easiest word to write about right now. Federal vaccine policy is in a period of real change — a January 2026 CDC schedule revision departed from the usual advisory process, the courts are actively weighing in, and the professional response has been substantial. Whatever you think about the substance, the authority structure underneath American vaccine policy looks different than it did two years ago.
Into that shift, something specific has happened: trust didn’t disappear. It relocated.
27 states and DC have adopted their own vaccine guidance rather than the new federal schedule. The American Academy of Pediatrics has kept its own broader schedule in place. And when researchers asked people directly who they’d believe on a specific recommendation — the hepatitis B birth dose — the answer wasn’t close: 42% said they’d accept the AAP’s guidance, 11% said the CDC’s. People didn’t stop trusting expertise. They moved their trust to the source still standing in the room with them.
That source is usually a provider. Not because providers are louder than the federal government. Because they’re doing something no national body can scale: sitting with a specific parent’s specific fear and answering it, person to person, instead of issuing a policy to a population. There’s a real evidence base behind this, not just intuition — research on narrative-based health communication consistently finds it builds emotional engagement and credibility in ways fact-sheets don’t. The honest caveat: evidence on whether this moves actual vaccination rates, not just attitudes, is still thin. That gap is exactly where the opportunity sits.
Here’s the part worth naming plainly. Providers now carry more narrative weight than they were ever built to carry alone. The real-time data and evidence that used to flow predictably from a single federal source now arrives less consistently — the kind of information that matters most when something is genuinely infectious. Providers are piecing together what reaches them, doing careful work with a harder job. There’s real room to make that job easier.
This is where vaccine makers come in, and I want to be precise about what I’m arguing, because it’s not “start partnering with providers.” Life sciences companies and providers have partnered for decades — medical affairs materials, education programs, access support. That infrastructure isn’t new.
What’s new is what that infrastructure is now quietly holding. It was built to support commercial distribution and clinical education. It didn’t used to sit underneath the country’s trust infrastructure — a functioning federal authority did. Now that authority is more contested, and the provider relationship is carrying public confidence in vaccines whether it was designed to or not. The job changed. The job description hasn’t caught up.
I’d call this what it actually is: narrative stewardship, sitting alongside medical affairs rather than replacing it. Medical affairs asks whether a provider has accurate information. Narrative stewardship asks whether a provider has what they need to hold a family’s trust in a conversation that used to happen at a national level and now happens one exam room at a time.
It’s the same instinct already visible in how vaccine makers show up internationally — moving quickly, in close partnership with governments and the global health community, when an outbreak demands it. Domestic vaccine confidence is a slower-moving emergency, but it’s asking for the same instinct turned toward a quieter problem: not “who develops the vaccine,” but “who’s resourced to hold the trust that gets it into someone’s arm.”
So the real question for vaccine makers isn’t whether to invest more in provider relationships. It’s who inside the organization owns making sure those relationships can carry the weight they’re now carrying — and whether that person has the mandate, not just the materials, to do it.
I'm Ari Mostov. I help healthtech, medtech, and life sciences leaders find the story their organization is already carrying but hasn't named yet. More in this series, Narrative Dx.