Implantable and wearable medical devices are used for monitoring, diagnosis, and treatment of an ever-increasing range of medical conditions, leading to an improved quality of life for patients. The addition of wireless connectivity to medical devices has enabled postdeployment tuning of therapy and access to device data virtually anytime and anywhere but, at the same time, has led to the emergence of security attacks as a critical concern. While cryptography and secure communication protocols may be used to address most known attacks, the lack of a viable secure connection establishment and key exchange mechanism is a fundamental challenge that needs to be addressed. We propose a vibration-based secure side channel between an external device (medical programmer or smartphone) and a medical device. Vibration is an intrinsically short-range, user-perceptible channel that is suitable for realizing physically secure communication at low energy and size/weight overheads. We identify and address key challenges associated with the vibration channel, and propose a vibration-based wakeup and key exchange scheme, named SecureVibe, that is resistant to battery drain attacks. We analyze the risk of acoustic eavesdropping attacks and propose an acoustic masking countermeasure. We demonstrate and evaluate vibration-based wakeup and key exchange between a smartphone and a prototype medical device in the context of a realistic human body model.