If we put a charge into a polarizable medium, we'll find lots of dipoles, very analogous to particle-antiparticle pairs. That is, an E&M field distorts the medium in which it exists, and thus distorts the medium's charge distribution. In QED, the medium is the real vacuum, and it is indeed polarizable. So we can imagine pair production, crudely to be sure, as another form of the photo-electric effect -- a photon zaps the vacuum, which, in turn, then emits a pair.
Why is the vacuum polarizable? The ultimate, fancy answer is gauge invariance. A more "nuts and bolts" answer is framed in terms of QED's interaction energy, which, of course, takes a lot of work to formulate. The interaction contains terms like b*d*a and b*d*a*, where * denotes transpose, and b* creates an electron, d* creates a positron, and a destroys a photon. So this first term is the classic case of a photon transforming into a pair. The second term, because of a*, creates a pair plus a photon from nothing. How's that again?
We can use a simple model-- everything is in a gravitational well. Just think of this as a substitute for the "potential" created by pair-pair interactions. We'll find bound states of pairs with wave like behavior, but they can't get very far from the well's boundary. That is, we have what are often called quasi-bound states; almost free. The something from nothing phenomena is pretty much like boiling or evaporation, that is thermal energy can, locally, give enough energy to free a quasi-pair along with a photon. (Seems like the something from nothing can be generated by a phonon, while the classic case is generated by a photon. ) When interactions are taken into account, the QED vacuum has a structure of pairs and photons. In reality, this structure can support thermal properties, that is, it can have a local temperature, which can have fluctuations, which can create pair-photon states.
No stuff, no creation from nothing. Stuff allows "creation of particles" in analogy to boiling bubbles in liquid, or surface evaporation. It just looks like something from nothing, but really isn't.
Regards,
Reilly Atkinson