Teaching

This course explores critical topics in vaccination policy in the United States and internationally. It does so by examining the interconnected political, regulatory, social, cultural, ethical, economic, legal, and historical issues that contribute to ongoing debates about the design and implementation of vaccination programs and policies. Students acquire an understanding of the scope and design of contemporary vaccination programs and policies in the United States and worldwide; the policy and political landscapes in which vaccination programs are developed, funded, and implemented; the positions, evidence, and arguments of both proponents and critics of contemporary vaccine policy; and the application of principles and concepts from health policy and policy analysis to the study of vaccination policy.

Featured in a December 2022 article on the Yale School of Public Health website

HSHM 462/HIST 485J -- Pharmaceuticals in Medicine and Health Care, 1900-Present

Undergraduate seminar in Yale College -- Program in the History of Science, Medicine, and Public Health

The history of pharmaceuticals and their role in medicine and health care from 1900 to the present. This seminar examines how pharmaceuticals have shaped the practice of medicine and delivery of health care, approaches to prevention and treatment, medical knowledge and disease definitions, and related topics. It looks broadly at pharmaceuticals in the United States and globally as well as deeply at specific classes of products that have raised particular questions and considerations throughout their histories. Additional topics include pharmaceutical regulation and the U.S. Food and Drug Administration, pricing and financial issues, marketing and direct-to-consumer advertising, research and development, and safety controversies.

HSHM 473/HIST 403J -- Vaccination in Historical Perspective

Undergraduate seminar in Yale College -- Program in the History of Science, Medicine, and Public Health

For over two centuries, vaccination has been a prominent, effective, and at times controversial component of public health activities in the United States and around the world. Despite the novelty of many aspects of contemporary vaccines and vaccination programs, they reflect a rich and often contested history that combines questions of science, medicine, public health, global health, economics, law, and ethics, among other topics.

This course examines the history of vaccines and vaccination programs, with a particular focus on the 20th and 21st centuries and on the historical roots of contemporary issues in U.S. and global vaccination policy. Students will gain a thorough, historically grounded understanding of the scope and design of vaccination efforts, past and present, and the interconnected social, cultural, and political issues that vaccination has raised throughout its history and continues to raise today.

EPH 510 -- Health Policy and Health Care Systems

This course--the core health policy course in the Yale MPH program--provides an introduction to the making, understanding, and consequences of health policy. The design and performance of the health care system are assessed, with particular attention paid to the complex and often contested manner in which health care is organized, financed, and delivered in the United States. The course also considers the fundamental concerns—such as cost, access, and quality—that shape the development of health policy and health systems in all countries, and it looks to the health systems of other countries in order to understand the advantages and disadvantages of alternative approaches. An overview of the important actors in the health care and political systems is provided, and students are introduced to methods for understanding the behavior of these policy-makers and stakeholders. Health issues are placed in the context of broader social goals and values.

Upon completion of this course, students will be able to:

1) Explain the major health policy issues facing national policymakers in the United States and in other countries,

2) Critically assess the range of policy strategies and programs that have been used to address these health policy challenges,

3) Evaluate the design and relative advantages and disadvantages of programs for organizing, financing, and delivering health care to various populations in the United States, including Medicare, Medicaid, the VA health care system, and various private insurance models,

4) Explain the effects of the Affordable Care Act on these programs and on U.S. health policy more generally,

5) Describe key features of other countries’ health care systems, noting their similarities or differences to each other and to the United States,

6) Explain the relationship between clinical medicine and public health in the evolution of health systems and the development of health policy, and

7) Systematically assess complex health policy issues and evaluate different reform strategies.

This course will examine issues at the intersection of ethics, policy, and public health, paying particular attention to the centuries-long tension between individual rights and the common good. Ethical considerations are increasingly visible in public health programs and policy in the United States and worldwide. Mandatory vaccination laws, taxes on soft drinks, the regulation of tobacco, and ongoing health care reform efforts are just a few examples of the continued relevance of long-standing debates over the proper role of government in promoting and protecting the health of individuals and communities. Surveying the remarkable breadth of public health regulation and practice, we will consider the historical context of contemporary policy debates; the institutions and individuals responsible for developing and implementing public health policy; the scientific, medical, and public health arguments offered by advocates and critics regarding specific policies; and the relevance of ethical considerations throughout these activities and debates. We will pay particular attention throughout the course to themes and scholarship in the emerging sub-field of public health ethics, highlighting its relationship to contemporary bioethics and medical ethics. -- Featured in University Center for Human Values Annual Review and Princeton University Bulletin

FRS 129 -- Vaccination and Society: Ethics, Politics, and Public Health
Vaccination is routinely described as one of the foremost achievements in the history of public health. Vaccines are credited with myriad achievements in efforts against infectious diseases in the 20th and 21st centuries, and they are viewed as powerful potential tools against a growing list of novel disease targets. Despite this record of success, vaccines are also a frequent source of controversy, with critics in the United States and worldwide questioning their safety, effectiveness, and necessity. Persistent allegations of a link between childhood vaccines and autism, vocal opposition to U.S. state laws that mandate vaccination in order to attend school, and debates over the appropriate distribution of vaccines during public health emergencies are three of the most visible examples of the often contentious atmosphere surrounding vaccination programs and policy in 2014. In this course, we will examine how ethical considerations inform and influence contemporary discussions of vaccination among government health officials, the scientific and medical communities, patients, parents, and the media. We will explore a variety of topics in vaccine policy in the United States and internationally, considering the interconnected ethical, social, cultural, legal, political, economic, and historical issues that contribute to ongoing debates about the proper role of vaccines and vaccination programs in public health and global health activities. We will read papers, book chapters, government reports, and other materials that offer insights and evidence on these topics from numerous disciplinary perspectives, including public health, medicine, health policy, history, ethics, and the social sciences. Students will gain a thorough understanding of the scope and design of contemporary vaccination efforts in the United States and worldwide, the major concerns of vaccine proponents and critics alike, and the contributions of principles and concepts from bioethics and public health ethics to the promotion of individual and population health through vaccination.-- Offered through Program of Freshman Seminars in the Residential Colleges

The testing, regulation, marketing, cost, and safety of pharmaceuticals are among the most complex and controversial topics in contemporary medicine and health policy. In the United States and throughout the world, pharmaceuticals have transformed the practice of medicine, approaches to prevention and treatment, and the creation and evolution of disease definitions, among their many other effects. At the same time, they are a frequent focus of critics who question the conduct of the pharmaceutical industry, the competence of national and international regulators, and the unacknowledged or unidentified risks of pharmaceuticals for patients. This course will explore the critical yet highly contested place of pharmaceuticals in efforts to protect or improve the health of individuals and populations. In this work, we will direct particular attention to the often underappreciated effects of ethical considerations, individual and community values, and value judgments throughout these activities. Among the specific topics we will examine are: the global pharmaceutical industry, U.S. and international drug clinical trials, drug regulation by the FDA and international authorities, the role of risk-benefit and cost-effectiveness assessments, drug pricing and advertising, global access to pharmaceuticals, and the role of pharmaceuticals in medicalization.

BIOE 550 -- Vaccine Ethics and Policy
Vaccination is routinely described as one of the foremost achievements in the history of public health. Vaccines are also viewed as powerful potential tools against a growing list of novel disease targets from HIV to Ebola, to name just a few. Despite this enthusiasm, vaccination is a frequent source of controversy, with critics in the United States and worldwide questioning the safety, effectiveness, and necessity of vaccines. Persistent allegations of a link between childhood vaccines and autism, vocal opposition to U.S. state laws that mandate vaccination in order to attend school, and debates over the appropriate distribution of vaccines during public health emergencies are three of the most visible examples of the often contentious atmosphere surrounding vaccination programs and policy today. In this course, we will explore critical topics in vaccine policy in the United States and internationally, considering the interconnected ethical, political, social, cultural, legal, economic, and historical issues that contribute to ongoing debates about the proper role of vaccines and vaccination programs in public health and global health activities. We will read papers, book chapters, government reports, and other materials that offer insights and evidence on these topics from numerous disciplinary perspectives, including public health, medicine, health policy, history, ethics, and the social sciences. Students will gain a thorough understanding of the scope and design of contemporary vaccination efforts in the United States and worldwide, the major concerns of vaccine proponents and critics alike, and the contributions of principles and concepts from bioethics and public health ethics to the promotion of individual and population health through vaccination.

BIOE 540 -- Public Health Ethics
This course will examine issues at the intersection of ethics, policy, and public health, paying particular attention to the centuries-long tension between individual rights and the common good. Ethical considerations are increasingly visible in public health programs and policy in the United States and worldwide. Mandatory vaccination laws, taxes on soft drinks, the regulation of tobacco, and ongoing health care reform efforts are just a few examples of the continued relevance of long-standing debates over the proper role of government in promoting and protecting the health of individuals and communities. Surveying the remarkable breadth of public health regulation and practice, we will consider the historical context of contemporary policy debates; the institutions and individuals responsible for developing and implementing public health policy; the scientific, medical, and public health arguments offered by advocates and critics regarding specific policies; and the relevance of ethical considerations throughout these activities and debates. We will pay particular attention throughout the course to themes and scholarship in the emerging sub-field of public health ethics, highlighting its relationship to contemporary bioethics/medical ethics.