Medical Ethics Unpacked: Shifting Vaccine Regulation and Policy, with Jason Schwartz, PhD

In this episode of Medical Ethics Unpacked, hosts Dominic Sisti and Steve Levine welcome Jason Schwartz, PhD, associate professor at the Yale School of Public Health, for a discussion on vaccine ethics, public health infrastructure, and the challenges of maintaining trust in immunization programs.Together, they explore how the COVID-19 pandemic reshaped public attitudes toward vaccines, while also underscoring long-standing tensions between individual autonomy and collective responsibility. Schwartz, whose work focuses on vaccine policy and history, offers perspective on the systems and institutions, such as the CDC's Advisory Committee on Immunization Practices (ACIP), helping to translate scientific evidence into public health recommendations.This episode comes at a time when ACIP is once again in the headlines as HHS Secretary Robert F. Kennedy Jr. recently replaced all 17 members with a new slate of individuals, citing concerns about groupthink and conflicts of interest. The move has generated widespread commentary about the role and value of such expert advisory bodies in shaping public health decisions, especially in the face of growing skepticism and political scrutiny.Ethical questions about equity, communication, and responsibility are threaded throughout the discussion. The hosts and Schwartz reflect on what it means to make fair vaccine recommendations in the context of incomplete data, and how institutions can maintain public trust amid scientific uncertainty. They also discuss how the infrastructure behind public health decisions—committees, advisory boards, and interagency coordination—can either strengthen or undermine confidence depending on how they function and how well they are understood.Chapters00:00 – Introduction and Vaccine Policy in Crisis03:00 – The Long History and New Politics of Vaccine Skepticism09:30 – Erosion of Public Health Infrastructure and Expert Advisory Systems14:50 – Why Vaccines Became a Political Flashpoint19:10 – Clinician Ethics and the Vaccine-Hesitant Patient32:00 – Data, Misinformation, and the Future of Vaccine TrustReferences:Stone W. RFK Jr. names new slate of vaccine advisers after purging CDC panel. NPR. Published June 11, 2025. Accessed June 17, 2025. https://www.npr.org/sections/shots-health-news/2025/06/11/nx-s1-5430870/cdc-vaccine-experts-rfk-jrAsturias EJ, Brewer NT, Brooks O, et al. Advisory Committee on Immunization Practices at a Crossroads. JAMA. Published online June 16, 2025. doi:10.1001/jama.2025.10776