Book Reviews - Autumn 2014

Taking Shots

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A powerful plea for vaccination

Work Projects Administration Poster Collection, Library of Congress

By Harriet A. Washington

September 8, 2014


 

On Immunity: An Inoculation, By Eula Biss, Graywolf Press, 216 pp., $24

The myth of Achilles becomes, in the hands of Eula Biss, the perfect allegory for her powerful new book, On Immunity: An Inoculation. Ignoring the angry adult warrior of the Iliad, she instead illuminates his mother’s terrifying choice, as represented in the dark, moody palette of the painting that adorns the book’s cover, Rubens’s Thetis Dipping Achilles into the River Styx. Thetis maintains a precarious grasp on one of her son’s heels as she submerges him headfirst into the Stygian waters. The black depths, the scenes of the departing dead in the background, and the angst on Thetis’s face clearly signify the threat inherent in her desperate act of protection: a casual observer might think she is drowning Achilles rather than trying to inoculate him against future assaults. What better metaphor for the contemporary argument over vaccination?

Until I read On Immunity, I had wearied of the endless rounds of recrimination that have contaminated the debate, but Biss’s careful, sympathetic treatment of her subject made me realize that it was merely a surfeit of incivility that had driven me away. Kirkus Reviews praised her book as a “withering critique to more recent fears of vaccines.” Persuasive, yes, but hardly withering. On Immunity succeeds by eschewing the breathless hyperbole so common to other works of its kind.

In service of her carefully nuanced (and nearly unassailable) argument in favor of vaccination, Biss mines a dazzling array of sources—ancient mythology, folktales, science fiction, literature, and pop culture, to name a few. But what makes On Immunity worth your attention is its author’s deeply personal approach to her subject. Biss’s own worries began with the birth of her son, she writes, when she learned of the supposed hazards of inoculation from headlines and other mothers. Her unflinching description of her anxieties is presented so viscerally that readers share her confusion as she faces a choice between the Scylla of childhood disease and the Charybdis of possible toxicity. Amid the panic of a flu pandemic, she writes, “It was as if the nation had joined me in the paranoia of infant care. Like many other mothers, I had been informed of a syndrome affecting infants that had no warning signs and no symptoms other than sudden death. … There was lead paint, I knew, on my walls and hexavalent chromium in my water, and the books I was reading were telling me to run a fan while my baby slept because even stagnant air could suffocate him.”

Biss doesn’t shy away from the science, either. A prize-winning essayist and critic, she explains complicated immunological principles with minimal medical jargon and a maximum of poetry and warmth. Viruses are “mysterious creatures, parasitic and vampiric by nature”; “vaccines are of that liminal place between human and nature—a mowed field, [Wendell] Berry might suggest, edged by woods.” And of the ceaseless responsibility of parenting, she muses, “Every day with a child, I have discovered, is a kind of time travel. I cast my mind ahead with each discussion I make, wondering what I might be giving or taking from my child in the future.”

Biss’s evenhandedness is a welcome relief from the heated language and ad hominem criticisms that rule the debate between vaccination defenders and autism-causation theorists. The latter’s ideas are often described by their critics as emanating from the overheated imaginations of untutored parents, ex-Playboy centerfold Jenny McCarthy, and rapacious medical charlatans. Yet dinner conversations and the Internet are filled with specious vaccine risk assessments, many disseminated by people ill-equipped to evaluate statistics. Their warnings prey on our psychology: we fear the shark more than the mosquito, Biss writes, even though the latter is “probably the most dangerous creature on earth,” and the former unlikely ever to make our acquaintance.

immunityDespite her book’s strengths, Biss makes some missteps. In an endnote, she defends her use of “mother” instead of “parent” throughout the book in order to honor the mothers with whom she had fruitful conversations. But Biss’s choice reinforces a troubling tradition of dismissing fathers’ medical roles, as detailed in Paul Raeburn’s recent, Do Fathers Matter? What Science Is Telling Us About the Parent We’ve Overlooked. She also misses the mark when she invokes the political manipulations and “rumors” that keep many people in the developing world from seeking vaccination. She mentions how the CIA used sham vaccinations in its search for Osama bin Laden, but she ignores the widespread fear sown by Western medical miscreants, small in number but widely known, who have been accused or convicted of harming or even killing patients under the guise of caregiving. Also, Biss concludes her book with a perfunctory discussion of medical interdependence that seems tacked on: I wish it were more robust.

But those failings pale in comparison with her achievement—a brilliant and empathic exploration of the vaccine wars, at once entertaining and useful, for parents or anyone else seeking a more complex understanding of immunology and vaccines. Biss’s respectful argument for continued childhood inoculation makes her book—full of scintillating narratives, riveting bits of history, and touching memoirs that can be relished for their own sake—one that all vaccine skeptics should read.


Harriet A. Washington is a medical ethicist and Bennett Fellow at the University of Nevada’s Black Mountain Institute. Her latest book, Infectious Madness: The Surprising Science of How We “Catch” Mental Illness, will be published in October.


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