On Immunity: An Inoculation

On Immunity: An Inoculation is a 2014 work of nonfiction by American author Eula Biss. A response to contemporary questions about medical science and its ethical responsibilities, particularly the responsibility to vaccinate, the book examines complex arguments from a variety of perspectives. Biss also connects arguments for and against vaccination to important narratives and metaphors from the history of ideas about the human body. These ideas range from the mythological (for example, the myth of Achilles), to the pseudoscientific (quack “vaccinations” in pre-scientific medical history), to the fantastical (the concept of the blood-sucking “vampire”). Together, they help explain how public discourse on vaccines in America is informed by its collective unconscious. The book was nominated for a National Book Critics Circle Award for Criticism.

Biss states the main purposes of writing her book. The first is to expose why certain fears about vaccinations exist. Biss acknowledges the irony that many of these fears are both very irrational and extremely compelling. She goes on to argue that exposing the cultural sources of these fears will help to diminish them over time. Second, her book aims to encourage more open and fact-based debate over vaccinations to help shift its center away from the partisan political world. She believes that many of the negative and pseudoscientific aspects of the debate are based in socio-political diseases, such as misogyny and xenophobia. She addresses the book mainly to mothers, hoping to connect with those who may be uncertain about their stance on the issue but are hoping to learn more.

To drive her connection with other mothers home, Biss writes extensively on her decision to vaccinate her son. When she first gave birth, she thought of herself mainly as her son’s caregiver, neglecting the mutualistic relationship between her own health and his. Soon enough, she noticed that her own well-being directly affected the quality of care she could give to him. Once he was a few months old, she realized that the relationship was even more complex and involved the health of the community in which they lived. She was particularly struck by an article that discussed the spread of the virus Hepatitis B, and its relationship to infant health. Recent research shows that the immunization of infants against Hepatitis B is the best way to inoculate communities against its spread. Earlier research was not as comprehensive, isolating the epidemiological source of Hepatitis B to populations deemed “high-risk.” She began to think of her son as already a member of their community, and therefore responsible, from birth, to help maintain its health.



Biss also highlights some of the main sources of negative sentiment about vaccination. The biggest offender, she claims, is capitalism. The consumerist logic that most people now employ to make decisions about purchases, Biss argues, cannot be repurposed to make decisions about health care and general well-being. Health care is similar to art and education in that it does not pay off to think in terms of products that should be optimized according to limited quantities like price. In reality, these things are processes that involve time and contemplation. Biss advocates for awareness building in health care, in which one interrogates “the economy of health care and its corruptions.” Part of doing this is to learn about one’s individual role in renewing (or challenging) different aspects of this economy. A work that she believes exemplifies this challenge is Susan Sontag’s 1989 book AIDS and its Metaphors. Sontag’s book shows that progress in health care is undeniably related to the ideas that common individuals generate about their bodies, which they inherit from everywhere in the world – not just from their health care contexts. These “metaphors,” no matter how trivial they seem, exert power on real health care processes.

Finally, Biss considers the American notion that our most dangerous threats are those that are physically closest to us. This notion is sometimes reversed: for example, though the common mosquito kills many times more people each year (through disease transmission) than do shark attacks, people tend to fear sharks more. Biss argues that we can think more rationally about what threats we might actually be vulnerable to by remembering that almost anything can pose a health risk, including ourselves. If we can somehow separate popular images, like the sinister caricature of the shark waiting for its victim in Jaws, from our concepts about medical science, we will make progress in educating and protecting generations to come.