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Friday, June 05, 2015

On Immunity: An Inoculation

On Immunity: An Inoculaton, by Eula Biss, is a hybrid of a book. It is both an informative history of vaccination, and also a personal memoir of Biss' own experiences as a mother, as well as a daughter of a doctor. I think the combination works quite well, as Biss confronts the fears that have founded the anti-vax movement, and while she shoots down their arguments, understands those fears.

Biss shows that vaccination is not a new thing. The very first thing she discusses, and which is on the cover, is Achilles' mother, Thetis, attempting to immunize him in the River Styx. Those who know Greek myth know how that turned out. Vaccines, Biss points out, are precursors of modern medicine, not the product of it: "It was 'poison of adders, the blood, entrails and excretions of rats, bats, toads and sucking whelps' that was imagined into vaccines of the nineteenth century. This was the kind of organic matter, the filth, believed responsible for most disease at that time. It was also a plausible recipe for a witches' brew. Vaccination was fairly dangerous then. Not because it would cause a child to grow the horns of a cow, as some people feared, but because arm-to-arm vaccination could communicate disease like syphilis, as some people suspected."

At one time vaccinations were thought to be miraculous. The polio vaccine inventor, Jonas Salk, was hailed as a hero, mostly because polio was a real evil, not some long-ago problem like small pox or measles. Today, Biss points out: "Unvaccinated children, a 2004 analysis of CDC data reveals, are more likely to be white, to have an older married mother with a college education, and to live in a household with an income of $75,000 or more--like my child." Where did this mistrust of doctors in the upper-middle-class come from? The thesis that vaccinations cause autism come from a paper that is now totally debunked, but spread like demi-celebrities like Jenny McCarthy, these things become hard to be unlearned. Biss talks about talking with her mother friends, and they all have bits of info that make them suspect too many vaccinations. Indeed, there are many. They are now vaccinating for chicken pox, and Biss wanted to hold the line. But her doctor assured her it was necessary, if only to eliminate shingles in the child when it became an adult.

What is most important about vaccination is the community aspect. Biss' father, an oncologist, puts it best: "'Vaccination works,' my father explains, 'by enlisting a majority in the protection of a minority.' He means the minority of the population that is particularly vulnerable to a given disease. The elderly, in the case influenza. Newborns, in the case of pertussis. Pregnant women, in the case of rubella."

It's interesting to see Americans, in particular, react to a disease invading our shores. Whether it's H1N1, or Ebola, there is a hue and cry for vaccines. But for something like the measles, which has perhaps has come to sound quaint and benign, but is a killer and maimer, there is general mistrust.The history of smallpox is useful. "That vaccine is responsible for the worldwide eradication of smallpox, with the last case of natural infection occurring in the year I was born. Three years later, in 1980, the disease that had killed more people in the twentieth century than all that century's wars was officially declared gone from Earth."

Biss also discusses, fascinating for me, Bram Stoker's Dracula, and sees the vampire as a metaphor for disease. Remember in that book that he is coming to England, so Stoker is tying into both the fear of the immigrant (Dracula is given Semitic features) and the fear of contagion. He is not a romantic hero, as some films have portrayed him, he's just hungry, like a germ.

I also found interesting her discussion of the "war" metaphor. She quotes Susan Sontag often, whose Illness as Metaphor is something or a precursor to this book. We always talk about wars on things--drugs, poverty, and disease. But there's another wrinkle: "The metaphor of a 'war' between mothers and doctors is sometimes used for conflicts over vaccination. Depending on who is employing the metaphor, the warring parties may be characterized as ignorant mothers and educated doctors, or intuitive mothers and intellectual doctors, or of caring mothers and heartless doctors, or irrational mothers and rational doctors--sexist stereotypes abound."

That this book was written is indicative of the general anti-science atmosphere in which we are living. Where some people put more faith in a mystical super-being that proven medicine, or in the random ramblings of an Internet story that mountains of research. But there it is. I would recommend this book to anyone who is a parent or thinking about being one when it comes to vaccinating their child.

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