What to do with the anti-vaxxers, those parents who withhold lifesaving vaccines from their own children, leaving them vulnerable to measles, mumps, whooping cough, even polio? How to explain to them that scoffing at science and evidence is a first-world luxury, affordable only where it’s rare to see somebody on crutches, crippled for life by a childhood disease we know how to stop? How to make them understand that the health of each individual one of us is ensured by the herd immunity obtained when we all get our shots—and that for the tiny minority of people who cannot get their own shots, because of allergies or compromised systems or because they are newborns, what keeps hideous old-timey diseases at bay is the common sense of other children’s parents? How to explain to them that the overwhelming consensus of doctors and scientists counts more than Jenny McCarthy’s twisted passion for her cause?
Evidence won’t work. Shock and awe—black-and-white pictures of pre-war smallpox victims, or contemporary color photos of the grotesque backs of children who never got their shots and now have measles—do not work. Doing what I do, which is acting annoyed and rolling my eyes in the presence of anyone who is not 100 percent in agreement with me, has so far persuaded nobody.
So perhaps we should try Eula Biss’s tack. Biss, whose first book was the splendid 2009 essay collection Notes from No Man’s Land, specializes in radical empathy. The essays in that collection, all of them about race in America, are models of how to mold strangers’ shoes so that you can walk a mile in them. In her new book, On Immunity: An Inoculation, she pins vaccine skepticism to her corkboard, then inspects it from all angles. Although I am sure that Biss did not mean to write a polemic, she ends up with an agenda, and the agenda is more powerful for never being stated. For just what is this book meant to inoculate the reader against, per her subtitle? Fears of inoculation itself, it turns out. Like a doctor giving shots, she delivers an extremely weakened form of vaccine skepticism, so that we might develop antibodies to the real thing. She’ll give us a little taste of the anti-vaxxer mindset, hoping that we’ll become resistant to that disease of the brain.
In other words, Biss comes not to rail against the vaccine skeptics, but to understand them. She is pro-vaccine, but she’s not an op-ed writer: she’s a high-style essayist, elliptical like Joan Didion, aphoristic like Susan Sontag, familiar like Anne Fadiman. Biss comes down on the side of science and reason, but in such an MFA-ish fashion that maybe some of the educated white women who are, alas, the main constituency for anti-vaccine nonsense, will be persuaded that they can trust Biss. Because she either has no animus toward those parents who withhold vaccines from their children, or because she hides that animus so very well—she’s a grandmaster of judgment-withholding—this may be the perfect book to hand to that mother or father of a newborn who is on the fence.
But if Biss has scored a minor success, we still have to bemoan that she succeeded where public science education failed. Vaccinating children should not be up for debate, so to read an elegant, incisive book that takes the debate seriously is bound to be an ambivalent experience. This is a book fair to both sides of a debate that, among people who know the evidence, does not exist. That there’s a market for it makes it a curiosity, a time-capsuled bit of evidence for a hysterical fad that surely must pass.
I read this book with pleasure. On Immunity begins with Biss’s pregnancy during the H1N1 influenza epidemic, and continues through her son’s birth and early life. During that time, she confronts the typical new-mother anxiety, if a worrisomely heightened case; vaccinations are one focus of her anxiety, and one that fellow mothers are eager to chat about. Being a writer, she begins researching. But she’s less interested in the evidence (she quickly figures out where it all points) than in immunity’s place in our time-built cabinet of fears. She draws on Sontag to examine illness as metaphor, and on John Rawls to think about the “veil of ignorance” and justice. She offers a sensitive reading of Bram Stoker’s Dracula, showing how deeply inscribed in Western thinking is a dread of contamination.
Biss is not self-pitying, although I often pitied her. After learning that the Food and Drug Administration does not regulate cosmetics, she finds herself “paralyzed in the drugstore, staring at the ingredients of the lotion” her doctor had recommended for her son’s chapped skin. She is of the fragile-and-fraught school of parenting, or perhaps of parenting writing. It’s amazing she ever got her son out of the house. Biss seems to know as much, and she can inject a note of self-deprecation just when one is needed: “The idea that toxins, rather than filth or germs, are the root cause of most maladies is a popular theory of disease among people like me.” She’s very much an original; only once does she fall into lazy groupthink, when she cites the now-discredited theory, still on far too many outdated women’s-history syllabi, that “[m]idwives and wise women … were particularly persecuted in the witch hunts.” (Roxane Gay, one of Biss’s peers among great American essayists, cites this faulty theory in her recent Bad Feminist.)
But On Immunity is mostly not about its author. I learned a great deal of history: I had not known, for example, that “the term conscientious objector, now associated primarily with war, originally referred to those who refused vaccination.” And few writers write prose as neat, efficient, and cliché-free as Eula Biss. One is never in doubt about her meaning, and one never despairs that she’s taking extra words to get it across. And so, amidst all the handwringing and careful listening to the other side, when it comes time to state the case for immunization, nobody does it better.
After visiting an old graveyard, Biss remarks to her father, a doctor, that she had seen the graves of 5- and 10-year-old children, but not of infants. “This, my father reminded me, was probably because infants died in such large numbers during the nineteenth century that they were not routinely buried in marked graves,” Biss writes. “Later, I would learn that one out of every ten children born in 1900 died before their first birthdays. I would read this in a report on vaccine side effects, which concluded its brief historical overview of child mortality with the observation that ‘now children are expected to survive to adulthood.’”
Indeed, to anyone interested in the facts, it should be clear that widespread public vaccination is one of the best things humanity has ever done. Which does raise the question: How should we feel that a smart writer could spend years on a book about the anti-vaccine movement?
I once wrote a long multipart article about the Holocaust-denial movement in the United States. I focused on two men in particular—one of whom, it turned out, had a Jewish sister, while the other had been in a long-term relationship with a Jewish woman. Neither man thought he was an anti-Semite, and neither would ever personally hurt a Jew. They thought they were bringing historical truths to light. This was interesting to me, but one professor I spoke with, a revered Jewish historian, told me I had wasted my time. “These guys are like shit you accidentally stepped in,” she said. “You just want to scrape them off your shoe and move along.”
She had a point. People who are emphatically, irresponsibly wrong about something should not have too much claim on our time or attention. To be fair, Biss is ruthlessly clear about where the data take us, and about how we should see the denialists. The popular anti-vaxxer Dr. Bob Sears should never recover from the dissing that he’s served up here. Biss may have missed her vocation as a Hitchens-like beatdown artist. But for all her savvy, she seems unaware of how bizarre it is that an intelligent, educated woman, the daughter of a doctor no less, feels this particular tug of fear.
Biss comes closest to this realization when she writes, near the end of the book, “What has been done to us seems to be, among other things, that we have been made fearful.” But then she asks, “What will we do with our fear?” That’s not the question at all. It’s clear what we will, and what we must, do with our fear: master it, get our kids their shots, be grateful for our good fortune to live in the time and place we do, and move along to stuff that matters, like helping the less fortunate around the world get medical care, too. So a better question, the only one that makes sense, is, “Why did we let those wrongheaded people make us so afraid? And how can we stop them?”