One day I picked my toddler up from his Montessori school and, along with the usual bags of laundry and lunch detritus, I was handed a slip of paper informing me that during his day at school my son had been vaccinated for polio. I sucked in my breath lest I do damage I could not undo, and carried home my child and my outrage.
The school might have bothered checking their records: my son was already vaccinated against polio, the disease that had defined my grandmother’s gait her whole life. I am not at all averse to vaccines (for reasons not entirely above reproach, as I’ll get into) but I could suddenly and viscerally relate to the anti-vaccinators of my parenting cohort. I could not tolerate that my child—a still-felt extension of my body—had been pierced, pricked, possibly even contaminated by the double dose—without my consent.
Believe me, I am a mother who is more than willing to voice my indignation when offended. And I was offended. The rub was this: I was an American mother mothering in Mexico. With this slight shift in geographical situation, so much changed entirely. Risk assessment, for one, and the degree to which parenting was atomistic, for another. And also, the role and significance of vaccines, and, for that matter, the implications of voicing my American indignation.
Examined in light of Eula Biss’s panoramic new inquiry, On Immunity: An Inoculation, my collision with the Mexican public health system becomes useful in depicting the scope of this book. Where the event felt personal to me at the time—as an affront to my idea of self, a violation—Biss inverts my perspective. The slip of paper I was handed represents not a bureaucratic error, but the history of a nation, a government’s relationship with the body politic, even international politics, and my reaction embodied fear born out of myth and metaphor, out of my own cultural and racial biases.
Although Biss arrives at a definitive pro-vaccine stance in On Immunity, this is not one of those insipid, reader-affirming parenting books. Nor is it a polemic. In fact, Biss describes the current squabble over the politics of vaccines as sadly devoid of nuance:
The debate over vaccination tends to be described with what the philosopher of science Donna Haraway would call ‘troubling dualisms.’ These dualisms pit science against nature, public against private, truth against imagination, self against other, thought against emotion, and man against woman.
On Immunity might be classified as a work of deep ecology. It sees, for example, the body as a garden, the immune “system” as a tidal ebb and flow, and immunity as inseparable from community. Above all, it seeks connections over divisions in its approach to the subject of our collective health.
There are many, many threads to this book. Vampires, for one. Linguistics (including “immuno-semiotics”), for another. Also environmentalism, medical narrative, and a reading of American history that makes the case that both the practice of, and the debate over, inoculation are intrinsic to U.S. nationhood. For this reader, Biss’s linking of vaccines to politics is particularly illuminating. According to Biss, vaccines are necessarily connected with governments, and their acceptance or lack thereof is likewise reflective of the public opinion about that government. My son’s re-vaccination for polio is case-in-point. Where the U.S. fought a civil war over states’ rights and the rights of personhood, and a cold war against communism, Mexico is shaped by a legacy of colonialism, repressive governments, and single-party rule. When my son was re-vaccinated Mexico was very actively at war, with federal police and the army deployed domestically. If the nature of government is expressed by a given country’s vaccination policies, there is much to be read into the fact that Mexico’s compulsory vaccination program doesn’t just not inform parents; it administers vaccines at schools and without warning so as to maximize immunity and circumvent resistance.
The gulf between Mexico’s constitutionally guaranteed public health care and the U.S.’s libertarian-tinged objections to the same are easy to write off as untranslatable, but of course national borders don’t apply to viruses. As such, any discussion of vaccination necessarily has a global aspect, and in the case of neighboring countries (and here Biss naturally invokes Kierkegaard’s definition of neighbor as “the other, that by which the selfishness in self-love is to be tested”), the interconnectedness is even more apparent. In the case of Mexico, immigration and disease share many metaphors: invasion by foreign bodies and so forth. The recent H1N1 influenza outbreak, or “swine flu,” which originated in Mexico, fueled America’s anti-immigration lobby, just as the word “Ebola” now comes up in the more inflammatory headlines about children detained at the border. “Our fears are informed by history and economics,” writes Biss, “by social power and stigma, by myths and nightmares.”
On Immunity takes a global perspective. In places like Nigeria, the emphasis on vaccines over basic primary health stoked conspiracy theories and ultimately a vaccine boycott, which significantly undermined ongoing international efforts to wipe out polio. Perhaps more troubling still, in Pakistan, one Taliban leader banned vaccination programs as leverage against U.S. drone strikes, and likewise the CIA conducted a fake hep B campaign to track Osama bin Laden via DNA samples—a tactic that, when exposed, resulted in vaccination bans and the murder of nine legitimate health workers. In other words, vaccines have been implicated in acts of war.
As mothers, we tend to orbit our babies and maybe lose track of current events in Nigeria and Pakistan, but Biss connects dots like constellations, needle by needle, across borders, across racial and cultural lines, and most certainly across economic divides:
Power, of course, is vampiric. We enjoy it only because someone else does not. Power is what philosophers would call a positional good, meaning that its value is determined by how much of it one has in comparison to other people. Privilege, too, is a positional good, and some have argued that health is as well. Our vampires, whatever else they are, remain a reminder that our bodies are penetrable. A reminder that we feed off of each other, that we need each other to live.
We each inhabit our own body, and our body politic too. But Biss brings the equation a few degrees closer, and finds the problem rooted in the words that name its parts: immunity occurs only in relationship to community. “Our bodies,” writes Biss, “may belong to us, but we ourselves belong to a greater body composed of many bodies. We are, bodily, both independent and dependent.” In my case, I did not want Mexico—the public health system an extension of the political state—in my son’s body. But my son’s body was in Mexico.
This after all is the downside of community—the othering that defines its parameters. Us. Them. When I really think about it, my zeal for vaccinating my son was a direct extension of my aversion to his being infected by some exotic pest. The year before we moved to Mexico from the U.S., the H1N1 flu pandemic—the response to which Biss explores in depth—crossed the U.S./Mexico border and infiltrated my son’s daycare. I was not entirely purged of the insidious American conviction that Mexico is filthy. (How often myths belie reality!) And although filth theory predates germ theory, as Biss explains, it adds a moral component to the question of disease. (“Cleanliness is next to godliness,” implies its opposite.)
Disconcerting as it is to have my latent fears poked at, this knee-jerk “conflation of otherness with disease,” while not defensible, is hardly unique. For example—this extended list is from the not-to-be-missed Notes section at the back of the book—one strain of smallpox that circulated around the turn of the twentieth century was known variously as “Cuban itch,” “Puerto Rico scratch,” “Manila scab,” “Filipino itch,” “Nigger itch,” “Italian itch,” and “Hungarian itch.” Syphilis, as Biss quotes Sontag in another section, “was the ‘French Pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese.” Jump forward to the moralizing and othering of the early years of the AIDS epidemic: clearly very little has changed. This aversion to difference may be innate, what evolutionary psychologists deem a “behavioral immune system,” but because it bears little relationship to actual risk it may do more damage than good. While fear of others may have propelled me to vaccinate my child post-haste, it has had the inverse effect on many parents who object to their children being vaccinated against disease that only affect “other” kinds of people or to be injected with a substance containing “debris from other bodies.”
Safety and risk, help and harm: so much of parenting feels like spinning a roulette wheel, with no way of knowing how our choices will bear out. With the subtitle An Inoculation, Biss seeks to fortify mothers (explicitly) with contextualizing information in the same way that an inert virus trains the immune response. She seeks to remind us, as motherhood tunnels our vision, of the bigger picture: of history, of class and race, of philosophy. “The more vulnerable we feel,” writes Biss about a study linking pregnancy to heightened xenophobia, “the more small-minded we become.” But this big-minded book seeks to prime our defenses against a response that might, in the big picture, run contrary to our own self-interest, even our own health. It does so by refreshing the memories of those of us in the privileged position to fear even the vaccines intended to make our children safer, reminding us that there are many more on this planet who are far more vulnerable, and that, given how interdependent our porous bodies are, their vulnerability is also our own.
Not even Thetis, the Grecian goddess who sank her infant Achilles in the River Styx, channel to the underworld, could fend off the horror that belongs to every mother: her child’s mortality. But our awareness of our mortality is grounds for morality. And this morality, Biss convincingly concludes, is “a radical inversion of the historical application of vaccination, which was once just another form of bodily servitude extracted from the poor for the benefit of the privileged. There is some truth, now, to the idea that public health is not strictly for people like me, but it is through us, literally through our bodies.”
