Eula Biss opens her new book, On Immunity: An Inoculation, with a description of a video her husband recorded the day before she gave birth to their son. In the video, she observes, her face looked free of fear. Twenty-four hours later, after a difficult labor and a blood transfusion, this was no longer true. Suddenly she feared many things: lead paint in the walls, toxic plastics in the crib mattress, carcinogenic minerals in the water. It was 2009, the H1N1 vaccination campaign was soon to launch, and a post-recession wariness tinged the air—“not a good season for trust,” as Biss notes. Groups of mothers wondered about the safety of vaccines. But as Biss began investigating immunity and public health, her interest moved from the question of fear to the question of how to move past it, and into a discussion of social ethics and care: What does an individual body—scared or not—owe the collective body?
As you explain, people often use metaphors to talk about immunity and vaccines. Vampires come up a lot. How do you see them as connected to immunity?
The vampires were a surprise to me; I didn’t go into this expecting to write about them. But in my research, I read about an anti-vaccination movement in Victorian England—I wasn’t aware that resistance to vaccines was that old—and learned that one of the metaphors activists gravitated towards was that of the vaccinator as vampire. That piqued my interest. I started looking at the vampire literature of that time as well as our contemporary literature, movies, and television. I got interested in the use of the vampire as a tool for talking about social power. It was fascinating to me: the ways that the vampire invites us to think about what we ask of each other, and what we ask of each other’s bodies. The image of one person sucking another person’s blood remains compelling and terrifying in part because it invites us to think about how the needs of one person’s health can draw on the well-being of another person, and more broadly, the ways in which the individual draws on the social body.
You talk a lot about contamination, the narratives of contamination. You quote anti-vaccination activist Jenny McCarthy, for example, railing against “the frickin’ mercury, the ether, the aluminum, the antifreeze.”
In that quote, it’s obvious that the items on the list are metaphors, because most of them aren’t actual ingredients of vaccinations; the naming of the substances speaks to our fear of contamination. The concern is legitimate: We live in a world in which there is quite a bit of industrial pollution. But I’m interested in the place where a legitimate fear tips into being irrational or simply symbolic. Vaccines have served as a symbol for contamination since the era of the Victorian vampire. Bodily contamination, contamination of the blood—there are race and class anxieties embedded in those fears. But Victorians were also concerned about being contaminated with something animal through the vaccine, because the technology at that time involved drawing puss out of a cow. So theirs was the fear of animal-human contamination. Our fears are more industrial and chemical.
In the book, you use the word “trust” to mean something more than just a lack of fear.
The book is concerned with trust in its many senses. In the legal sense, which I found really fascinating, a trust involves caring for or taking possession of something that doesn’t ultimately belong to you. That speaks to how I feel about my role as a mother, and what I think mothering is: I feel like I’ve been entrusted with the care of someone who doesn’t ultimately belong to me. More than any other experience in my life, becoming a mother forced me to be aware of my dependence on other people—my friends and family, but also the broader community around me. That’s part of what propelled me into the meditation in this book about trusting other people. You can’t rely on or fully use your community network unless you trust people in that network. What’s especially disturbing to me about the rhetoric around vaccines and vaccinations is its deep cynicism about other people and other people’s motives. That cynicism is a complicated brew—some of that is earned, some imagined, some historical, some contemporary. But I think it’s ultimately destructive, particularly to us as parents who need an extended network of people who can help us and make our work easier.
I want to go to a specific case of vaccine refusal you looked at—your experience with the hepatitis B shot—in your discussion of public health, and who we think of public health measures as being for.
Probably more than anything else, my personal experience with the hepatitis B shot was what propelled me into writing this book. My initial research on hep B, which included a meeting with my son’s pediatrician, led me to believe this wasn’t a very important vaccine to give my son. My initial choice not to vaccinate him was made with partial, flawed knowledge. And part of what this book does is to interrogate that decision. I don’t think it was the best decision for my child, nor the most socially responsible decision.
The vaccination of newborn babies against hep B has done more to control the disease than any other public health initiative. It works. And as I’ve thought about my decision, I’ve felt less and less comfortable with not participating in a public health initiative that is valuable to society as a whole. It could have potentially had ramifications not just for me and my son, but for other children that he came into contact with, future sexual partners, and who knows who else down the line.
You did get into a conversation about more privileged vaccine refusers understanding public health measures as being for someone else, some mass of people that isn’t them, and then opting out.
Part of the problem is that we tend to have very consumerist attitudes around healthcare. We approach healthcare the way we approach other consumer purchases, with the question, “What is this going to do for me?” I think that attitude is problematic when it interfaces with a public health initiative, where the main benefit may be for people who are not you.
You mentioned that at some point in your research you started to appreciate the metaphor of a body of information. Why do you like that metaphor?
At first the word itself attracted me. I was already looking at bodily metaphors, and I wondered, what are we saying when we say body of knowledge, body of information? It spoke to my experience as a researcher. When we say body of knowledge, we’re talking about something as complex and interdependent as our own bodies—you can’t just chop off a finger and treat it as representative of the whole being. This illustrates a major problem with how laypeople like me are engaging with scientific knowledge around vaccination. There’s a tendency for us to fixate on one study or a handful of studies instead of looking at the whole body of knowledge. Because our knowledge base is so massive, to do that requires a lot of cooperative thinking.
That brings us back to the question of trust. A single thinker is no longer capable of taking on this whole issue. You have to trust not only what other people have observed and learned but also other people’s analysis of information. I think that’s something people resist. We like the idea of the individual investigating rigorously and arriving at her own conclusion, and it’s especially thrilling if that conclusion is counter to commonly held practices and beliefs. It’s a seductive narrative because it plays into our ideas about individual, heroic thought and discovery. But does it produce a truth? I’m not convinced it does.
You relate a lot of personal conversations with friends who are mothers. Has writing this book changed the way you talk to other mothers?
When I started talking with other mothers about vaccination, I found it surprisingly explosive. People, including myself, could get really angry really fast. But as I researched, I gradually gained a fuller understanding of people’s motivations, and I think I’ve become more patient in the way I engage in conversations around this issue. That’s one of the most valuable things to me about this project—learning to have honest discussions with other women on subjects where we disagree. I think that’s something women are discouraged from doing; instead, we’re encouraged to agree with each other, and told that we’re being hostile if we don’t.
Maybe particularly in the project of motherhood.
Definitely. A popular message is that your job as a mother is to support other mothers in their decisions, no matter what. When I first became a mother, I started reading parenting magazines and was bombarded with the standard line of thinking: “I’m OK, you’re OK.” Vaccination challenges that ethos, and the assumption that ethos rests upon; that your choices don’t affect me and my choices don’t affect you, so we’ll just be nice to each other. It may be true in most cases. But in the case of vaccination, it’s really important—to our project as mothers and to society as a whole—for us to voice disagreement. There are some decisions that are dangerous to the social body, and that’s where this subject gets hot: when it gets into questions of morality and ethics.
Throughout the book, I mostly say “mothers” when I’m talking about other parents. My editor and I had a conversation about whether I would change that to “parents” instead, and I chose to keep it gender-specific in part because I was thinking about the gendered implications of this conversation. We’re encouraged to interact with each other as women in a way that sometimes limits our intellectual engagement. The culture of friendly debate is less nurtured among women, and there are areas where that’s really problematic. There’s a certain amount of pandering in the idea that we shouldn’t debate each other, and I think the underlying notion is that our ideas aren’t very socially meaningful. If our ideas are important, we should be compelled to challenge those we don’t agree with.
Before On Immunity you wrote The Balloonists and Notes from No Man’s Land. These were personal stories about love and its breakdown, and essays on race. Do you think about your work in terms of a body of knowledge or body of information? What do you see as your themes or points of connection?
I thought about that as I was writing this book. A major question emerged in Notes from No Man’s Land. Say you’re someone who has privilege because of your class or race. What’s the responsible way to handle that privilege? I believe you have to use it in a redemptive way. But I left that book still not knowing what the practical application of that idea would look like, exactly. This new book is about exploring one practical application, one means of ethical action. When I was writing this—and also living it—I had to come to terms with the idea that if I really believe in living my privilege responsibly, I have to put my child’s body on the line. I have to believe it through him. And that’s a real test of a person’s beliefs. I’d written a whole book on this and still found it quite challenging.
There’s also a less obvious point of connection between my books that was a big deal to me. In both The Balloonists and Notes from No Man’s Land, my writing is very associative. This new book is different. I still jump from topic to topic, but I am also interrogating my habits of thought, one of which is the tendency towards loose association. That habit has been productive for me artistically, but here I was able to think about the other side of that. Are there places where loose association can get me in trouble as a thinker? I think it can. In my thinking around vaccination, my habits of thought were landing me in places where I was misinterpreting information. The book is obviously a social critique, but for me, it was also a personal critique of my own thinking. Refusing my own leaps of association was probably the hardest thing about writing it. It was incredibly painful, totally unfun. But in terms of this book’s relationship to my body of work, it was an essential thing to do. I want my next book to be more lyric, to return to the space I occupied with The Balloonists, but I think I’ll return there as a more responsible writer having written this.
Miranda Trimmier is a New York-based writer.
