What I remember most vividly now is how ritualized it all felt, despite the assurances otherwise: Regimental lines inside the school gym, airy puff of a swab, those lollipops no one ever actually ate. “The shot,” we call inoculation, something quick and painless and definitely not transfiguring. Many of us fear needles regardless. When I asked about it on Twitter the other day, one person called them “instruments of torture,” while another said she only avoided looking at their tips (“it’s an eye thing”). Whether tetanus or influenza, I used to get a certain queasy thrill watching the moment happen. It wasn’t just flesh meeting the synthetic, I think, though pretend science fiction might appeal to any weird kid—it was the sight of my body integrating a foreign one. “We find ourselves to be cyborgs, hybrids, mosaics, chimeras,” Donna Haraway wrote in A Cyborg’s Manifesto, sort of a feminist-futurist equivalent to Marx’s effort. “Why should our bodies end at the skin, or include at best other beings encapsulated by skin?”
On Immunity, the thoughtful new book by Eula Biss, notes that “the metaphors we find in [inoculation] are overwhelmingly fearful, and almost always suggest violation, corruption and pollution.” She considers dozens of them, vampiric, sylvan, or militarized. A virus is language. Vaccination itself predates medical science, the folkloric boon of milkmaids whose cattle spared them smallpox. In the 19th century, it was carried out arm-to-arm via blooms of pus; before then people would simply infect themselves with a mild case of disease to ward off worse ones, or at least people in China and Africa would, since European physicians still prized leeches and the touch of a king. When the practice became widespread and then sometimes mandatory, impurity was the first fear, not unreasonably (primitive vaccination could also transfer syphilis). These days our paranoia fastens onto refining agents like mercury. “Where the word filth once suggested, with its moralist air, the evils of the flesh,” Biss writes, “the word toxic now condemns the chemical evils of our industrial world.” Anxiety about capitalist modernity filters down into its plasticky secretions.
Many of those, Biss takes care to point out, also occur naturally inside our bodies, and her book makes its own origins ambiguous. It’s a memoiristic history, essayistic vignettes. Much of her calm, lapidary prose was inspired by conversations with other new mothers, some airborne and infectious idea. On Immunity defers attributing any quotations until the end of the text, as if playing on the suspicions of anti-vaccine conspiracists. (“Why are they filling our children with Sontag?”) But it also mimics the behavior of a volatile virus, mutating between one page and the next; a brief section might begin with Ralph Waldo Emerson, touch on germ theory, and then end inside Dracula’s castle. Causality becomes knotted. We use subdued microbes to inoculate ourselves against the outbreak yet to come, like a premonition that arrives through uneasy dreams.
Biss observes that unvaccinated American children tend to be white and middle-class, while undervaccinated ones are more likely to be black, poor, and move homes frequently. Like the surveillance camera that replaces a glowering cop, biopolitical oppression discreetly aestheticizes itself: Exposing the underclass to measles is just your lifestyle choice!
Reading about the Black Death, I keep returning to its terrible swiftness—something all the more traumatic in places where the dominion of lord over peasant was claimed to be an eternal verity, though feudalism proper would receive the deepest wound. English countryside still bears a faint impression of villages abandoned to the plague. The agonized dread of the pandemic, that frenzy for a convincing explanation, echoes faintly through Biss’s work. At one point, she waits for surgery to alleviate her son’s severe allergies: “Studies had shown, [the doctor] told me, that the body language and facial expressions of anxious mothers can cause children to fear surgery and resist anesthesia … The implication that I was a hysterical woman and a threat to my child was making me so angry that it seemed possible I might actually become hysterical.” My own allergies were minor enough to avoid surgical stirrups, but I still brought an asthma inhaler to elementary school every day, in case I started breathing very hard and then not at all.
Biss repeatedly invokes the phenomenon of herd immunity, which demonstrates that vaccinating only part of a given population can stave off an epidemic completely. But cows have no workers or colonies to exploit. During America’s last nationwide smallpox outbreak in 1898, the citizens of Middlesboro, Kentucky subordinated public health to white supremacy: “Everyone in the black part of town who resisted vaccination was vaccinated at gunpoint. These campaigns did limit the spread of the disease, but all the risk of vaccination, which at that time could lead to infection with tetanus and other diseases, was absorbed by the most vulnerable groups. The poor were enlisted in the protection of the privileged.” Medieval Christians blamed the Black Death on Jews rather than mosquitoes, and felt no more conflicted about exterminating either. Biss observes that unvaccinated American children tend to be white and middle-class, while undervaccinated ones are more likely to be black, poor, and move homes frequently. Like the surveillance camera that replaces a glowering cop, biopolitical oppression discreetly aestheticizes itself: Exposing the underclass to measles is just your lifestyle choice!
She hardly strains herself dispensing with the theories of “toxic” vaccines, but Biss extends unusual compassion to the people who believe them, so often desperate to make sense of a child’s chronic malady. The major pseudoscientific explanation for autism used to be bad mothers—why wouldn’t you blame pharmaceutical companies, if the only alternative encouraged was to blame yourself? (The typical vaccine is profitable, but only at a fraction of sleeping pills or diet drugs.) Biss reserves her disdain for self-interested gurus like Robert Sears, or “Dr. Bob,” who specializes in manipulative hedging: “Vaccines don’t cause autism, except when they do,” “I’m not sure where this hard line comes from,” “I’m sure the truth of the matter is somewhere between causality and coincidence,” “If we stop using this vaccine, polio may come back.” Polio remains endemic throughout a small handful of countries, and public-health workers hope it could join smallpox in extinction. Several years ago the CIA did its best to sabotage their efforts in these mostly-Muslim nations, running a fake vaccination drive to glean intelligence on Osama bin Laden’s Pakistani compound.
“No single person … has the genetic material to respond to all diseases,” Biss writes, “but collectively humans have enough genetic diversity for humankind to survive any disease.”
Dr. Bob is generous with his expertise. Flipping through the magazines in her midwife’s office, Biss notices his “advice column” promoting a private umbilical-cord blood bank. Rather than the standard donation to a public bank, making it available to cancer patients, this company would save the material for her family’s use at a fee. “As new treatments develop,” Dr. Bob states, “having cord blood on hand may be invaluable.” Then, the legal disclaimer: “There is no guarantee that treatments being studied in the laboratory or in clinical trials will be available in the future.” The vague suggestion of apocalypse was presumably unintentional. Under capitalism, we can become investors before even leaving the womb. When Biss herself gave birth, her uterus inverted, and the physicians massaged bags of blood to replace the two litres she’d lose. “You’ve had a lot of people’s hands in you,” a nurse tells her.
The premise of this book culminates in that little blessing, unsentimental yet ecstatic. “What kind of politics could embrace partial, contradictory, permanently unclosed constructions of personal and collective selves and still be faithful, effective—and, ironically, socialist-feminist?” Donna Haraway’s manifesto inquired. One potential answer would begin here. We can quite literally bleed for the friends and strangers whose bodies cannot. “No single person … has the genetic material to respond to all diseases,” Biss writes, “but collectively humans have enough genetic diversity for humankind to survive any disease.” On Immunity rejects the metaphors of acquisition and contamination for a microcosmic communism: “We owe each other our bodies.” What else might we reinvent with that new language? When a pandemic chokes the air, private property stands exposed as the specious and cruel figment it is. “In the garden of the body, we look inward and find not self, but other … not a retreat from the world, but a place where we cultivate the world.” Solidarity between all revolutionary cells!