On Immunity: An Inoculation

by Eula Biss

It was the myth of Achilles, whose mother tried to make him immortal. She burned away his mortality with fire, in one telling of the story, and Achilles was left impervious to injury everywhere except his heel, where a poisoned arrow would eventually wound and kill him. In another telling, the infant Achilles was immersed in the River Styx, the river that divides the world from the underworld. His mother held her baby by his heel to dip him in the water, leaving, again, one fatal vulnerability.

May have to follow this book up with “song of Achilless”

A king who had heard an ominous prophecy could not keep his daughter childless by locking her in a tower.

As my father relates the plot, I understand why I confused the two. The hero of this story is made immune to injury by bathing in the blood of a dragon. But a leaf clings to his body while he bathes, leaving a small spot on his back where he is unprotected.

My son’s birth brought with it an exaggerated sense of both my own power and my own powerlessness. I found myself bargaining with fate so frequently that my husband and I made a game of it, asking each other what disease we would give our child for prevention against another—a parody of the impossible decisions of parenthood.

cupidity.

By the time my son was born late the next day a cold rain was falling and I had crossed over into a new realm in which I was no longer fearless.

That spring, a novel strain of influenza would begin spreading from Mexico to the United States to the rest of the world. I did not register those early reports,

I did not register those early reports, as I was too busy listening to my son breathe at night. During the day, I was entirely preoccupied by how much he did or did no...

Like many other mothers, I had been informed of a syndrome affecting infants that had no warning signs and no symptoms other than sudden death. Perhaps this is why, despite everything, I do not remember feeling particularly scared of the flu—it was just one concern of many.

When I search now for a synonym for protect, my thesaurus suggests, after shield and shelter and secure, one final option: inoculate. This was the question, when my son was born—would I inoculate him? As I understood it then, this was not a question of whether I would protect him so much as it was a question of whether inoculation was a risk worth taking. Would I enter into a gamble, like Thetis dipping the infant Achilles into the River Styx?

Excited to read this book and here this woman’s story. Professor recommended on how to talk to community

Another mother said that her child had screamed frighteningly all night following her first vaccination and she would not risk another vaccination of any kind. Every exchange about the new flu vaccine was an extension of the already existing discussion about immunization, in which all that is known of disease is weighed against all that is unknown about vaccines.

How to address concerns and educate the public

As the virus spread, a mother I knew in Florida reported that her entire family had just had the H1N1 flu and it was not any worse than a bad cold. Another mother in Chicago told me that her friend’s healthy nineteen-year-old son had suffered a stroke after being hospitalized with the flu. I believed both of these stories, but they told me nothing more than what the Centers for Disease Control and Prevention already seemed to be trying to tell me—the flu could be harmless in some cases and serious in others. Under the circumstances, vaccination began to seem prudent.

The fact that the press is an unreliable source of information was one of the refrains of my conversations with other mothers, along with the fact that the government is inept, and that big pharmaceutical companies are corrupting medicine. I agreed with all these concerns, but I was disturbed by the worldview they suggested: nobody can be trusted.

Inflammatory and misleading sometimes yes. But I kinda disagree overall. However curious where this book will go and if her view changes.

The women with whom I debated the merits of the flu vaccine possessed a technical vocabulary that was entirely unfamiliar to me at the time. They used words like adjuvant and conjugate, and they knew which vaccines were live virus vaccines and which were acellular. They were familiar with the intricacies of the vaccine schedules of other countries, and literate in an array of vaccine additives. Many of them were, like me, writers. And so it is not surprising that I began to hear metaphors behind the technical language and information we traded.

“Data wins debates, but empathy wins trust; metaphors speak” — Professor X

The metaphors we find in this gesture are overwhelmingly fearful, and almost always suggest violation, corruption, and pollution.

The British call it a “jab,” and Americans, favoring guns, call it a “shot.” Either way, vaccination is a violence.

another mother told me that she did not believe in herd immunity. It was only a theory, she said, and one that applied mainly to cows. That herd immunity was subject to belief had not yet occurred to me, though there is clearly something of the occult in the idea of an invisible cloak of protection cast over the entire population.

to imagine as absolutely vulnerable, are dangerous in their ability to spread disease. Think of the unvaccinated boy in San Diego, for instance, who returned from a trip to Switzerland in 2008 with a case of measles that infected his two siblings, five schoolmates, and four children in his doctor’s waiting room.

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.

Undervaccinated children, meaning children who have received some but not all of their recommended immunizations, are more likely to be black, to have a younger unmarried mother, to have moved across state lines, and to live in poverty.

As the hygiene hypothesis took hold, scientists searched for one particular childhood disease that might prevent allergies, but this thinking gave way to the understanding that the overall diversity of germs in our environment is probably more important.

Fears of vaccines do not seem easily quieted by an abundance of expert risk-benefit analyses assuring us that the good they do is far greater than the harm. Serious side effects from vaccination are rare. But it is difficult to quantify exactly how rare,

But we do know that 1 in about every 1,000 cases of measles leads to encephalitis, and that encephalitis has been reported after vaccination in about 1 out of every 3 million doses of the MMR (measles-mumps-rubella) vaccine.

I’m not a parent but I’m wrestling with the idea of how protective a parent is of their child. It’s difficult to understand their fear, especially in light of the dangerous rhetoric today. I think dangerous is an understatement of how awful the situation is. When I ask others what they think the R0 of covid was they usually guess a 9 or 15. The shock and perspective falling into place when I tell them at the height of the pandemic, covid only had an R0 of 2-3. Measles has an R0 of ~ 12-18. It’s steadily increased with new variants, fueled by mutations and further exacerbated by the antivax movement. Sure Covid had a higher mortality rate that the measles , roughly 20-30:1000 people vs. the measles mortality of 1:1000. But these are our kids… To say RFK and the heritage foundations agenda is precarious is an understatement. It’s recklessly inept and will have potentially calamitous consequences. The erasure of facts or data from government sites like the CDC makes it difficult to trust. Our professors tell us record everything. Log everything. Copy everything from your eText or scan pages from the schools copy in the library; keep it safe, for it may vanish a few years from now.

“Perceptions of risk—the intuitive judgments that people make about the hazards of their world,” the historian Michael Willrich observes, “can be stubbornly resistant to the evidence of experts.” We do not tend to be afraid of the things that are most likely to harm us.

“Do people know which risks lead to many deaths and which risks lead to few?” the legal scholar Cass Sunstein asks. “They do not. In fact, they make huge blunders.” Sunstein draws this observation from the work of Paul Slovic, author of The Perception of Risk.

When we encounter information that contradicts our beliefs, as Slovic found in one of his studies, we tend to doubt the information, not ourselves.

“Perhaps what matters,” Sunstein muses, “is not whether people are right on the facts, but whether they are frightened.” And people do seem to be frightened.

Freaking out never helped anyone. It won’t help parents trying to protect their kids. I hope the author gives us tools to speak to antivax parents so we can acknowledge their fear and put it to rest. How do we engage emotions and validate them, rather than default to facts and “cold” logic?

“Paranoia,” Sedgwick writes, “knows some things well and others poorly.”

We seem to believe, against all evidence, that nature is entirely benevolent.

ONE OF THE APPEALS OF ALTERNATIVE MEDICINE is that it offers not just an alternative philosophy or an alternative treatment but also an alternative language. If we feel polluted, we are offered a “cleanse.” If we feel inadequate, lacking, we are offered a “supplement.” If we fear toxins, we are offered “detoxification.” If we fear that we are rusting with age, physically oxidizing, we are reassured with “antioxidants.” These are metaphors that address our base anxieties. And what the language of alternative medicine understands is that when we feel bad we want something unambiguously good.

True as it may be, the idea that our medicine is as flawed as we are is not comforting. And when comfort is what we want, one of the most powerful tonics alternative medicine offers is the word natural. This word implies a medicine untroubled by human limitations, contrived wholly by nature or God or perhaps intelligent design. What natural has come to mean to us in the context of medicine is pure and safe and benign. But the use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world.

“Obviously,” the naturalist Wendell Berry writes, “the more artificial a human environment becomes, the more the word ‘natural’ becomes a term of value.”

Allowing children to develop immunity to contagious diseases “naturally,” without vaccination, is appealing to some of us. Much of that appeal depends on the belief that vaccines are inherently unnatural.

The publication of Silent Spring in 1962 led to the creation of the Environmental Protection Agency and a ban on the production of DDT in this country. The book popularized the idea that human health depends on the health of the ecosystem as a whole, but Carson did not use the word ecosystem. She preferred the metaphor of an “intricate web of life,” in which a disturbance anywhere on the web sends tremors across the entire web. “Silent Spring,”

I can’t help but be reminded of this TedTalk (https://youtu.be/V8APZmk82xc?si=0S8zfdqK1TK5cqY5) by an epidemiologist on the pandemic. She calls for reform, and tells us there is no going back. She emphasizes it’s possible that we have done it before (firefighting and fire safety).

All of us who have been vaccinated are cyborgs, the cyborg scholar Chris Hables Gray suggests. Our bodies have been programmed to respond to disease, and modified by technologically altered viruses.

This is a stretch….wow.

Purity, especially bodily purity, is the seemingly innocent concept behind a number of the most sinister social actions of the past century.

The Lady Health Workers of Pakistan, a team of over 110,000 women trained to deliver health care door-to-door, had already endured years of brutal intimidation by the Taliban and hardly needed association with the CIA. Not long after the Taliban banned immunization, nine polio vaccinators, five of them women, were murdered in a coordinated series of attacks.

We discussed this last semester and partially this semester, logistics, cost, and intimidation are big barriers.

If vaccination can be conscripted into acts of war, it can still be instrumental in works of love.

This is such an odd reasoning.

Some countries rely on multidose vaccines, not just because they are more cost effective and produce less waste than single-dose vaccines, but also because they do not require refrigeration. There are places, mostly in poorer countries, where a ban on thimerosal would effectively be a ban on vaccination against diphtheria, pertussis, hep B, and tetanus.

Wealthier countries have the luxury of entertaining fears the rest of the world cannot afford.

But refusing immunity as a form of civil disobedience bears an unsettling resemblance to the very structure the Occupy movement seeks to disrupt—a privileged 1 percent are sheltered from risk while they draw resources from the other 99 percent.

That so many of us find it entirely plausible that a vast network of researchers and health officials and doctors worldwide would willfully harm children for money is evidence of what capitalism is really taking from us. Capitalism has already impoverished the working people who generate wealth for others. And capitalism has already impoverished us culturally, robbing unmarketable art of its value. But when we begin to see the pressures of capitalism as innate laws of human motivation, when we begin to believe that everyone is owned, then we are truly impoverished.

Autonomy is usually imagined as the alternative to paternalism. But in what is sometimes called the “restaurant model” of medicine, the paternalism of doctors has been replaced by the consumerism of patients. We

Doctors may be tempted to give patients what we want, even when it is not good for us.

Wendy about the Hippocratic oath?

If fathering still reminds us of oppressive control, mothering might help us imagine relationships based not just on power, but also care.

I get the terms paternalism and materialism but these are kinda outdated constructs that I dis agree with. There are plenty of good men, husbands, and fathers and vice versa for women. I’d caution against this binary / rigid thinking in medicine. Medicine is dominated by women, at l ast in nursing. Sure they were barred from becoming doctors for awhile but I think the sheer lopsided metrics in this industry kinda dismantle this person argument early on . My relationship with my parents was the opposite father extremely caring and mother extremely controlling. It’s a bias I really dislike with other so called feminists. Maybe I need to reread after my exam with a fresh pov.

This was, at the time, a standard preventive measure against rheumatic fever, which ceased after research revealed that the dangers of the surgery outweighed its benefits.

Isn’t this only off there are frequent infections? Tonsils are meant to help catch pathogens before the respiratory tract and rarely do people have them removed now.

The allergist recommended that I keep our floors clean, a Sisyphean task, considering that microscopic allergens were constantly circulating through the air and settling on the floors. But I mopped the invisible dirt and I changed my son’s sheets and pillowcases daily. Despite his protests, I flushed his sinuses with salt water every evening. I gave him a prescription nasal spray. I fed him raw honey and nettle tea. Then his breathing, already loud, became irregular at night. I crouched next to his bed, holding my own breath during the pauses in his breathing to gauge how long he was going without air.

Germ exposure can be good, we build up immunity. This seems like overkill but idk maybe justified. I’d think it’d be a risk to exacerbate them or like a catch 22.

and while he came back to consciousness. The doctor stiffened at this suggestion. Studies had shown, he told me, that the body language and facial expressions of anxious mothers can cause children to fear surgery and resist anesthesia.

Idk if this was a common practice but it’s similar to when i I was hospitalized at 4 or 5 with a severe unknown infection. My lymph nodes swelled to the size of a small golf ball. I had to get injections under my knee caps and they held me down. I recall crying for my mom, and saw her distraught through the small porthole window; the shot looked huge ( like as big as my forearm back then). Probably some strong antibiotic (NOT penicillin 🚩🚩🚩) injection. The doctor told me if I quieted down they’d let her in. I did, putting on a brave face with a few tears still running down my cheeks. They let my mom in to hold my hand. Strangely shots don’t phase me anymore. I was there for two weeks. Given what I’ve been learning in pre nursing, it was likely something like a staph infection / lymphadenitis and the shot was likely clindamycin which would explain the pain and burning post injection.