Biss sympathizes with parents who fear vaccines, and she understands the cultural roots of their hesitation, which include an insistence on bodily independence; an obsession with physical purity, free from chemicals; and even a kind of pre-industrial nostalgia that casts vaccines as newfangled and unnatural. She focusses on the historical antecedents to today’s shots, complicating the view that immunization is modern and therefore scary. In the eighteenth century, farmers observed that those who were exposed to cowpox tended not to develop smallpox later on. The physician Edward Jenner tested this connection by transferring fluid from a milkmaid’s pustule to the skin of a young boy, who then developed immunity to smallpox. Historical figures, including Cotton Mather, Mary Wortley Montagu, and Voltaire, championed the practice of variolation, in which individuals were infected with a mild form of smallpox to protect them from a more severe version of the disease.
If variolation had been more widely practiced in France, Voltaire wrote, “twenty thousand persons whom the smallpox swept away at Paris in 1723 would have been alive at this time.” Biss acknowledges that these practices were far less safe than the highly regulated shots administered in pediatricians’ offices today. Yet she seems to take comfort in the idea that “vaccination is a precursor to modern medicine, not the product of it.” But even if shots against some childhood diseases, like measles, mumps, rubella, and polio, have not changed substantially in recent decades, the leading edge of vaccine development—against pandemic flu, cancer, or Ebola, for instance—benefits enormously from advances in genetics and immunology.
Despite some misgivings, Schaffer sees an advantage to the book’s tone:
Biss’s gracious rhetoric and her insistence that she feels “uncomfortable with both sides” of the rancorous fight may frustrate readers looking for a pro-vaccine polemic. Yet her approach might actually be more likely to sway fearful parents, offering them an alternative set of images and associations to use in thinking about immunization.
Mark Oppenheimer has mixed feelings about the book:
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.
(Photo: A statue representing a child receiving a injection of vaccine is seen at the World Health Organization (WHO) headquarters on September 5, 2014 in Geneva. By Fabrice Coffrini/AFP/Getty Images)