Immunity, vaccination and the common good: a prescient book is helping people make sense of the pandemic

** This story was originally published on September 13, 2020

Author Eula Biss has thought deeply about why some people vaccinate and others do not.

As pharmaceutical companies work to develop a COVID-19 vaccine, a resurgence in the anti-vaccination movement is mobilizing against it. Biss's 2014 book On Immunity: An Inoculation explores that apprehension, and many are turning to it to understand the anxieties around vaccination today.

Writing the book wasn't what prompted Biss to begin her research — it was the birth of her son right before the 2009 H1N1 pandemic.

Fully vaccinated herself, she became curious about people's vaccination concerns.

"I had already begun researching vaccination in earnest when the first flags went up around H1N1," Biss told The Sunday Magazine's Piya Chattopadhyay.

"Learning that there was also a brand-new virus circulating that could possibly become a deadly pandemic felt like just one more new terrifying aspect of the experience of new motherhood."

That fear further motivated her research and she began talking to other people, primarily mothers, about vaccination.

Just because a fear is legitimate or well-earned doesn't mean that it's accurate.- Eula Biss

A 'faceted' debate

As she continued researching H1N1, Biss was struck by how many different reasons other parents had for being concerned about vaccines.

"This is one of the things that sometimes gets lost when we think about the debate over vaccination, as a pro-con debate or a pro-vaccine, anti-vaccine debate," she said. "It's actually a very faceted debate. And when people are vaccine-hesitant or opposed to vaccination, they have lots of different reasons for that stance."

She discovered that many women were resistant to vaccination on feminist grounds, because of the history of how women's bodies and their concerns had been treated by the medical establishment.

Others had environmental concerns, fearing that the same government that wasn't regulating the release of pollutants into the environment would also fail to regulate what went into people's bodies, Biss said. In some cases, political and racial concerns made people resistant.

"A friend of mine, who is a child of refugees, was reluctant around vaccination, in part because she had been exposed to Agent Orange as a child," Biss explained. "She did not trust a government that had already put her own infant life in jeopardy … to safeguard her children's lives."

In the process of writing the book, Biss said she had to separate the fears from the realities around vaccination.

"Just because a fear is legitimate or well-earned doesn't mean that it's accurate," she told Chattopadhyay.

In her research, Biss found that some people who oppose vaccination draw a parallel between poorly-regulated consumer products and vaccines. Similarly, they don't trust the government to properly regulate vaccination.

"In [the US] … every single stage of the process of producing and administering a vaccine is better regulated than anything else," she said. "We would live in a better world if every product was regulated the way vaccines are regulated in this country."

However, Biss noted U.S. President Donald Trump's efforts to fast track the approval of a vaccine may lead to further hesitancy and opposition.

Even the name — Operation Warp Speed — is damaging, she said.

"We know it needs to happen speedily, but if anyone gets the sense that it's being rushed and that the regulations that are put in place to protect people are not being held up, that will damage people's trust in the process and make it harder to convince people to accept a vaccine," Biss said.

Interdependence, choice and responsibility

While COVID-19 has prompted a resurgence in the anti-vaccination movement, it has also revealed society's interdependence and underscored the importance of vaccines, Biss said.

It's important for parents concerned about vaccination to realize that if their children get sick, they could pass a disease on to an immuno-compromised child, whose life could be at risk, she said.

"Many people don't want to be told what to do with their child's health. But most people also do not want to be the person who costs the life of another person," she said. "To make the decision not to be that person, you have to understand what the stakes really are."

Those stakes are what convinced Biss to ultimately change her mind about vaccines, after declining the first round for her son.

"My research on vaccination led me to the conclusion that it was my social and moral responsibility to vaccinate my child," she said. "It was in the best interest not only of his health, but the health of everyone who was going to come into contact with him."

Racial reckoning amidst pandemic

Biss said the pandemic is showing us "that every time we make a personal choice, we're also making a choice for other people." It's also revealing our capacity to harm others.

"We're being forced to reckon with the fact that we are all both vulnerable and dangerous," she said.   

Biss also pointed to a parallel reckoning taking place in the U.S. against police violence and racism.

"This movement is demanding and asking that white people understand the ways in which we are dangerous to other people around us," she explained. "That's incredibly difficult and challenging for many white people. But we're also being primed for that thinking by the pandemic."

In fact, the author's earlier works focused on whiteness and how white people tend to imagine themselves.

"Innocent, blameless and utterly vulnerable is how many white people imagine themselves. And when you look at the realities of life in this country, none of that is true," Biss said. "In fact, white people are very, very dangerous to people of colour in ways that have bearings on their physical well-being … but also dangerous in social and emotional terms."

"For many people, it's very difficult to conceive of themselves as potentially dangerous to other people," Biss said. "But that's something that, again, is being underscored by the pandemic."

Interview produced by Pauline Holdsworth.