I finished “On Immunity” by Eula Biss on the T on Friday morning. (What better place to ponder the public good and herd immunity than on a heavily delayed subway car with a couple of hundred other miserable, sniffling commuters). Both a history and defense of vaccines, it’s a book that defies categorization: part medical journalism, part ethical tract, part meditation on paranoia, privilege, and the common good. From the first moment I picked it up I felt a sense of recognition, like, yes, this is what has been missing from this conversation, this is what we need to talk about.
Every time I’m in Copley Square I think about the inscription on the Public Library there: “Founded through the munificence and public spirit of citizens.” It’s not something you hear much about, “public spirit.” Sometimes, depending on what’s going on in the news, I read that dedication and think that we’ve abandoned the concept entirely.
These last couple of weeks have been an absolute bear for the MBTA, and while the T and city are making excuses, individuals are overwhelmingly helpful: always making room for one more person on a jam-packed train, helping an elderly woman elbow her way to the doors so she doesn’t miss her stop, hopping out at a street level stop to help a mother drag a stroller through the deep snow and onto the train. These interactions are not something any decent person needs to stop to think about: people living in a society look out for each other, especially for the most vulnerable. Public spirit is alive in Boston.
Herd immunity is about public spirit. You do not get vaccinated to protect only yourself, you get vaccinated to protect both yourself and others, especially those who are most vulnerable to disease. (People with auto-immune diseases, people too young or ill to receive a vaccine). Depending on what parts of the Internet you frequent, the vaccination conversation can be framed as hysterical mothers vs. rational doctors, or profit-hungry pharma companies vs. establishment-rattling mommy bloggers. In “On Immunity”, though, the crux of the argument is this: if you believe that it’s fine for healthy families to refuse vaccinations, you must also believe that your social privilege exempts you from any moral obligation to our fellow humans.
Rhetorically, “On Immunity” pulls off something tricky: extending empathy to a group without making excuses for their (dangerous) behavior. A mother of a young child herself, Biss can inhabit both the fear and the privilege that defines much of the anti-vax crowd. She connects anti-vaccine paranoia to a very simple fact: the scarier things get, the less trustworthy that our authority figures become, and the more control we try to exert over our health and the domestic sphere. Biss lingers here, acknowledging the fear and expressing her own original hesitance about vaccines, but then isolates the dark core of this kind of thinking: a catastrophic failure of public spirit.
This is something I think about a lot: that we’re always holding in tension our responsibility to the public good and our desire to draw inward, shrink our focus down to a pinhole of protecting ourselves and our families. And scrabbling for a little control, however illusory, is all too familiar to me. Biss recalls her sudden, mysterious fear the first time she was on a boat since the birth of her son, and then finally naming it: “Oh, I’m going to die.” I don’t have kids, but my husband had cancer at 26–a very effective crash course in “oh, I’m going to die” that I don’t recommend. I’m not a stranger to that overnight change: one day the world seems fine, the next everything feels perilous.
What I liked most about “On Immunity” is that it acknowledges this paranoia with compassion and something like respect, but then methodically shreds it to pieces using science, ethics and the long, fraught history of vaccination and public health. It arrives at a fact that’s easy to say, but not always easy to live: the public good is greater than individual fear. It is not an exaggeration to say that our survival depends on reason trumping panic–indeed, that triumph is the only thing that has ever moved society forward. I don’t know how many minds “On Immunity” will change–probably not many, unfortunately–but it’s starting the conversation in the right place.