On Immunity : An Inoculation (9781555973278) (2 page)

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?

The mothers I knew began debating whether or not to vaccinate our children against the novel influenza virus long before any vaccine became available to us. We were hearing that what made this particular strain of flu dangerous was that it was new to humans, like the virus that caused the Spanish-flu epidemic of 1918 in which more than 50 million people died. But then we were also hearing that the vaccine had been produced hurriedly and that it might not have been fully tested.

One mother told us that she had miscarried while she was sick with the seasonal flu and, being wary of any flu now, she planned to vaccinate. 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.

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. My baby was just over six months old and I had just returned to work at a large university where the majority of my students would be coughing by the last week of classes.

That fall, the
New Yorker
ran an article in which Michael Specter noted that influenza is regularly among the top ten causes of death in this country and that even relatively mild pandemics of influenza have killed in the millions. “And, though this H1N1 virus is novel,” he wrote, “the vaccine is not. It was made and tested in exactly the same way that flu vaccines are always made and tested.” Some of the mothers I knew did not like the tone of this article. They found it insulting for the same reason I found it reassuring—it did not acknowledge any good reason for doubt.

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.

It was not a good season for trust. The United States was engaged in two ongoing wars that seemed to be benefiting no one other than military contractors. People were losing their houses and their jobs while the government was bailing out the financial institutions it deemed too big to fail and using taxpayer money to shore up the banks. It did not seem unlikely that our government favored the interests of corporations over the well-being of its citizens.

During the initial aftershocks of the economic crash there was talk of “restoring the public’s trust,” though even then the emphasis fell more often than not on consumer confidence. I disliked the term
consumer confidence
, and I bristled every time I was encouraged to trust myself as a mother. I had little confidence, consumer or otherwise, but I tended to believe that confidence was less important than the kind of trust that transcends the self. Even now, years after my son’s birth, I remain interested in the precise meaning of
trust
, particularly in legal and financial terms. A trust—in the sense of a valuable asset placed in the care of someone to whom it does not ultimately belong—captures, more or less, my understanding of what it is to have a child.

By late October, the mothers who were still talking about the flu vaccine were mainly talking about how hard it was to get a child vaccinated. My son had been on a waiting list at his pediatrician’s office for over a month. Other mothers were waiting in long lines outside community colleges and public high schools. While we waited, a mother who did not vaccinate her children mentioned that she had heard there was an additive called squalene in the H1N1 vaccine. No, another mother countered, squalene was used in flu vaccines in Europe, but it was not used here. The mother who had originally mentioned squalene was not so sure—the fact that US vaccines did not contain squalene, she said, had been disputed elsewhere. “Where exactly is elsewhere?” one of my friends wondered.
What
, I wondered,
is squalene?

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.

Squalene is found in a great many living things including the human body, where it is manufactured in the liver. It circulates in our blood and is left behind in our fingerprints. Some European flu vaccines do indeed contain squalene from shark liver oil, but squalene has never been added to US-licensed vaccines. Squalene’s presence in absence is something like the curious properties of thimerosal, the mercury-based preservative that was removed from every childhood vaccine except multidose flu vaccines by 2002. Well over a decade later, fear of mercury in vaccines persists.

My son finally got his flu vaccination in late November. We didn’t know it yet, but the worst of the pandemic was already over—cases of H1N1 influenza had peaked in October. I remember asking the nurse if the vaccine my son was receiving contained thimerosal, but I was asking more out of due diligence than true concern. I already suspected that if there was a problem with vaccines it was not thimerosal, and it was not squalene.

W
HAT’S THAT?” WAS MY SON’S FIRST PHRASE, and for a long time it was all he could say. As he learned to talk, I learned, in naming the parts of things for him, how often our language reflects our bodies. “We give a chair arms, legs, a seat and a back,” writes the poet Marvin Bell, “a cup has its lip / and a bottle its neck.” The ability to make and understand basic metaphors of this kind arrives with language, which is itself made of metaphor. Plumbing most any word will reveal what Emerson called “fossil poetry,” metaphors submerged below the surface of our current usage.
Fathom
, a means of measuring the depth of the ocean, now means
understand
because its literal origin, using outstretched arms to measure cloth from fingertip to fingertip, was once used as a metaphor for grasping an idea.

“Our bodies prime our metaphors,” writes James Geary in
I Is an Other
, his treatise on metaphor, “and our metaphors prime how we think and act.” If we source our understanding of the world from our own bodies, it seems inevitable that vaccination would become emblematic: a needle breaks the skin, a sight so profound that it causes some people to faint, and a foreign substance is injected directly into the flesh. 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. And when vaccination is intended to prevent a sexually transmitted disease, it seems to become a sexual violence. In 2011, Republican presidential candidate Michele Bachmann warned of the “ravages” of the vaccine against human papillomavirus and argued that is was wrong “to have innocent little twelve-year-old girls be forced to have a government injection.” Her opponent Rick Santorum agreed, adding that no purpose was served by “having little girls innoculated at the force and compulsion of the government.” The vaccine, some parents had already complained, was “inappropriate for girls of such a young age,” and other parents feared it would encourage promiscuity.

Throughout the nineteenth century, vaccination left a wound that would scar. “The mark of the beast,” some feared. In an Anglican archbishop’s 1882 sermon, vaccination was akin to an injection of sin, an “abominable mixture of corruption, the lees of human vice, and dregs of venial appetites, that in after life may foam upon the spirit, and develop hell within, and overwhelm the soul.”

While vaccination no longer leaves a mark in most cases, our fears that we will be permanently marked have remained. We fear that vaccination will invite autism or any one of the diseases of immune dysfunction that now plague industrialized countries—diabetes, asthma, and allergies. We fear that the hepatitis B vaccine will cause multiple sclerosis, or that the diphtheria-tetanus-pertussis vaccine will cause sudden infant death. We fear that the combination of several vaccines at once will tax the immune system, and that the total number of vaccines will overwhelm it. We fear that the formaldehyde in some vaccines will cause cancer, or that the aluminum in others will poison our brains.

It was “the poison of adders, the blood, entrails and excretions of rats, bats, toads and sucking whelps” that was imagined into vaccines of the nineteenth century. This was the kind of organic matter, the filth, believed responsible for most disease at that time. It was also a plausible recipe for a witches’ brew. Vaccination was fairly dangerous then. Not because it would cause a child to grow the horns of a cow, as some people feared, but because arm-to-arm vaccination could communicate diseases like syphilis, as some people suspected. In arm-to-arm vaccination, the pus from the blister that developed on a recently vaccinated person’s arm was used to vaccinate another person. Even after vaccination no longer involved an exchange of bodily fluids, bacterial contamination remained a problem. In 1901, a vaccine contaminated with tetanus bacteria killed nine children in Camden, New Jersey.

Now our vaccines are, if all is well, sterile. Some contain preservatives to prevent the growth of bacteria. So now it is, in the activist Jenny McCarthy’s words, “the frickin’ mercury, the ether, the aluminum, the antifreeze” that we fear in our vaccines. Our witches’ brew is chemical. There is not actually any ether or antifreeze in vaccines, but these substances speak to anxieties about our industrial world. They evoke the chemicals on which we now blame our bad health, and the pollutants that now threaten our environment.

An 1881 handbill titled
The Vaccination Vampire
warns of the “universal pollution” delivered by the vaccinator to the “pure babe.” Known to feed on the blood of babies, the vampires of that time became a ready metaphor for the vaccinators who inflicted wounds on infants. Blood-sucking monsters of ancient folklore were hideous, but Victorian vampires could be seductive. The macabre sexuality of the vampire dramatized the fear that there was something sexual in the act of vaccination, an anxiety that was only reinforced when sexually transmitted diseases were spread through arm-to-arm vaccination. Victorian vampires, like Victorian doctors, were associated not just with corruption of the blood, but also with economic corruption. Having virtually invented a paid profession and being almost exclusively available to the rich, doctors were suspect to the working class.

Bram Stoker’s Count Dracula is of the bloodthirsty bourgeois—he keeps dusty piles of gold coins in his castle, and gold coins pour from his cloak when he is stabbed. But it is difficult to read him as a vaccinator. Of all the metaphors suggested within the plentiful pages of
Dracula
, disease is one of the most obvious. Dracula arrives in England just as a new disease might arrive, on a boat. He summons hoards of rats, and his infective evil spreads from the first woman he bites to the children she feeds on, unwittingly, at night. What makes Dracula particularly terrifying, and what takes the plot of the story so long to resolve, is that he is a monster whose monstrosity is contagious.

Germ theory was widely accepted by 1897, when
Dracula
was published, but only after having been ridiculed earlier in the century. The suspicion that microorganisms of some sort caused disease had been around for so long that the theory was already considered outdated by the time Louis Pasteur demonstrated the presence of germs in the air with his corked and uncorked flasks of sterile broth. Among the vampire hunters who pursue Dracula, “sterilizing” his coffins so that he cannot take refuge in them, are two doctors, who initially disagree on their diagnosis. The younger doctor cannot bring himself to believe in vampires, despite the evidence, so the older doctor delivers an impassioned speech on the intersection of science and faith.

“Let me tell you, my friend,” he says, “that there are things done today in electrical science which would have been deemed unholy by the very men who discovered electricity—who would themselves not so long before have been burned as wizards.” He then goes on to evoke Mark Twain: “I heard once of an American who so defined faith: ‘that which enables us to believe things which we know to be untrue,’” saying, “He meant that we shall have an open mind, and not let a little bit of truth check the rush of a big truth, like a small rock does a railway truck.”

Dracula
is as much about this problem, the problem of evidence and truth, as it is about vampires. In proposing that one truth may derail another, it invites an enduring question—do we believe vaccination to be more monstrous than disease?