A girl receives a typhoid inoculation in rural Texas, 1943.

A girl receives a typhoid inoculation in rural Texas, 1943. Credit: Library of Congress

ON IMMUNITY: An Inoculation, by Eula Biss. Graywolf Press, 205 pp., $24.

The gifted essayist Eula Biss is the daughter of a poet and a doctor. With her important new book, "On Immunity: An Inoculation," she illuminates fear of vaccines with a lucidity and grace that honors both her bloodlines.

Consider the cover art: a detail from Rubens' 17th-century painting "Achilles Dipped into the River Styx." It depicts a mother desperate to protect her child from an oracle's prediction he would die young. The viewer sees the intensity on Achilles' mother's face, and that vulnerable baby heel.

"My son's birth brought with it an exaggerated sense of both my own power and my powerlessness," writes Biss, a lecturer at Northwestern University. "When my son was an infant, I would hear many variations of 'All that matters is that he is safe.' I would wonder whether that was, indeed, all that mattered."

Such measured thoughtfulness characterizes Biss' foray into the dank bog of the vaccine debate. This is turf contested by everyone from Jenny McCarthy to Voltaire. Biss is a canny and steady guide, expert at plucking quotes, so we read about the "mercury, the ether, the aluminum, the antifreeze" that McCarthy believes contaminates our system of inoculation. Or we reflect on the painful suggestion from Voltaire (a smallpox survivor himself) that if the French had taken up prevention as readily as the English "twenty thousand persons whom the smallpox swept away at Paris in 1723 would have been alive at this time."

Inoculation has its roots in folk medicine; its first practitioners were European farmers. The idea, Biss writes of smallpox, "that pus from a sick cow can be scraped into a wound on a person and make that person immune to a deadly disease is almost as hard to believe now as it was in 1796."

For readers scanning the headlines and cringing at the Ebola epidemic in West Africa, "On Immunity" is a useful primer. There is, of course, no vaccine for Ebola (though one is being studied), and not much profit expected for any pharmaceutical company that develops one. But the mosquito has killed more people than any pest in history, and failure to find a vaccine against malaria has meant carnage that dwarfs Ebola. Biss considers the case of Rachel Carson's seminal 1962 "Silent Spring," which squelched the manufacture of American DDT that still saves some lives outside the United States. Carson's hypothesis that DDT "was a widespread cause of cancer ... was not supported by the decades of research on DDT that followed the publication," Biss notes, but Carson was right in seeing health as porous -- the exact point of vaccination.

Biss, 37, won a National Book Critics Circle Award in 2010 for her quietly groundbreaking essay collection, "Notes from No Man's Land." With "On Immunity," she strengthens her brand. As readers of "Notes" would expect, she stays attuned to the class and race questions laced through her topic. "The working-class people who resisted Britain's 1853 provision for free, mandatory vaccination were concerned, in part, with their own freedom," she writes. " sometimes compared their predicament to slavery." Mandatory vaccination, Biss notes, "like slavery, raises some pressing questions about one's right to one's own body." Historically and in some developing nations, those questions have been answered with resistance, riots, violence: "Nine polio vaccinators were shot in Nigeria in 2013 and, as of this writing, twenty-two health care workers have been killed in Pakistan."

In this country, a 2004 Centers for Disease Control study shows that an unvaccinated child is more likely to have an older, college-educated mother, be white and living in a household with an income of $75,000 or more. Why?

"My father was vaccinated against five diseases as a child," Biss writes. "I was vaccinated against seven, and my son has been vaccinated against 14. This proliferation of childhood vaccines has become, for some of us, a kind of metaphor for American excess."

But "Illness as Metaphor" is dangerous terrain, as Susan Sontag demonstrated in her landmark 1978 book of that title. Sontag serves as muse to "On Immunity," whereas Dr. "Bob" Sears of "The Vaccine Book" is succinctly spanked for advising readers to game the system by partial participation in inoculation. All the while, Biss' erudition makes the book a pleasure, even as it renders her argument for vaccination profound.

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