On Immunity

Starred review from July 7, 2014
Biss (Notes from No Man’s Land) advocates eloquently for childhood immunization, making her case as an anxious new mother intent on protecting her son—and understanding the consequences. Her exploration is both historical and emotional, and she receives some metaphorical guidance from Bram Stoker’s Dracula, a story that to Biss invites an “enduring question—do we believe vaccination to be more monstrous than disease?” Her son’s birth coincided with an outbreak of the H1N1 flu (popularly known as “swine flu”), triggering an inquiry that involved her doctor father, other mothers, researchers, and her own copious research. Biss’s study ranges from the beginnings of vaccination—a “precursor to modern medicine”—in the 1700s, through Andrew Wakefield’s disastrous, and later retracted, 1998 study that proposed the MMR vaccine might be linked to autism. Protecting her baby set off an “intuitive toxicology,” Biss writes, but grew to understand that we harbor “more microorganisms in our guts than we have cells in our bodies.” She comes down hard on Robert Sears, author of The Vaccine Book, which suggests an alternate shots schedule, for his “equivocal” conclusions, and defends oft-criticized pediatrician Paul Offit for his research and integrity. Biss frankly and optimistically looks at our “unkempt” world and our shared mission to protect one another. Agent: Matt McGowan, Frances Goldin Literary Agency.

Starred review from July 15, 2014
National Book Critics Circle Award winner Biss (Notes from No Man's Land, 2009) investigates the nature of vaccinations, from immunity as myth to the intricate web of the immune system.The fears surrounding vaccines are not late-breaking news, as the author notes in this literate, rangy foray into the history and consequences of vaccination. In the 18th century-and frankly, little less today-it was understandable to associate vaccination with the work of witches: "The idea...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." Indeed, the idea of poking yourself with a dose of virulent organisms to save yourself from them is not an intuitive leap. Biss ably tracks the progress of immunization: as metaphor-the protective impulse to make our children invulnerable (Achilles, Oedipus); as theory and science (the author provides a superb explanation of herd immunity: "when enough people are vaccinated with even a relatively ineffective vaccine, viruses have trouble moving from host to host and cease to spread"); as a cash cow for big pharma; and as a class issue-the notion of the innocent and the pure being violated by vaccinations, that "people without good living standards need vaccines, whereas vaccines would only clog up the more refined systems of middle-class and upper-class people." Biss also administers a thoughtful, withering critique to more recent fears of vaccines-the toxins they carry, from mercury to formaldehyde, and accusations of their role in causing autism. The author keeps the debate lively and surprising, touching on Rachel Carson here and "Dr. Bob" there. She also includes her father's wise counsel, which accommodates the many sides of the topic but arrives at a clear point of view: Vaccinate.Brightly informative, giving readers a sturdy platform from which to conduct their own research and take personal responsibility.

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Starred review from September 1, 2014
In her elegant, book-length essay, Biss (Notes from No Man's Land, 2009) inoculates readers against the misinformation and paranoia surrounding vaccinations. The daughter of a doctor and the mother of a young son who is fully vaccinated, Biss carefully measures current knowledge of disease along with what remains unknown about immunization. She concludes that the benefit of vaccination to individuals and communities is much greater than any harm. Yet some people view immunization as a violent act, an attack on bodily purity. Biss writes, 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. Indeed, vaccinations are dubbed shots. Her far-reaching and unusual investigation into immunity includes a discussion of the chemicals thimerosal and triclosan, Dracula, measles and smallpox, the hygiene hypothesis, herd immunity, Achilles and Voltaire, altruism, and the appeal of alternative medicine. Artfully mixing motherhood, myth, maladies, and metaphors into her presentation, Biss transcends medical science and trepidation.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)