Eula Biss’s inoculation against misinformation about vaccines

Vaccination has never been legally mandated in the U.S., though during the early 20th century, one-third of the states had compulsory laws. In her research, Biss learned how in 1898, during the last national smallpox outbreak, the black residents of Middlesboro, Kentucky, had been vaccinated at gunpoint. In 1853, Britain made a provision for free, mandatory vaccinations. Some working-class people resisted; they said it limited their personal liberty and compared it to slavery.

Vaccination works because of a concept called herd immunity: as long as a certain percentage of the population is inoculated against a disease, the other, unvaccinated, part will be protected, too. This fascinated Biss. (It was also one of the hardest sections of the book for her to write; an earlier draft, she says, was highly technical and almost entirely mathematical formulas.) Americans usually don’t like being part of a herd: “The herd, we assume, is foolish,” she writes. Perhaps a better metaphor, she suggests, is a beehive, where the health of each individual bee depends on the health of the hive as a whole.

Inoculation against disease by variolation, the process of deliberately exposing a noninfected person to smallpox, existed for centuries before vaccination—specifically, inoculation by injection of the cowpox virus (which is similar to smallpox, except it doesn’t cause disease in humans)—was discovered in the late 18th century. And, Biss discovered, “anti-vaxxers” have been around nearly as long. She found a handbill called The Vaccination Vampire from 1881 that reads like it was written by the spiritual ancestor of Jenny McCarthy, the former Playboy playmate and View host who has stridently—and, it turns out, inaccurately­­—blamed vaccines for her son’s autism. It calls vaccinations the “universal pollution,” sexual and economic corruption, delivered to “poor babes.” (One of the luxuries of living in the 21st century, Biss observes, is that children are practically guaranteed to live into adulthood. In 1900, one in ten wouldn’t live past its first birthday.)

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