Photo: Sanofi Pasteur

In light of the recent measles outbreak in California, I want to share this excerpt from an interview with Eula Biss, author of On Immunity. After the birth of her first child, Biss’s research turned to vaccination, and she ruminated on a culture in which no man, woman or child is an island. Michael Schulson interviewed Biss at Salon:

Salon: You point out that people who oppose vaccination tend to be wealthier, whiter and more educated than the population at large. Why does this kind of social (but not medical) immunity hold a particular attraction for this demographic group?

Eula Biss: I should say that there are a few different demographics that tend not to vaccinate.

I think there’s a lot going on there, actually. Maybe the largest component is the kind of thinking that attends privilege. What I mean is a pattern of thought that’s been developed over a long period of time.

One of the favorite narratives [of privilege] is that we’ve just worked harder, so we deserve more. But there’s another narrative. It has to do with vulnerability, and that’s a narrative that I first started thinking about and noticing when I was writing about race. It justifies certain ways of wielding privilege, on the argument that the person who is privileged is actually not powerful but very, very vulnerable and needing protection, and that the people who are dangerous are the people who are less privileged. There’s a story line that runs something like this: vaccination may be OK for some people, but my child is uniquely vulnerable. My child is actually too vulnerable to receive this preventative medicine, and therefore I’m going to opt out of this public health initiative to spare my child this risk.

Salon: The healthcare system is large and confusing. To what extent does anti-vaccination sentiment involve individuals trying to reckon with these enormous systems that are just so hard for us to comprehend?

Biss: I think there are many, many facets to this question, and I think that is one facet. In some cases, lack of information and lack of understanding is compounded by the fact that vaccination works quite differently from other medical interventions. Just because you understand something else, like how stitches or aspirin work, it doesn’t mean you’ll understand vaccination in great detail without having it explained to you.

One of the shortcomings of our medical system is that doctors have very little time with their patients. There isn’t really the time for a doctor to sit down and carefully explain to you how the vaccines are working, what each of the different diseases are that your child is being vaccinated against, why those diseases are of concern, who they’re of concern to, and basically the whole public health strategy or justification behind mass vaccination.

Read the interview