A health worker administers the polio vaccine to children in Yemen. Photo: Reuters
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How immunity became a political issue: Eula Bliss’s timely study of disease and vaccination

With "anti-vaxxers" dominating the headlines, Biss's new book is a thoughtful examination of how people feel about vaccines.

On Immunity: an Inoculation
Eula Biss
Fitzcarraldo Editions, 216pp, £12.99

In recent news, no one is immune from: making mistakes, random acts of violence, heartbreak, or our intention to thwart attacks against us. The metaphorical use of the word “immunity” (originally a legal, then a medical term) is, it seems, a temptation to which few writers are immune. At the same time, biological immunity (or the lack of it) is on our minds as carriers of the latest potential pandemic virus hop around international airports, or ebola vaccination trials begin in Africa. And for the worried rich who believe the misinfor­mation put about by “anti-vaxxers”, immunity from disease is to be weighed against the supposed risk of worse disease from the act of vaccination. Fear of the MMR vaccine, for example, is being blamed for the current outbreaks of measles in the US and Germany.

The word “vaccination” comes from “vacca”, the Latin for cow. (It was the country doctor Edward Jenner who successfully used cowpox to inoculate patients against smallpox in the late 18th century.) Notional cows crop up, too, in the widely used phrase “herd immunity”, one of those buried metaphors that Eula Biss regularly stops to unearth throughout this beautifully written essay. “The very expression herd immunity suggests that we are cattle, waiting, perhaps, to be sent to slaughter,” she writes. “If we were to exchange the metaphor of the herd for a hive, perhaps the concept of shared immunity might be more appealing.” And as bees and human beings signal to one another, so immunologists speak of immune cells within us communicating, interpreting and remembering. Biss even writes at one point of “cells that swallow pathogens and then display pieces of them for other cells to see”, as though our cells have tiny eyes.

This book is partly a fruitful archaeology of ideas about immunity – which sometimes seem to be metaphor all the way down – and partly a memoir: the subject took on visceral importance for the author once she gave birth to a son who turned out to have severe allergies. She was also surprised to find that many of her fellow intelligent, middle-class mothers believed all kinds of nonsense about vaccination. It’s true that vaccination can in rare cases, Biss points out, lead to complications such as fever (in people with weakened immune systems) or allergic reaction (in those with severe allergies). But the question of whether, say, MMR causes autism, as Andrew Wakefield suggested in 1998, is “not . . . the subject of any ongoing scientific debate”.

Herd or hive immunity, Biss insists, is a political issue, and riven with problems of class and power. Because herd immunity needs only the majority of a population to be inoculated to thwart the spread of disease, the unvaccinated children of the superstitious rich get a free ride from the vaccinated many. There is even a North American phenomenon of “chicken pox parties”, in which parents actively try to get their children to catch a disease that can later lead to the agonising nerve pain of shingles.

This long after Wakefield, it is still a surprisingly popular paranoid belief that vaccination is a harmful scam. Biss concludes, more in sorrow than in anger: “That so many of us find it entirely plausible that a vast network of researchers and health officials and doctors worldwide would wilfully harm children for money is evidence of what capitalism is really taking from us . . . When we begin to see the pressures of capitalism as innate laws of human motivation, when we begin to believe that everyone is owned, then we are truly impoverished.”

Another aspect of the paranoid mindset is the frequent dismissal of public-health responses to potential new pandemics as “fear-mongering”. The H1N1 “swine flu” did not go, as it were, supernova, but it still killed, as Biss reports, between 150,000 and 575,000 people – mostly in poor countries, thus enabling western cynics to pretend that nothing much had happened. “The complaint that preventive measures against the flu were out of proportion to the threat strikes me as better applied to our military action in Iraq,” she comments drily. Meanwhile the latest ONS figures suggest that ordinary flu was the cause of 7,000 excess deaths in Britain during a two-week period in January. Perhaps “flu” makes the disease seem too domesticated and trivial, and we should revert to “influenza”.

As there is no such condition as immunity from everything – whether influenza or the slings and arrows of outrageous fortune – so, too, there is no such thing as the global eradication of infectious disease. The future holds increasing antibiotic resistance and the certainty that some mutable virus will cause a pandemic on the scale of the 1918 Spanish flu, which killed between 3 and 5 per cent of the world’s population. In this context, immunity is also a problem of capitalism, specifically one of failing incentives: “Older vaccines make considerably less money than new vaccines,” Biss writes, “and vaccine production has not proved profitable enough to keep many companies from leaving the business over the past thirty years.”

Part of the suspicion of vaccination (among those who don’t have more serious things such as malaria to worry about) is a fantasy of bodily purity, Biss argues persuasively. Historically, the spread of disease was once explained by reference to “filth” – which was accurate enough in its way, although there was as yet no germ theory to explain why sewage and the like transmitted illness. Now, we worry instead about “toxins”. Scientists know that toxicity is all about the dose (drinking too much water will kill you) but the wider cultural chat becomes fixated on invisible molecular threats, “toxins”, that threaten to compromise the sanctity of our bodies – bodies that contain more bacterial cells than human ones. (And we go about “ritually sanitising our hands” with antibacterial liquids, though Biss points out that studies have found they are “no more effective at reducing bacteria” than ordinary soap.)

The notional purity of our physical engineering is also presumably the idea behind the argument that mitochondrial transfer amounts to “tampering with our DNA”. But other things have long been tampering with it already. “A rather surprising amount of the human genome,” Biss notes, “is made up of debris from ancient viral infections.”

The unscientific, New Agey fantasy of “detoxing” is one of purging undesirable chemical immigrants. Metaphors of border protection and war are routinely used, too, to describe the workings of the “immune system” itself (which is another metaphor, Biss points out, and of surprisingly recent vintage: the phrase was coined in 1967). It turns out that the barrier between such metaphors and the outside world is intriguingly permeable. How we think about micro-organisms that might enter our bodies affects how we think about human beings who might enter our countries. One study showed, Biss reports, that “people who had read about harmful bacteria were later more likely . . . to express both concern about bodily contamination and negative opinions on immigration”. On the other hand, people who had been vaccinated against the H1N1 flu “expressed less prejudice against immigrants” than those who hadn’t.

In some way, then, immunity from illness confers a measure of immunity from hatred – perhaps simply because the first eases fear. It is not clear whether the converse is true: whether stoking fear of immigration causes people to feel physically more sick. Perhaps, as the general election approaches, someone will try to find out.

This article first appeared in the 13 February 2015 issue of the New Statesman, Assad vs Isis

Harry Styles performing in London on April 11. Photo: Hélène Pambrun
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How Harry Styles’ European tour was transformed into a LGBT-positive safe space

And all thanks to two fans, 50 volunteers and 28,000 pieces of paper.

After 21 dates, 20 cities, 19 suits, 14 countries and one kilt, Harry Styles’s European tour came to a close last night in Dublin. Some of his most dedicated fans attended a handful of dates in a row, organising their own queuing systems, and arranging tributes to the Manchester terror attacks. “Feel free to be whoever you want to be in this room,” Styles said at every gig, always bringing an LGBT flag on to the stage as he performed. As ever, his shows were a always collaboration between artist and audience to create a safe space for teenage girls and LGBT fans.

On this tour, two fans in particular went above and beyond to create a visually striking, affirmational statement. Ksenia, 17, and Luna, 20, came up with the Rainbow Project, a labour-intensive and involved plan to invite those attending the London dates of the tour to participate in a giant rainbow running around the circumference of the O2 Arena. The project involved distributing 14,000 pieces of differently coloured paper and instructions each night to different seat sections: fans were then invited to put the paper over their phone torches during the song “Sweet Creature” to create a rainbow light effect.

Ksenia and Luna tell me they have been fans of Harry's since his One Direction days: in 2014 and 2012 respectively. “We are really proud of how far he’s come,” Luna explains, “from being afraid of what people thought of him, to confidently pulling off wearing a dress!” The two say they were inspired by Harrys support of the LGBT community: “We just wanted to do something for him.”

Such fan projects aren’t new. As the writer Aamina Khan explains, One Direction fans – who are known for collectively organising to win polls, drive obscure songs to become chart hits, or raise money for charities the band have supported in the past – have been organising fan projects around the rainbow flag since 2014. As the presence of such flags became more and more visbile, Styles in particular started engaging with both the symbol and its message: draping flags around him speaking of love and equality to the crowd. Last year, fans brought hundreds of #BlackLivesMatter signs to Harry Styles concerts.

But Ksenia and Luna’s project seems by far the most complex and challenging so far. “It took us three months to prepare the project,” Luna explains. “We had a group of about 25 volunteers for each show who helped us to hand the colours out. Almost everyone in the arena got a colour, so we made 28,000 pieces in total for the two days.”

Aside from the hours and organisation needed to produce, print, cut out and distribute close to 30,000 small pieces of paper, they both feared that the strict security teams at venues like the O2 wouldn’t take too kindly to their plan. “Obviously you are scared that what you planned doesn't work out,” Luna explains. “But we were pretty optimistic.”

“The venue sadly did take 5,000 pieces away from us on the first night, as we needed permission to do the whole thing – which we didn’t know. The next day, the O2 and its venue manager Rachael reached out to us, and we were happy to have official permission. That night everything worked out perfectly and we’ve never seen something more stunning. It left us speechless.”

“Harry creates wonderful safe spaces each night he steps on stage,” they tell me. “We think we speak for everyone when we say that we’re thankful for that.”

Luna says that the inclusive feeling of Harry Styles concerts is a collaboration between both audience and artist:  “He brings a message, and we as fans chose what we can identify with or look up to. The combination of that creates the feeling at a concert.”

The Harry Styles tour has left Europe, but it’s far from over. As it moves on to Australia, Asia and America, more creative fan projects are undoubtedly on the way.

All photos by Hélène Pambrun.

Anna Leszkiewicz is the New Statesman's deputy culture editor.