Vaccines & immunology

The DO Book Club, November 2020: On Immunity: An Inoculation

In 2014, Eula Biss wrote about how cultural perceptions of immunity inform the general public’s outlook on personal responsibility. In 2020, her words resonate strongly.


Welcome back to The DO Book Club! For November, I read On Immunity: An Inoculation by Eula Biss. If you’ve read this one, please share your thoughts in the comments below. And if you’d like to write a book review for a future month, please email Andy Brown at

Plot summary

On Immunity is a personal narrative by nonfiction writer Eula Biss that tracks the history of vaccines and aims to debunk the various pervasive myths and misleading metaphors that sometimes surround immunizations.

This book doesn’t follow a plot so much as it floats from subject to subject. Through anecdotes, interviews and text analysis, Biss facilitates an open, yet opinionated dialogue on how cultural perceptions about immunity inform the general public’s outlook on personal responsibility.

As an example, she critiques The Vaccine Book by Robert Sears, MD (otherwise known as Dr. Bob), a popular source of information.

In the book, Dr. Bob writes that if parents fear the measles, mumps, and rubella vaccine, they should avoid telling their friends and neighbors. He sees this as necessary because the diseases will likely spread significantly if too many people avoid the vaccine.

These are the kinds of ethical quandaries that Biss often dives headfirst into. In this case, she consults her sister, an ethicist, who counters Dr. Bob by saying “‘you don’t own your own body — that’s not what we are … the health of our bodies always depends on the choices other people are making. … there’s an illusion of independence'” (p. 124).

Though this book was written in 2014, that “illusion of independence” resonates strongly during the year of COVID-19, as individual actions like mask-wearing and social distancing remain paramount in limiting the population-wide spread of the virus.

Biss is also critical of those who ignore the importance of vaccine-achieved herd immunity, another term we are all too familiar with nowadays. Noting that some people find the concept of “herd immunity” difficult to understand, she prefers to look at immunity through the lens of a “hive mentality” because the health of any individual bee (or person) depends on the health of its hive.

Interesting tidbits for DOs

Biss’ experience as a new mother gauging the safety of her child’s flu vaccine inspired her to write this book. She concedes that it’s natural to worry about the contents of vaccines if you don’t fully understand how they work. Formaldehyde, for example, which many vaccines contain traces of in order to inactivate viruses, is an ingredient that may initially be alarming to “those of us who associate [it] with dead frogs in glass jars” (p. 73-74).

As for why she understands this area of concern to an extent, Biss is honest about her fear of the outside world coming into contact with her newborn, which she later overcame. DOs may find this open vulnerability from a patient’s perspective insightful.

“As long as a child takes only breast milk, I discovered, one can enjoy the illusion of a closed system, a body that is not yet in dialogue with the impurities of farm and factory. … I remember feeling agony when my son drank water for the first time. ‘Unclean! Unclean!’ my mind screamed” (p. 73).

However, Biss makes it clear that it’s not practical to consider the subject of vaccine safety a debate with two sides of equal merit. Doing so unfairly pits parents and physicians against each other, she writes. Her conversations with parents with misguided theories on vaccine risks paint a picture of a skepticism of mainstream medicine. In ultimately making the decision to trust medical experts and vaccinate her child, Biss reframes this narrative in a way DOs may find refreshing.

“I [dislike] the term consumer confidence, and I bristled every time I was encouraged to trust myself as a mother. I had little confidence … but I tended to believe that confidence was less important than the kind of trust that transcends the self” (p. 9).

Notable quote

Biss says the “hive mentality” metaphor is also apt for her strenuous experience giving birth. She writes that she found a synergistic beauty in how much her health and that of her child relied on the efforts of health care workers.

“My pregnancy … had primed me for the understanding that my body was not mine alone and that its boundaries were more porous than I had ever been led to believe. … During birth, when the violence to my body was greatest, I was most aware not of the ugliness of a body’s dependence on other bodies, but of the beauty of it. Everything that happened to me in the hospital after my son’s delivery … I experienced at that time as aglow with humanity. Alarms were sounded for me, doctors rushed to me, bags of blood were rigged for me, ice chips were held to my lips. Human hands were in me and in everything that touched me” (p. 80-81).


This is a fascinating book that I’ve only barely scratched the surface of in this review, which is really saying something since it’s only 163 pages! It’s a super quick read that I would highly recommend to anyone, this year in particular.

Biss couldn’t have anticipated 2020’s chain of events in 2014, (though she did allude to the imminent risk of a global pandemic), but her framing of immunity as a kind of public space that should be cared for and tended to by a unified global community has obviously aged quite well. As hopes for a COVID-19 vaccine inch closer towards reality, I found this book to be a comforting reminder that we are all in this together.

December’s book

For December, The DO Book Club will be reading The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman. We encourage all who are interested to read along (this book club can be followed at any pace)! If you are unable to get out to a local library or bookstore due to COVID-19, we recommend checking out eBook options for rent or purchase.

As a reminder, if you read On Immunity or any previous Book Club selection and want your reflections to be shared in future posts, or want to write your own book review for a future month, please leave a comment below or email

Happy reading!

Related reading:

The DO Book Club, October 2020: The Beauty in Breaking

The DO Book Club, September 2020: Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness

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