Immunity as Metaphor
the first of three essays on inoculation
The word inoculate comes from the Latin inoculare, “to graft a bud of one plant into another,” oculus meaning “eye” or “bud.” This botanical metaphor was handy to describe the method of grafting infectious material into the skin of a healthy person. By this violence we cultivate both apples and antibodies.
I’m brushing up on my vaccine history in preparation for more of this: Conspiracy Theories Spread As Man Dies From New Bird Flu Strain. Either the government is downplaying the threat just like it did with COVID-19, or the government manufactured the viruses to further enslave us to Big Pharma and Big Food.
Four years after the beginning of the COVID-19 pandemic, which never ended or never happened, depending who you ask, the news of H5N2 and H5N1 slides into preexisting discourses on two same-but-different threats to health—toxins and pathogens—and how we immunize ourselves against them.
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Trump-era mistrust of science and the “experts” that represent its authority has roots in filth theory, the 19th-century belief that diseases like smallpox were caused by bad air, AKA poor-people air. Air was thought to be contaminated by rot and waste in the poor neighborhoods of cities, and then waft menacingly into wealthy neighborhoods. Though this is not an entirely accurate representation of infectious disease transmission, it fits with how we understand the spread of other things: fire, crime, conspiracy theories, drugs, communism.
Privileged urbanites built walls between themselves and the infectious poor by shuttering their windows against their vapors. Britain’s 1853 Compulsory Vaccination Act turned this rather literal immune barrier into something more invasive, mandating that parents vaccinate their babies against smallpox within their first three months of life or face fines or imprisonment.
Historian Nadja Durbach argues that the ensuing movement to resist compulsory vaccination involved both middle-class reformers and working-class activists, though the former were focused on the principle of individual liberty while the latter were focused on the violation of their own bodies: Vaccination in the 19th century was painful and disfiguring, and while the Act targeted children, many employers demanded workers be vaccinated or be dismissed. The resistance movement unified the working class by locating its identity in the vulnerable body.1
The privileged classes use science to justify their fear of the poor; they imagine immunity as the successful containment of the mob beyond their walls. The working class retorts that the invasion of the government into their bodies is tyranny, not progress, and that their bodies are not dangerous but in danger.2 I see the great-great-grandchild of this argument all the time, with anti-vaxxers articulating vulnerability to contamination by the state as a reaction to being labeled as vectors of disease, both literal and metaphorical.
Locating political oppression in the injured body seems to confirm that both health and freedom are individual concerns. All bodies are both contagious and vulnerable, but instead of using this anxious interdependence to build coalition, I see a continuing movement toward isolation.
“The very expression herd immunity suggests that we are cattle, waiting, perhaps, to be sent to slaughter,” Eula Biss writes in On Immunity. “Those of us who eschew the herd mentality tend to prefer a frontier mentality in which we imagine our bodies as isolated homesteads that we tend either well or badly.”
Thanks to the neoliberal western values that go much deeper than red-state/blue-state, that hold up the fallacy of self-sufficiency as an American ideal, everyone seems to prefer the homestead to the herd. We imagine health as a function of personal choice and investment. Freedom, after all, means consuming what you want.
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Pharmaco- comes from the Ancient Greek phármakon, which means both “medicine” and “poison.”3 To a small but growing number of Americans, vaccines represent the duplicity of modern pharmaceuticals: they claim to be life-saving and safe while harboring toxins that “injure” and make us sick. To many others, pathogens make us sick, and science rescues us.
The toxin-pathogen axis is oriented along political lines due to the twin beliefs that everything touched by science is unnatural and everything unnatural is toxic.
Inoculating against smallpox using the milder cowpox virus seemed monstrous compared with the older method of variolation, which involved inoculating a patient with smallpox itself. Human-to-human conveyance of immunity seemed safer than cross-species grafting since it followed the natural route of disease transmission.
A contemporary (and extreme) (and illegal) example of opting for natural immunity even though the risks are higher would be parents exposing their children to chicken pox via contaminated lollipops. A milder (but also illegal, depending where you live) example is raw milk, which is believed to boost the immune system since it retains the probiotic microbes destroyed by pasteurization. Raw milk, beef tallow, grass-fed steak and grass-fed butter have become positive symbols to pair with the negative symbol of vaccination, ironically all sourced from cows.4
Pasteurized milk is cleansed of pathogens, but raw milk, an inoculation against tyranny and contentious phármakon, is untouched by machines, chemicals, and the FDA. If you’re pro-raw milk and anti-vaccine, you see raw milk as a natural immunity elixir while vaccines are full of toxins that can cause disease and injury. To the other camp, raw milk is infested with disease-causing pathogens, while vaccines are both life-saving and safe. People on both sides believe themselves to be rational, realistic free-thinkers. Realistically, vaccines and raw milk come with both benefits and risks, albeit unequal ones, but don’t tell that to anyone on TikTok.5
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Which phármakon you reach for seems to depend on your definition of purity. In On Immunity, Biss reflects on the vaccine skepticism she experienced as a new mother during the H1N1 pandemic of 2009. She recounts feeling dread when her baby weaned off breastmilk and her body could no longer act as a filter between her child and the world. Everything entering the child’s body suddenly looked like poison.
I empathize with this. I fantasize about a closed system, too. But, the idea that the body begins pure and becomes contaminated through contact with modern toxins is part of the homestead fantasy that both misunderstands and underestimates the body.
My favorite talking point on this is formaldehyde. Formaldehyde is a carcinogenic and DNA-damaging toxin that is whispered about in horrified tones by vaccine skeptics on both sides of the political aisle. I myself have feared it since I learned that gas stoves constantly leak it into the air. What I didn’t know is that formaldehyde is produced inside the human body: Our cells produce about 1.5 ounces of the toxin per day as part of the carbon cycle that all living things use to make DNA and amino acids.6
Formaldehyde does not accumulate in the body—accumulation being another fear of the intuitive toxicologists among us—but gets turned into formate by enzymes, while other enzymes repair the DNA it damages.7 The lesson here is that formaldehyde is bad, but certainly not unnatural: When we understand that toxins are produced and mitigated by our bodies, the image of the invasive man-made toxin contaminating us via medical and consumer products loses some of its horror. To make the world feel safer, we want bad things to be obviously bad and good things to be purely good.
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The various things we imagine invading our homestead, in spite of our efforts to protect it with guns and probiotics and partisanship and vaccines, are already inside. We are walking hosts for pathogens and born polluted with chemicals. I’m not saying that immunity is a foolish project, rather that the homestead is a foolish metaphor.
In the next two essays I’ll explore the herd versus homestead notion further, and suggest that beauty is deployed as a metaphor for health to both retrench its individualism and sell new inoculations: Ozempic and Botox, to name a couple. In the spirit of Susan Sontag’s Illness as Metaphor, “It is toward an elucidation of these metaphors, and a liberation from them, that I dedicate this inquiry.”
Durbach, N. (2000). “They might as well brand us”: Working-class resistance to compulsory vaccination in Victorian England. Social History of Medicine, 13(1), 45–63. https://doi.org/10.1093/shm/13.1.45
Anti-vaxxers, both in Victorian England and here-and-now, went so far as to compare forced vaccination with slavery. Durbach clarifies that vaccine resisters in 1850’s Britain were more interested in abolition as a metaphor for bodily autonomy than they were in liberating Black people from systemic racial oppression. I assume that many of the white anti-vaxxers who make such comparisons today are only doing so to attract engagement.
In an essay called “Plato's Pharmacy,” theorist Jacques Derrida discusses writing as a phármakon, which he says can mean either remedy, poison, or “scapegoat,” that must remain a composite of these meanings. He says efforts to favor or purge a particular signification of phármakon, to call it either cure or poison, “do interpretive violence to what would otherwise remain undecidable.” The essay is difficult so I won’t say more about it, unless of course someone asks nicely.
It makes me laugh to think that Louis Pasteur is responsible for both ruining milk (inventing the microbe-killing process that now bears his name) and the modern usage of the word vaccine. Edward Jenner used the cowpox virus to immunize against smallpox, but it was Pasteur who generalized the idea. He developed the attenuation process to make inoculations that don’t make the recipient sick, calling the resulting immunizations for chicken cholera, anthrax and rabies “vaccines” in honor of Jenner.
Politico cites a CDC study finding raw milk is estimated to have caused three deaths from 1998-2018, adding that oysters cause 100 deaths every year.
Burgos-Barragan, G., et al. (2017). Mammals divert endogenous genotoxic formaldehyde into one-carbon metabolism. Nature, 548(7669), 549–554. https://doi.org/10.1038/nature23481.
This process, believe it or not, could someday treat cancer: BRCA1 and BRCA2 breast cancers, among other types, lack the DNA repair enzymes to protect themselves from formaldehyde toxicity. Burgos-Barragan et al. found that treating laboratory-grown cells with folate lead to the release of formaldehyde, and they speculated that this could lethally damage the DNA of BRCA cancer cells since they cannot repair themselves. Healthy surrounding cells would not be damaged since they have functioning DNA repair mechanisms.