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In which John, inspired by Eula Biss's book On Immunity, considers how immunity and inoculation happen. Other topics discussed include vaccination, the relationship between individual efforts and collaboration, and what must be shared to be experienced.

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Book club:

Good morning, Hank. It's Tuesday.

I've been thinking a lot about vaccines and inoculation — I mean, for the obvious reason, but also because our community's book club, Life's Library, has been reading Eula Biss's brilliant book On Immunity.

I should say that Life's Library is an online book club where a lovely group of people read books together and discuss them. Our annual membership enrollment period begins this Friday and you should totally become a member and/or gift a subscription to a friend (links in the dooblydoo).

But right, this book, On Immunity, which was selected by our guest curator, Celeste Ng, really deepened my understanding of immunity and inoculation—

—and the book achieves something really remarkable because it's like a page-turny [sic] history about vaccines and disease and our fears about them, but it is not centered on individuals.

Like most nonfiction I read (and almost all fiction I read) is centered on individuals and their highly individualistic individual choices bending the arc of some larger story. And I'm not like, opposed to those books (I mean, for one thing I've written some) but also I do think the choices of individuals bend the arc of the human story.

When we think of human history, though, as primarily the exploits of powerful or lauded or brilliant individuals, there's just so much we miss.

Like here's how I always heard the story of the smallpox vaccine: in the late eighteenth century, a brilliant young scientist named Edward Jenner noticed that milkmaids were routinely infected with a relatively mild disease called cowpox which seemed to make them immune to the much more serious disease of smallpox.

Having made this discovery, Jenner borrowed the eight-year-old son of his gardener, made two small cuts in the boy's arm, and then put some pus from a cowpox pustule into the wound. The boy got a fever but recovered and was thereafter immune from smallpox.

Word of this wonder spread and suddenly one of the world's deadliest diseases was completely preventable.

Like a lot of great stories, this one isn't exactly untrue, it just isn't the whole truth. For one thing, Jenner did not discover that milkmaids were immune to smallpox. Lots of people knew this, including milkmaids, for whom not dying of smallpox was one of the chief perks of the gig.

Also there were already many strategies for smallpox inoculation. Like in China, for instance, for centuries, people had been inhaling dried smallpox scabs in order to induce a mild version of the disease and thereafter immunity.

There were also effective strategies for inoculation in African communities. Like, y'know Cotton Mather of Salem witch trials fame? He's often credited in America for having invented smallpox inoculation?

But he learned the technique from an enslaved African named Onesimus. Like, when Mather asked Onesimus, "Have you ever had smallpox?" Onesimus was like, "Yes and no."

Mather later wrote that Onesimus, quote, "told me that he had undergone an operation [that] had given him something of the smallpox and would forever preserve him from it...He described the operation to me and showed me in his arm the scar."

Now, there are important differences between the variolation techniques promoted by people like Mather and true vaccination.

But several other people, independent from Jenner, were doing very similar work on smallpox vaccination at the time because true innovation is almost never about a heroic individual succeeding via the sweat of his Randian brow and almost always about a growing body of expertise and evidence making new breakthroughs possible.

Lastly, and most importantly, Jenner's work did not like, end smallpox. By the end of the nineteenth century, smallpox vaccination was extremely safe and effective, so we knew how to prevent the disease.

And yet, in the twentieth century, smallpox killed over 300 million people, many of them children and most of them living in places impoverished by colonialism.

None of this is to say that Edward Jenner's work was unimportant. It was extremely important; it contributed to our eventual eradication of smallpox. But he was participating in a massive, centries-long species-wide collaboration. If a new vaccine is coming (and God, I hope it is), let's not build a statue of one person or another, let us instead build monuments to the sprawling cooperation of thousands of people who shared their work openly and efficiently, so that together we might achieve what we cannot achieve alone: shared immunity.

Hank, I'll see you on Friday.