Vaccination expert: Culture of fear in American parenting 'oppressive'

Amid the firestorm of media reports about the recent measles outbreak that began in Southern California and the debate over vaccination, Eula Biss’s book, “On Immunity” – which came out in September – is particularly timely. In the book, she explores historical and contemporary attitudes to immunity and vaccination through scientific, cultural, and personal lenses. Ardently pro-vaccination herself, she empathizes with parents who opt out, and examines the fears that may drive their decisions. And she sees the "us versus them" mentality driving much of the discussion as counterproductive.

In a recent interview with the Monitor, she addressed the anger about vaccination that has taken over much of the current debate, how to bridge the divide between groups, and the pervasiveness of fear in our culture. Here are some excerpts from that interview.

What do you think is being missed in the current coverage of the measles outbreak and vaccination?

I’m heartened by some things that aren’t getting missed… I saw less of the conversation about vaccinations being a social duty [in the 2010 pertussis outbreak in California], and I’m seeing more of that now.

But what I’m worried about as I watch this conversation play out in the news – this is already a very polarized issue, and it seems like it’s getting even more polarized. [New Jersey Gov.] Chris Christie can say something I didn’t think was outrageous about vaccinations, and get jumped on for it. It’s getting very us and them, and those of us who vaccinate are the good guys and those who don’t are the bad guys. We need to have a real hard look at the factors contributing to people’s mistrust of the medical establishment and mistrust of the government…. I do think vaccines are much better regulated than just about any other pharmaceutical out there, but it’s also fair for people who know how poor our regulation is to be skeptical or fearful.

You’re pro-vaccination, but in your book you wrote very compassionately about those who choose not to vaccinate. Are there ways to break out of that 'us versus them' mentality?

Part of how I bridged it is that I’ve occupied both traditions. That’s where a lot of that empathy came from. All the fears I wrote about were fears I held. I worked myself out of them, but I knew what it felt like to have them.

Maybe part of the way to bridge the "us and them" mentality is to work from a place where we assume people have legitimate reasons for their fears even if we don’t like how they act on that fear. [In my case], I acknowledged this fear, saw there were fairly good reasons for it in some areas, then decided my fear was not a good enough reason to … forgo something essential for other people’s health.

This is one of those rare issues where we really do need community consensus and we’re not used to operating that way. We’ve got this very pluralistic society, and the community we need consensus among is huge, it’s the world.

Instead of calling people dumb or ignorant, I think we could focus on a conversation about what other people need from us, and how we’re going to live together as an international community.

The more I’ve talked to people, the more I’ve realized this can be very personal, and there’s a lot of life history feeding this. I wrote about a woman whose parents were Vietnamese refugees, and were exposed to Agent Orange. It’s not hard to understand someone like that’s extreme chemical sensitivity – in a psychological sense – and reluctance to trust the government. For a lot of people this is a political or philosophical position, but it’s informed by life experiences, and some of those are really difficult life experiences, and that difficulty needs to be honored.

You write in the book about the degree to which we’re governed by fear. It seems like fears are pervasive right now, both about vaccinations and about the measles outbreak.

The writer Marilynne Robinson had a quote in The New York Times recently about how our culture gives fear so much respect. [The exact quote is that “fear has, in this moment, a respectability I’ve never seen in my life.”] I think that’s so true. If another parent says they’re afraid of something, you almost can’t answer that. We’re in a weird unproductive place around our own fear.

Part of my book was about how oppressive I found this parenting culture which is very fear-promoting and fear-encouraging.

I don’t know [if we’ve become more fearful as a country] but I do think at least the rhetoric around fear has changed. I have a hard time imagining a politician right now saying all we have to fear is fear itself. Or a politician saying we should be most afraid of what our fear of terrorism has made us do…. Something has shifted, and we’re honoring fear in a way I don’t think it should be honored.

Why do you think there is so much anger right now about non-vaccinators, and fear of the measles outbreak which seems disproportionate to the actual numbers, with just over 100 cases?

I think this is a serious issue, serious enough to have spent six years writing about it, but I also think some of the responses are completely overblown. I’ve been trying to figure out what is this about. It’s starting to seem like this anger is about something else.

Is it about us not being able to handle our own fear or think about risk in a way that gives it some proportion? Maybe that has something to do with it. But also – I have an overblown anger response when I see other people being bad at sharing their space….

Statistically, the risk, even if you’re living in Southern California, is quite minimal. But it’s also another cultural weak point. We’re not that great at shared spaces.

[Non-vaccinators] aren’t sharing. They’re not sharing the burden – and there is a burden that goes with vaccination, because there is a risk that everyone takes. So part of it is, I’m sharing, and you’re not.

That, I get. But I think the anger can be felt, but I’m not sure it’s productive to express it.