On Immunity: An Inoculation book club questions

1. 1.

   Biss argues that fear of vaccines is rooted in distrust of institutions, not ignorance of science. Does that framing change how you think about effective public health communication?

2. 2.

   She traces vaccine skepticism to a long cultural tradition of suspecting artificial intervention in natural processes. Is that tradition ever a useful check? When does it become counterproductive?

3. 3.

   The concept of herd immunity frames vaccination as a social act. Does thinking of it that way change how you feel about vaccine refusal? Does it change the ethics?

4. 4.

   Biss is honest about her own ambivalence as a new mother, even as she ultimately follows the vaccine schedule. Does that ambivalence make the book more or less persuasive?

5. 5.

   The Tuskegee study and other episodes of medical harm are invoked to explain why distrust of public health institutions is historically grounded. Does that explanation require endorsing the conclusions drawn from it?

6. 6.

   She reads Bram Stoker's Dracula as a cultural text about contamination anxiety. Does the literary approach to a scientific question work for you? What does it add that a purely scientific argument wouldn't?

7. 7.

   The book was published in 2014. How has the landscape of vaccine hesitancy changed since then, and how well do Biss's arguments address the current form of the debate?

8. 8.

   Biss treats the body as porous and interconnected — inherently social, not private. What are the implications of that view for how we think about individual rights versus collective welfare in public health?

9. 9.

   She is careful to avoid condescension toward parents who hesitate. Is that care fully achieved in the book? Or does the essay form create a distance from the people she's writing about?

10. 10.

    Herd immunity requires a high threshold of vaccination in a population. At what point, if any, does the state have legitimate authority to mandate vaccination? What does Biss's framework suggest?

11. 11.

    The book is about vaccines but also about motherhood, risk, and the experience of new parenthood. How does framing a public health question through a personal experience change the argument?

How to run the discussion

• Pick six to eight, not all of them. An hour of real discussion covers fewer questions than anyone expects, and racing the list is what makes a book club feel like homework.
• Open with what people noticed, not what they concluded. Asking for a verdict first hardens opinions before anyone has heard each other.
• Let the disagreement run. The questions below that split a room are the ones worth the time; the ones everyone answers the same way can be skipped.
• Ask the quiet person a specific question. A direct, narrow question is far easier to answer than an open invitation to contribute.