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Food & Nature in Cities

State of Immunity by James Colgrove

State of Immunity methodically follows the history of vaccination in public health from the late nineteenth into the twentieth centuries, from compulsory measures against smallpox enforced with police and violence to the rise of "health education" through advertising, alongside the anti-vaccine sentiment present from the start. This story made me realize how long routine vaccination has been commonplace in America, and how little has changed over time; though we have more and better vaccines, the public health profession's confusing messaging and the public's skepticism feel continuous over a century later.

The narrative around the smallpox & diphtheria vaccines mirror the COVID cycle remarkably. At first, many people are enthusiastic to line up and make any sacrifices to receive vaccination, with a "we're all in this together" narrative. Press heralds the incredible accomplishments of production, as the bobsleds to Nome, Alaska did. Later, institutions (like NYU did) make inoculation mandatory, which implicates another percentage of the population. A vocal minority continue rabble-rousing about the vaccines and are proud of their "free thinking." As the threat of the disease wanes, people stop getting boosted, institutions give in to public pressure and stop requiring it, and the disease gets more dangerous over time. Institutions like schools and universities do not provide true choice because they once required a vaccine and continue to require others, but we pretend the dropping of these requirements is some sort of social good in recognition that fewer people are dying.

The rise of health education as advertising is quintessentially American: making people feel like they have a choice, but shaping acceptance rates through for-profit, glossy advertising to them by insurance companies and local officials in the press. While dramatically less effective than public requirements, there is no greater gift to Americans than the illusion of choice.

This book is about power more than money, humans in their fight against nature, and connections to food are only theoretical. We've read little this semester that elevates nature, and this book is not an exception. Nature, as presented in this narrative, allows children to die in huge numbers from preventable diseases; humans overcome that misery through engineering ever-improving inoculations. Cows and goats are mentioned for their animal serum as vaccine ingredients, but only as resources. Money crops up in a few places, such as insurance companies wanting to reduce deaths and doctors whining about losing business because patients received free vaccinations, but the power of the state vs experts vs citizens is a more resonant theme.