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Alarmed and Dangerous

I read Eula Biss’s essay about the contemporary fear of vaccines [“Sentimental Medicine,” January] days after the violent deaths of twenty small schoolchildren in Newtown, Connecticut, and immediately drew a connection between the ethical questions surrounding vaccines and those surrounding federal gun laws.

Americans tend to regard both childhood vaccination and firearm ownership as personal decisions. With gun violence set to outpace car accidents as a leading cause of death in this country — having long since surpassed rubella and pertussis, thanks to vaccines — it becomes increasingly evident that gun control is above all else an issue of public health. We must acknowledge that many of the choices we consider private are in fact part of a far more complex ecology. Biss reminds us of the interconnectedness not only of individuals but also of the issues — from vaccination to gun control and beyond — that shape the course of our lives.

Suzanne Buffam

Biss offers a welcome perspective on a topic that frequently causes distress for physicians, but she barely mentions another cause of unease among doctors: the commercialization of disease treatment in the United States. Insurance payments tend to reward procedure over prevention. The average payout a doctor receives for administering a vaccine is around sixteen dollars; removing a skin lesion can pay many times that.

A capitalistic mentality may also be at the root of vaccine refusal: we fear vaccines because we are unconvinced of the benefits of disease prevention generally. The patient-as-consumer doesn’t participate because, in the absence of a manifest condition, he senses nothing is being offered. But shouldn’t we hold medicine to a different standard, one free of the taint of the market?

Anastasia Feifer
New York City

Biss argues that immunization should be considered “not just in terms of how it affects a single body but also in terms of how it affects the collective body of a community.” A third consequence is rarely discussed — vaccines’ effect on viruses themselves. Every active infection is a workshop for pathogens, which can mutate rapidly and adopt new features from other viruses or even their host. By limiting the overall number of infections, vaccines give viruses less room to experiment, slowing their progress and helping to protect future generations.

Lisa M. Boulanger
Princeton, N.J.

History of Abuse

Barry Lopez’s memoir of his sexual abuse [“Sliver of Sky,” January] is a personal tragedy wrapped in a collective one — a tale of deception and betrayal that has been repeated over and over again. Personal disclosures like Lopez’s contribute to ending such harmful interactions by reflecting back to society the consequences of inattention to the deepest needs of oneself and one’s progeny.

It is advisable for parents to be wary of adults taking unusual interest in their children, but perhaps more important is vigilance against the erosion of parent-child bonds. Without that foundation in place, children will remain at risk of the perils Lopez describes.

John Leland
Los Angeles

I have spent nearly thirty-five years representing victims of sexual abuse in courtrooms across the country. The most common question I face is why victims remain silent for so long. The devastating psychological and emotional toll exacted by abuse prevents many from being able to articulate not only its impact but also the degree to which it has taken on a life of its own. By recounting the history of his abuse, Lopez provides an eloquent and emotionally resonant response to this question, one that lends precious insight to both victims and the public.

Paul Mones
Portland, Ore.

Nothing Compares 2 U

There is something darkly humorous about how Hilton Als exploits Jamie Foxx’s stand-up comedy in his memoir about Prince [“I Am Your Conscious, I Am Love,” December]. Als and Foxx commit similar fallacies in their assessments of the artist. Foxx tells his audience when Prince’s gayness is “too much,” while Als warns his of an identity that is “not enough.”

Prince resists essentializing, as does his music. He thrives on abstraction and a fluid identity that intentionally defies categorization. This is the political wink in his aesthetic: it opens up a realm of multiplicity. Als, in his possessiveness, overlooks the significance of Prince’s upending of tiresome notions of identity and genre.

Jacques El-Chayeb
Chapel Hill, N.C.


An item in February’s Findings about a Canadian student’s allergy-related lawsuit was based on a report by a satiric CBC radio program. We regret the error.