1092 Big pharma & the anti-vaxxers

Lost Immunity
by Daniel Kalla

Toronto: Simon & Schuster Canada, 2021
$22.00 / 9781982150150

Reviewed by Tom Koppel

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“I’m only requesting a few thousand doses,” says Lisa Dyer, an epidemiologist who is Seattle’s chief public health officer. “To vaccinate the people at the highest risk. Direct contacts, health-care workers, and people living nearest to the victims.” In the latest medical thriller by Daniel Kalla, a Vancouver M.D who practices emergency medicine at a local hospital, Dyer is desperate to stem the tide of a pathogen that has swept in from abroad and has been claiming victims in Seattle at an alarming rate. A barely tested new vaccine produced by a large New York pharmaceutical company shows considerable promise. In a risky roll of the dice, a campaign to administer the vaccine is launched. And then things begin to go wrong.

The outbreak’s similarities to Covid-19 are noteworthy, so we are well prepared to understand the relevant concepts and medical jargon. We read about “asymptomatic carriers” of the disease, and “community spread,” and achieving hoped-for “herd immunity.” But Lost Immunity is set in a post-Covid near future, and the illness involved is a form of meningitis, a bacterial disease rather than a viral one. Its apparent source is not China but Iceland, where the drug company had been planning to do its initial rollout in response to the recent outbreak of meningitis there.

One early challenge for Seattle’s medical experts is to figure out when and how the disease spread to its first victims, a cluster of children at a Washington State bible camp. Another is to cope with well-organized opposition from the local anti-vaxxers. At a public meeting on vaccine promotion related to a different disease, a voice calls out to Lisa Dyer: “What about our right to choose? And our individual rights to protect our own children?” When she cites medical evidence showing that the relevant vaccine is safe, another person calls out: “Evidence planted by the drug companies to protect their profits….With enough money and influence, you can buy any result you want.”

Despite the meningitis vaccination campaign, strange and unexpected deaths continue to occur. Are these merely improbable mishaps that might plague any such mass immunization? Could there have been a bad batch of vaccine? Or does a sinister hand lurk behind these events? If so, whose, and with what kind of motive? Could it be the anti-vaxxers, or perhaps people who simply want to bring down the despised greed-heads of Big Pharma?

The picture Kalla paints of the intricacies of medical research, the vicissitudes of public health administration, and the politics and economics of the pharmaceutical industry is credible and enlightening. He weaves a fast moving plot peopled by complex yet believable individuals. They are not just scientists, public officials or corporate honchos, but a diverse and well-crafted cast of characters entwined in often-difficult personal relationships. Dyer’s own sister is strongly under the influence of anti-vaccine thinking. “I’m not saying doctors are all corrupt, but that you’re biased,” the sister tells her. “You’re spoon-fed a pro-vaccine agenda from your first day in med school. And most of you have drunk the Kool-Aid.” As Dyer’s marriage unravels, in part due to work pressures of the vaccination crisis, a strong attraction develops between her and Nathan Hull, the on-the-scene representative of the drug company. The prospective romance is undercut, however, by Dyer’s doubts that Hull has been entirely honest about his firm’s motivation and behaviour.

Kalla spices his plot with tantalizing bits of foreshadowing and hints of what might be happening behind the scenes. He has his characters look back to what took place during the recent Covid pandemic and what can be learned from it. As Dyer puts on her protective gear “the simple steps conjure grim memories of donning PPE during the dark days when Covid-19 terrorized Seattle.” One person on the public health team sighs, “At least with Covid-19, most of the ones who died were much older.” When yet another death from meningitis occurs, it impacts “the city hard, especially in the emotional aftermath of the damage left by Covid-19.”

Lost Immunity reminds us just how much the average reader has learned about a whole array of medical issues in the last year or so. We are now all too familiar with terminology such as N-95 masks, concepts like contact tracing, or the tenacity and gravitational pull of anti-vaccine sentiments in our society.

Kalla’s previous novels have dealt with the opioid crisis, bubonic plague, killer flus, and tracing guilt or innocence by means of DNA. It is a blessing to have a topic like disease spread covered in a fascinating way by someone who knows whereof he writes. One quibble is that several of Kalla’s earlier books were also set in Seattle, as a stand-in for his hometown of Vancouver. Am I the only BC reader who finds this disappointing?

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Tom Koppel is a veteran BC author and journalist who has published five books on history and science. For 35 years, he has contributed feature articles to major magazines, including Canadian Geographic, Archaeology, American Archaeology, Equinox, The Beaver, Reader’s Digest, Western Living, Islands, Oceans, and The Progressive. His book Kanaka: The Untold Story of Hawaiian Pioneers in British Columbia and the Pacific Northwest (Whitecap Books, 1995) is available by email from koppel@saltspring.com Tom lives with his wife Annie Palovcik on Salt Spring Island. Editor’s note: Tom Koppel has also reviewed books by Britt Wray, May Q. Wong, and Richard J. Hebda, Sheila Greer, & Alexander Mackie for The Ormsby Review.

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