Is Natural Infection Better Than Vaccination?

Paul A. Offit, MD, compares immune responses caused by natural infection and vaccination, using measles as an example of how vaccination can induce an immune response that is “good enough."


Is natural infection better than vaccination?

Paul Offit, MD: Hi, my name is Paul Offit. I’m talking to you today from the Vaccine Education Center at the Children’s Hospital of Philadelphia.

One question parents reasonably ask is: “Isn’t natural infection better than immunization?” Well, I mean I’m a man in my 60s; I was a child in the 1950s; I had measles. When I had measles, I developed an antibody response that is probably three-fold greater than what children will get if they get a vaccine. But, what I didn’t have to suffer by being naturally infected was I didn’t get pneumonia, which could’ve caused me to be hospitalized; I didn’t get encephalitis, or infection of the brain; and I didn’t die. I mean, every year in the 1950s, everyone got measles by the time they were 9 years of age. That meant that 3 [million] to 4 million people every year would get measles, about 48,000 would be hospitalized with pneumonia or encephalitis, and 500 would die. Fortunately, I wasn’t one of those people, but I could’ve been.

So, the better question isn’t, “Is natural infection better than immunization?” The better question is, “Is immunization good enough?” Can immunization induce an immune response that’s good enough to prevent and, arguably, eliminate these diseases? Well, we have the answer for measles. When we had a second-dose measles vaccine recommendation in 1991, that meant that all children in this country were recommended to receive a measles vaccine when they were 12 to 15 months of age and again at 4 to 6 years of age. With that, we eliminated measles from the United States — eliminated it by the year 2000. The only reason that’s come back recently is that a critical number of parents have chosen not to vaccinate their children.

So, I think the good news about the measles vaccine is it induces an immune response that’s good enough to have eliminated that virus from this country without asking children or having children risk these severe and occasionally fatal effects of a natural measles infection.

Thank you.

Related Centers and Programs: Vaccine Education Center

Last Reviewed on Mar 26, 2020