On natural and artificial vaccinations

Annu Rev Immunol. 2003;21:515-46. doi: 10.1146/annurev.immunol.21.120601.141045. Epub 2001 Dec 19.


This review summarizes the general parameters of cell- and antibody-mediated immune protection and the basic mechanisms responsible for what we call immunological memory. From this basis, the various successes and difficulties of vaccines are evaluated with respect to the role of antigen in maintaining protective immunity. Based on the fact that in humans during the first 12-48 months maternal antibodies from milk and serum protect against classical acute childhood and other infections, the concept is developed that maternal antibodies attenuate most infections of babies and infants and turn them into effective vaccines. If this "natural vaccination" under passive protective conditions does not occur, acute childhood diseases may be severe, unless infants are actively vaccinated with conventional vaccines early enough, i.e., in synchronization with the immune system's maturation. Although vaccines are available against the classical childhood diseases, they are not available for many seemingly milder childhood infections such as gastrointestinal and respiratory infections; these may eventually trigger immunopathological diseases. These changing balances between humans and infections caused by changes in nursing habits but also in hygiene levels may well be involved in changing disease patterns including increased frequencies of certain autoimmune and degenerative diseases.

Publication types

  • Review

MeSH terms

  • Animals
  • Autoimmune Diseases / etiology
  • Autoimmune Diseases / immunology
  • B-Lymphocytes / immunology
  • Cancer Vaccines / therapeutic use
  • Child, Preschool
  • Female
  • Humans
  • Immunity, Maternally-Acquired
  • Immunologic Memory*
  • Infant
  • Infections / immunology
  • Infections / therapy
  • Pregnancy
  • T-Lymphocytes / immunology
  • Vaccination*
  • Vaccines / immunology
  • Vaccines / pharmacology


  • Cancer Vaccines
  • Vaccines