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Vaccination makes sure that you have anti-bodies so that your immune system has a heads-start once you get infected. If you were infected before, your body also built anti-bodies.

Are there diseases where one knows (or at least has a good reason to believe) that having had the disease provides less protection than the vaccination?

This is a follow-up question to Is there a benefit of a COVID-19 vaccination if one had COVID-19 before?

Martin Thoma
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    since a person can have shingles multiple times, and there is a shingles vaccine, I suspect it may be an example. But someone other than me would have to look for the papers. – Kate Gregory Dec 29 '20 at 18:30
  • This is maybe a duplicate of this, although there is a slight difference in that that one is asking about no immunity vs. immunity whereas this is asking about weak immunity vs strong immunity. – BrenBarn Dec 31 '20 at 08:44
  • Tetanus. Answered in SE Biology april 2020. – Polypipe Wrangler Jan 03 '21 at 08:22

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There are a few categories:

Diseases where infection does not produce immunity

  • Tetanus infection does not produce immunity. Vaccination with the tetanus toxoid vaccination does (ref).

  • Respiratory syncytial virus (RSV) infection does not produce protective immunity; repeat infections are typical. As of May 2023, there's an RSV vaccine in the US.

  • Malaria needs continual exposure to the parasite to develop some degree of immunity, and it's probably never sterilizing immunity (ref). The R21/Matrix-M vaccine is about 77% effective at preventing clinical malaria (ref).

Diseases where infection results in worse immunity
  • Dengue virus famously exhibits "antibody-dependent enhancement (ADE)" of disease, meaning that immunity from infection with one of the four types of the virus results in worse disease after subsequent infection with any of the other types. The Qdenga/TAK-003 vaccine is licensed in some countries and there's no evidence that it causes ADE.
Chronic infections
  • Diseases that produce chronic infections, such as HIV and hepatitis C, don't produce useful immunity. Neither of those have vaccines yet, but several are being tested.
Highly fatal infections
  • Rabies and Ebolavirus disease have high mortality rates. You might not survive to ever develop natural immunity. Both have vaccines.
ZachB
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  • Why do you assume that if there were a vaccine for dengue, it would be more protective than infection? Antibody-dependent enhancement happens in vaccines also - https://pubmed.ncbi.nlm.nih.gov/34656289/ – user93353 Oct 19 '23 at 23:42
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    I just updated the answer. There's now a licensed dengue vaccine that has no evidence of ADE. The older Dengvaxia might cause ADE but is no longer used in people who haven't been naturally infected. – ZachB Oct 21 '23 at 01:33
  • That doesn't answer my question - even before there was one which didn't, why did you assume that the vaccine won't have ADE? – user93353 Oct 21 '23 at 03:11
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    Given that natural dengue infection makes subsequent infections with other serotypes worse, a dengue vaccine has a low bar to be more protective. It wouldn't be approved if it had known ADE. ("Known" is a key word here. You're right that there might be unknown ADE.) – ZachB Oct 21 '23 at 18:29
  • You could also add VZV here? There are vaccinations against Herpes zoster available now and the primary infection of course provides no sufficient immunity against shingles – Narusan Oct 25 '23 at 07:26