I think it would be better to use the term "disease-acquired" or "infection-acquired" and contrast that with "vaccine-acquired" immunity. I think that this terminology is more precise and superior for the following reasons:
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Firstly, for the purposes of public science communication, it's important to be mindful that the term "natural" carries with it certain connotations that are not necessarily congruous with reality:https://www.nature.com/articles/s41562-020-0891-0 …
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In using the term "natural immunity" it becomes easy to overlook that that immunity comes at the cost of infection which may mean disease, disability, or death. It also concatenates well with the notion of childhood rite of passage diseases which as a concept is abhorrent to me.
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Using the labels "disease-acquired" or "infection-acquired" makes it salient that this form of immunological protection may come at significant costs, in contrast with "vaccine-acquired" which is substantially lower risk.
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Outside of the purposes of public sci-comm the term implies a misleading dichotomy that vaccine immunity is somehow unnatural. While the immune responses to a vaccine may differ substantively from those that occur with infection depending on the vaccine and infectious disease...
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I think it a stretch to suggest that the immune response to a vaccine is "unnatural." For the most part it relies on the same basic processes to generate memory and immunological effectors as any response to an infection might.
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I think that the concept of "natural immunity" implies with it that there has to be a concept of "unnatural immunity" to go with it and the closest thing I can think of that applies to that would be chimeric antigen receptor technology...
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and other ex vivo work that produces an immunological effector directly within a cell without an immune response per se e.g.:https://immunology.sciencemag.org/content/4/35/eaax0644 …
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That said, for the same reasons that I think the connotations of the term "natural" pose issues, I think that unnatural should be refrained from as a descriptor of such technologies.
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I recognize here that I have treated "naturalness" to be a dichotomy rather than a spectrum, but I think in this context that is preferable because there is no reliable way to quantify naturalness to allow for meaningful comparisons.
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