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Vaccines do not guarantee complete protection from a disease. Sometimes this is because the host's immune system simply doesn't respond adequately or at all. This may be due to a lowered immunity in general (diabetes, steroid use, HIV infection) or because the host's immune system does not have a B-cell capable of generating antibodies to that antigen.Even if the host develops antibodies, the human immune system is not perfect and in any case the immune system might still not be able to defeat the infection.Adjuvants are typically used to boost immune response. Adjuvants are sometimes called the dirty little secret of vaccines  in the scientific community, as not much is known about how adjuvants work. Most often aluminium adjuvants are used, but adjuvants like squalene are also used in some vaccines and more vaccines with squalene and phosphate adjuvants are being tested. The efficacy or performance of the vaccine is dependent on a number of factors:the disease itself (for some diseases vaccination performs better than for other diseases) the strain of vaccine (some vaccinations are for different strains of the disease)  whether one kept to the timetable for the vaccinations (see Vaccination schedule) some individuals are 'non-responders' to certain vaccines, meaning that they do not generate antibodies even after being vaccinated correctly other factors such as ethnicity or genetic predisposition When a vaccinated individual does develop the disease vaccinated against, the disease is likely to be milder than without vaccination.