key: cord-1052995-4qz6wx0o authors: Brennan, Orlaith C.; Moore, John E.; Moore, Peter J. A.; Millar, Beverley C. title: Vaccination terminology: A revised glossary of key terms including lay person’s definitions date: 2021-08-31 journal: J Clin Pharm Ther DOI: 10.1111/jcpt.13516 sha: 2f7ddd3896ffc43520a7dda35401604649c2bbdb doc_id: 1052995 cord_uid: 4qz6wx0o WHAT IS KNOWN AND OBJECTIVE: There has been a paucity of vaccine and vaccine‐related definitions within the scientific and medical peer‐reviewed literature, particularly with the arrival of COVID‐19. Therefore, it was the aim of this commentary to collate definitions to 44 vaccine‐ and vaccinology‐related key terms, from four international and respected sources of information (where available), including (i) the World Health Organisation (WHO), (ii) the US Centers for Disease Control and Prevention (CDC), (iii) The Department of Health, Government of Australia and (iv) the European Union. In addition, it was a further aim to develop a lay person's definition to each of these 44 key terms, to act as a published and citeable reference point for pharmacists and other healthcare professionals, when communicating with patients and other public‐facing stakeholders. COMMENT: Definitions are important in health care in order to (i) provide concise insight on a specific topic, (ii) provide a common understanding and (iii) set reference points to allow the adoption of a standard uniform approach. WHAT IS NEW AND CONCLUSION: The collation of definitions of key vaccine terms was compiled from four respected sources of information. A glossary of 44 key terms was produced to help pharmacists and other healthcare professionals explain such terms professionally, as well as to patient stakeholders in lay person's vocabulary. These lay definitions had superior readability metrics than definitions from any of the four professional sources, indicating their suitability for engagement with patient‐facing stakeholders. Understanding the barriers to vaccine uptake is crucial for health professionals and policymakers to achieve improved uptake rates. This commentary has aimed at adding value to healthcare professionals and patients, by providing an up‐to‐date glossary of several professional definitions, from respected sources, as well as an accompanying lay definition to support the healthcare professional‐patient communicative interface. Vaccines have become an important preventative tool, particularly in the context of the COVID‐19 pandemic, to help mitigate disease severity and to help control the pandemic locally, nationally and internationally. Accessible and robust definitions help inform the dialogue to achieve this goal and the avoidance of obscurum per obscurius. The emergence of SARS-CoV-2 as the viral aetiological agent of COVID-19 disease has placed great emphasis on the role of vaccines and vaccination, as one way to help with disease prevention, as well as minimizing disease severity. 1 A list of 44 key terms relating to vaccines and vaccinology was prepared, encompassing those defined previously and supplemented with contemporary vaccine-related terminology. Definitions of these terms were sought from four international respected sources of information, including (i) WHO (https://vacci ne-safet y-train ing.org/gloss ary.html) (n = 30 definitions), (ii) CDC (https://www. cdc.gov/vacci nes/terms/ gloss ary.html) (n = 30 definitions), (iii) Australian Government Department of Health (https://immun isati onhan dbook.health.gov.au/techn ical-terms) (n = 20 definitions) and (iv) EU (https://ec.europa.eu/healt h/sites/ healt h/files/ vacci natio n/ docs/gloss ary_en.pdf) (n = 10 definitions). Definitions from these sources are presented in Table 2 . The readability (i.e., the ease with which a reader can understand a written text) of these definitions was checked using the readability calculator, Readability Test Tool, (https://www.webfx.com/tools/ read-able/), where individual vaccinology definitions were inputted to conduct a readability assessment of definitions, as previously described, 10 examining ten readability metrics, namely: Readability scores (n = 5; Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning Fog score, SMOG index, Coleman-Liau index) and Text parameters (n = 5; number of sentences, number of words, percentage of complex words, average number of words/sentence, average syllables/word), as detailed in Table 3 . Given that these four sources were not able to address all the key vaccination terms identified, lay person's definitions were constructed to all 44 key terms (Table 2 ). These were constructed from a K E Y W O R D S COVID-19, definitions, glossary, immunization, SARS-CoV-2, vaccination, vaccine syntheses of definitions from the four sources (where available), and their readability metrics checked (Table 3 ). The collation of definitions of key vaccine terms was compiled from four respected sources of information. A glossary of 44 key terms was designed (Table 2) to help pharmacists and other healthcare professionals explain such terms to patient stakeholders in lay person's vocabulary. These terms had superior readability metrics than definitions from any of the four professional sources, indicating their suitability for engagement with patient-facing stakeholders (Table 3) . Understanding the barriers to vaccine uptake is crucial for health professionals and policymakers to achieve improved uptake rates. Comirnaty is indicated for active immunization to prevent COVID−19 caused by SARS-CoV−2 virus, in individuals 12 years of age and older. Individuals 12 years of age and older: Comirnaty is administered intramuscularly after dilution as a course of 2 doses (0.3 ml each). It is recommended to administer the second dose 3 weeks after the first dose. Vaccinology Term Adjuvant A pharmacological agent (e.g., aluminium salt, oil-in-water emulsions) that modifies the effect of other agents, such as a drug or vaccine, while having few if any direct effects when given by itself. Adjuvants are often included in vaccines to enhance the recipient's immune response to a supplied antigen, while keeping the injected foreign material to a minimum. A vaccine component distinct from the antigen that enhances the immune response to the antigen A substance that is added to a vaccine during production to improve the immune response to that vaccine An adjuvant is an ingredient of a vaccine that helps create a stronger immune response in the patient's body. In other words, adjuvants help vaccines work better. Many vaccines developed today include just small components of germs, such as their proteins, rather than the entire virus or bacteria. These vaccines often must be made with adjuvants to ensure the body produces an immune response strong enough to protect the patient from the germ he or she is being vaccinated against. A substance that is added to the vaccine to improve the immune response. Adsorption n/a n/a n/a n/a When a substance is joined to something else. Antibody titre ANTIBODY. A special protein produced by plasmocytes in response to antigens (foreign substances, e.g., bacteria or viruses). Antibodies bind with antigens on microorganisms as one of the initial steps of the body's protection against infection The detection of antibodies in blood through a laboratory test n/a n/a A test to measure the amount of antibodies in an individuals blood. Clinical manifestation n/a n/a n/a n/a A visible symptom of a disease or infection. Clinical trial A systematic study of a medical intervention in human subjects (including patients and other volunteers) in order to discover or verify the effects of and/or identify any adverse reaction to the intervention. Clinical trials also study the absorption, distribution, metabolism, and excretion of the products with the objective of ascertaining their efficacy and safety. Clinical trials are generally classified into Phases I to IV. Phase IV trials are studies performed after the licensure and introduction of pharmaceutical products. They are carried out to expand the evidence base of the product characteristics for which the marketing authorization was granted. An experimental study that uses data from individual persons. The investigator specifies the type of exposure for each study participant and then follows each person's health status to determine the effects of the exposure n/a n/a A trial or study that evaluates the impact of new treatments and their effects on an individual's health. vaccine A vaccine that consists of two or more antigens in the same preparation (e.g., MMR, DTP). A product containing components that can be divided equally into independently available routine vaccines. Layperson's definition The probability that a vaccine, when used in the field under routine vaccination circumstances, confers immunity in a population. Expressed as a per cent The ability of an intervention or programme to produce the intended or expected results in the field. A measure of how well a vaccine works in a defined population in "uncontrolled" or routine circumstances-for example, in a vaccination programme Vaccine effectiveness is the probability that a vaccine confers immunity in a population when used in the field under routine vaccination circumstances. This is a "real-world" view of how a vaccine reduces disease in a population. It assesses the net balance of benefits and adverse effects of a national immunization/vaccination programme, not just the vaccine itself, under more natural conditions rather than in a controlled clinical trial. A measure to describe how good a vaccine is at preventing a disease when distributed for use in the general public. The potential of a vaccine to protect from a disease in controlled clinical trials. Expressed as a per cent. The ability of an intervention or programme to produce the intended or expected results under ideal conditions A measure of how well a vaccine works in a defined population in controlled or ideal circumstances-for example, in a randomized controlled trial The potential of a vaccine to protect from a disease in controlled clinical trials, expressed as a percentage reduction of disease in a vaccinated group of people compared with an unvaccinated group A measure to describe how good a vaccine is at preventing a disease under test conditions, for example a clinical trial. The occurrence of disease within a geographical area and/or population that is in excess of what is normally expected for a given period of time The occurrence of more cases of disease, injury or other health condition than expected in a given area or among a specific group of persons during a particular period. Usually, the cases are presumed to have a common cause or to be related to one another in some way Herd immunity A population with a high proportion of individuals with immunity to a particular pathogen, as a consequence of immunization or infection and recovery, may confer protection from infection on the small proportion of its non-immune members because there are too few susceptible people in the 'herd' for the infection to circulate A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community. Also known as herd immunity. A situation in which a large proportion of the population is immune to a disease through previous vaccination or illness. As a result, it is highly unlikely that the disease will spread from person to person. Non-immune people are indirectly protected from the disease n/a This happens when enough people are vaccinated or have immunity from a disease, thereby reducing the chances of someone who is not vaccinated from becoming infected. The process by which a person or animal becomes protected against a disease through an enhancement of their immune response. This term is different from vaccination which is a form of immunization where the body learns to recognize a particular foreign object (active immunization). Passive immunization can be provided by administering external antibodies that will temporarily help strengthen the body's response without inducing memory against a specific foreign object The process of being made immune or resistant to an infectious disease, typically by the administration of a vaccine. It implies that you have had an immune response. The process of inducing immunity to an infectious agent by giving a vaccine The process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Generally, immunization is used interchangeably with inoculation and vaccination. Technically, however, vaccination is a form of immunization (i.e., active immunization) where the body learns to recognize a particular foreign object. Passive immunization can be provided by administering external antibodies that will temporarily help strengthen the body's response without inducing memory against a specific foreign object. Immunization can also be acquired naturally, after contracting a disease The process where an individual becomes protected against a disease caused by a bacterium/virus. Layperson's definition The body's response mechanism for fighting against bacteria, viruses and other foreign substances. If a cell or tissue (such as bacteria or a transplanted organ) is recognized as not belonging to the body, the immune system will act against the "invader." The immune system is the body's way to fight external invasions. Protection against a disease. There are two types of immunity, passive and active. Immunity is indicated by the presence of antibodies in the blood and can usually be determined with a laboratory test. The ability of the body to fight off an infection. Immunity can result from natural infections or from vaccination. The body's response mechanism for fighting against bacteria, viruses and other foreign substances. If a cell or tissue (such as bacteria or a transplanted organ) is recognized as not belonging to the body, the immune system will act against the "invader." The immune system is the body's way to fight external invasions. The ability to fight off an infection caused by a harmful bacterium/ virus. The power of an antigen to induce an immune response. n/a The ability of a particular substance, such as a vaccine, to provoke an immune response, or the degree of response it provokes. n/a The power of a substance to produce an immune response. The substance can be present in a vaccine. A vaccine made from microorganisms (viruses, bacteria, other) that have been killed through physical or chemical processes. These killed organisms cannot cause disease. A vaccine made from viruses and bacteria that have been killed through physical or chemical processes. These killed organisms cannot cause disease n/a n/a This vaccine uses the killed form of the disease-causing bacterium/virus. The number of new cases (e.g., of a disease, adverse event) occurring in a defined population during a given time interval, often one year. The number of new disease cases reported in a population over a certain period of time n/a n/a This is how many new cases of disease occur within a population in a certain period of time. Live vaccine A vaccine prepared from living microorganisms (viruses, bacteria currently available) that have been weakened under laboratory conditions. LAV vaccines will replicate in a vaccinated individual and produce an immune response but usually cause mild or no disease. A vaccine in which live virus is weakened (attenuated) through chemical or physical processes in order to produce an immune response without causing the severe effects of the disease. Vaccine campaign n/a n/a n/a n/a Providing and ensuring that a vaccine is received by a large number of people over a short period of time. Vaccine failure n/a n/a n/a n/a This occurs when the a person develops the disease, even though they have been already vaccinated for it. Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence. A reluctance to accept a vaccine. Vaccine schedule n/a n/a n/a A timetable with recommended ages for immunizing against particular vaccine-preventable diseases This is a timetable of vaccines that an individual (baby, infant, adolescent adult, elderly) is to receive throughout their lifetime. Waning n/a The loss of protective antibodies over time. n/a n/a commentary has aimed at adding value to healthcare professionals and patients, by providing an up-to-date glossary of several professional definitions, from respected sources, as well as an accompanying lay definition to support the healthcare professionalpatient communicative interface. None declared. Data derived from public domain resources. 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