Jab, vaccine, booster

[sarawilcox]

What

We want to review our style guide recommendations about "jab" and "vaccine" in the light of recent covid work:

• https://service-manual.nhs.uk/content/a-to-z-of-nhs-health-writing#flu-jab-or-flu-vaccine
• https://service-manual.nhs.uk/content/a-to-z-of-nhs-health-writing#jab
• https://service-manual.nhs.uk/content/a-to-z-of-nhs-health-writing#vaccine

Why

We've seen some comments on Twitter, referring to our style guide entries: https://twitter.com/dandoescontent/status/1347468114645155840?s=20 I've checked with content colleagues working on covid and flu vaccines who say that we may be moving away from our current guidance.

Anything else

• Our page about the coronavirus vaccine talks about "giving the vaccine as an injection into your upper arm": https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/
• We more commonly say "give the vaccine" or "you will have the vaccine" and are moving away from the term "jab". It doesn't appear in our flu vaccine content or covid vaccine content.

[sarawilcox]

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[claelliott]

A couple of comments from the NHSD content team on vaccine vs. jab:

vaccine - preferred for. though I know we talk about flu jabs (but that feels more established language). Think it might be useful to leave jab/"injection" to contextual use in body copy in terms of the first and second doses (if at all)

I would say 'vaccine' rather than jab. On the NHS.UK site they use 'vaccine' and explain that it's given by injection.

[sarawilcox]

Proposed changes to our entry for jab - from the vaccine team:

Jab​

We avoid "jab". We prefer "vaccine" for the dose people get in their vaccination.​

For example: COVID-19 vaccine, 6‑in‑1 vaccine and HPV vaccine. Or “injection” if it’s a substance or medicine injected.​

"'Jab" may make people who are scared of needles more anxious.​

With vaccines, we say "you will have the vaccine as an injection in [part of the body].​

The exception is “the flu jab in pregnancy" as that is the top search term for that content.​

​To be discussed at January Style Council meeting.

[sarawilcox]

Proposed changes to our entry for vaccine - from the vaccine team:

Vaccine​

We use "vaccine" for the dose people get in their vaccination. For example: COVID-19 vaccine, 6‑in‑1 vaccine and HPV vaccine.​

The exception is “the flu jab in pregnancy" as that is top search term for that content.​

For the coronavirus vaccination programme, we say "the COVID-19 vaccine" and "your coronavirus vaccination".

For the annual flu vaccination programme, we use the term "flu vaccine" as that covers children and adults. We use "flu vaccine" for children, because the child vaccine is a spray.

To be discussed at January Style Council meeting.

[sarawilcox]

At January Style Council meeting

Content designers working on vaccine content put forward proposals for changes to the A to Z entries for jab and vaccine. Details in the comments above..

At the Style Council meeting, people felt that we should hold this issue back and look for more evidence. For example:

• "jab” seems to be the word people are hearing - what does our SEO data say?
• some people weren't sure it was the word "jab" that put people off - people are worried about the vaccine anyway
• using "jab" might mean that people are directed to good NHS content – we shouldn't just leave "jab" to the anti-vaxxers

However, it might depend on what kind of vaccine it was.

We agreed to hold this issue over to the next meeting.

[sarawilcox]

Since the meeting

Gail has shared some data from 111 online. They see a lot of feedback about “jab”, more so than “vaccine”. They see flu, tetanus, rabies, mmr and baby jabs and now covid jab. They also get significant numbers of “vaccination” (esp among the over-60s).

Mark has sent through analytics for NHS vaccination content that suggest that “vaccine” is far more common in search than “jab”. “Flu jab” is the only one where “jab” is more common than “vaccine”. Note though that our content doesn’t use “jab” at the moment, so won’t always pick up those searches.

In terms of covid content on NHS.UK, “jab” doesn’t feature at all in search terms. The only mentions of “jab” are outside the top 50 terms. "Covid vaccine” is high on the list.

Google Trends suggests that, overall, “vaccination” is more common a search term than “jab”.

Jean will contact the PHE immunisation team for any user insights.

[sarawilcox]

Our vaccine team content designers are currently thinking:

• "flu jab" - for the adult flu vaccine
• "coronavirus vaccination"
• coronavirus (COVID-19) vaccine and then COVID-19 vaccine from then onwards

Because it’s a vaccination against coronavirus but the vaccine is specifically for COVID-19.

[sarawilcox]

I've checked the NHS website Google search data and internal website search data. In the last 3 months, in Google search, "covid vaccine" outstrips "coronavirus vaccine" by around 2:1. For internal website search, we see more "covid vaccine" than "coronavirus vaccine".

[sarawilcox]

GDS is revising their coronavirus content style guide. We sent over the following recommendation, based on the insight we'd seen.

"We use "coronavirus vaccination" (for the process or programme) but say "coronavirus (COVID-19) vaccine" (for the product or dose) with "COVID-19 vaccine" after first mention.

It would be good to see more user insight in relation to using "jab". From the NHS point of view, when we look at Google searches for our content and compare "jab" and "vaccine", "jab" doesn't feature in the top 50 terms, except where people are searching for the adult "flu jab". People are searching for "vaccine" or "vaccination". The same with our internal site search. We don't see ourselves using "jab" in vaccine content on NHS.UK. The key thing for us is to increase uptake of the vaccine among people who are vaccine hesitant and we've seen some (limited) evidence that "jab" may be seen as aggressive or off-putting.

Our preference is to stick with "vaccine" but we recognise that "jab" may be used elsewhere."

We have also had some feedback from PHE. They are very clear that we shouldn't use the word "jab". Their work has shown that the word puts off a lot of groups, people with a learning disability, needle phobic people and others. "Vaccine" and "vaccination" are clearer and avoid connections to intravenous drug use, blood tests etc. I've sent this information to GDS too.

GDS is now proposing the following entry in their style guide:

Vaccination Use ‘coronavirus vaccination’ when referring to the vaccination process or programme.

Vaccine Use ‘coronavirus (COVID-19) vaccine’ on the first mention then use ‘COVID-19 vaccine’.

For example, a user would get the coronavirus (COVID-19) vaccine as part of the coronavirus vaccination programme.

[sarawilcox]

I've drafted some slides based on the above for March Style Council meeting and sent them to Laura, Gerard and Jean for comment.

[sarawilcox]

We brought a proposal to the January meeting but took away some questions for further research:

• analytics and SEO research
• how off-putting the word “jab” is
• whether we should use "jab" to point people to trusted NHS content

In the March meeting, people were broadly in agreement with the proposed changes (see presentation slides) around the COVID-19 and other vaccines, but suggested that content designers working on vaccine content review the following:

• are we confident that we should be making an exception for “flu jab” in pregnancy?
• is “flu jab” the most popular term for the flu vaccine (in adults)?
• should we push to use “flu vaccine” in rather than “flu jab” (in adults)?

Hoping to bring this back to the next Style Council meeting.

[sarawilcox]

Note - for next Style Council meeting

In our current entry for "vaccination", we say: "People become 'immune' after vaccination." Someone mentioned at the last Style Council meeting that this may not be true with the COVID vaccine. We recommend taking that line out.

[sarawilcox]

New proposals drafted for Style Council meeting on 11 May, drafted with help from Gerard, @Jean-Elg and Laura.

Jab

We use "vaccine", not "jab", for the dose people get in their vaccination.​

For example: ​

• 6‑in‑1 vaccine​
• coronavirus (COVID-19) vaccine ​
• HPV vaccine​

It's OK to use “injection” if a substance or medicine is injected.​

Research shows that "jab" can make people who are scared of needles more anxious.​

If "jab" is a popular search term for your content (for example "flu jab"), call it the "flu vaccine" but add "sometimes called the flu jab". Do this in the body content and the meta description.

Vaccination

We use "vaccination" for the process or national programme (not "immunisation programme"). For example:​

• NHS vaccination schedule​
• flu vaccination programme​
• coronavirus (COVID-19) vaccination programme​

Most people search for "vaccination", not "immunisation".​

"Vaccination" includes injections and oral or nasal spray.

Vaccine

We use "vaccine" for the dose people get as part of a vaccination programme. ​

For example: ​

• the 6‑in‑1 vaccine​
• the HPV vaccine​
• you will have the vaccine as an injection in [part of the body]​

Use "coronavirus (COVID-19) vaccine" on the first mention, then use "COVID-19 vaccine". ​

Use "coronavirus (COVID-19) vaccination" for the vaccination process or programme, then COVID-19 vaccination. ​

Example: someone would get the coronavirus (COVID-19) vaccine as part of the COVID-19 vaccination programme.​

For the annual flu vaccination programme, use the term "flu vaccine". The child vaccine is a spray, so "flu vaccine" covers children and adults. ​

We do not use "jab" [link].

To be discussed at Tuesday's meeting.

[sarawilcox]

All of the above was agreed at May Style Council meeting, except that we agreed to remove the last line to align it with the new entry on jab. Instead we will say: “See also the entry on jab”.

[sarawilcox]

Approved and published.

[sarawilcox]

Add "booster" to the style guide when the NBS content is signed off. Putting this back into "In progress" for now.

[sarawilcox]

From the National Booking Service team: Here's a few notes about the SEO/user research that led to us using 'booster' over other options that were proposed such as 'maintenance dose' or 'third dose':

• ‘Booster’ is the most popular searched-for query in relation to a maintenance dose of the covid vaccine.
• ‘Booster vaccine’ is the most popular pairing of keywords, followed by ‘booster jab’.
• Users are also using ‘3rd / third vaccine’, ‘third jab’ and ‘third dose’ – although this is not as searched for as ‘booster’. Users do not search for ‘maintenance vaccine’ or similar. (important to note that the 'booster' will not always be a user's third dose - for example if they had the Janssen vaccine or potentially teenagers who are only receiving one dose right now).

Based on user testing, the term 'booster' resonated with participants and was used naturally when speaking about an additional dose.

[sarawilcox]

See Oxford Languages Word of the Year 2021: https://languages.oup.com/word-of-the-year/2021/

But, from NHS website analytics, we know there are a lot of other terms related to vaccine that have been used in the last 12 months and while "vax" is used a lot more, it’s not a term that stands out in our search analytics data. We’re more likely to see someone searching for “jab” in relation to getting vaccinated.

Out of the 19 million searches on the NHS website since January, vaccine and vaccination have both appeared in 1st or 2nd place for searches. We’ve had a very high success rate of people clicking through to the content. Covid vaccination gets an 82% click through rate for example.

[sarawilcox]

Proposal re booster for December Style Council meeting:

Booster​

Booster - a dose of a vaccine that increases or renews the effect of a vaccine you had earlier.​

Explain in more detail the 1st time you mention it, for example "a booster dose of the coronavirus (COVID-19) vaccine. Then you can refer to it as a "booster" or "booster dose".

[sarawilcox]

From notes of December Style Council meeting

@rhiannonsmith presented the proposal and said that we talk about booster doses across a number of NHS website pages. Analytics and user research supports use of the term “booster”. With the help of Torchbox, we identified that the most common search terms are “booster” or “COVID booster”. The National Booking Service and COVID content team have done user research and found that people are comfortable with “booster” and understand what it means. (Rhiannon clarified that, on a COVID heavy page, once you’ve mentioned “COVID booster” the first time, it should be OK to just use “booster”.)

Proposal above approved. Next step clinical approval before we publish.

[sarawilcox]

Published: https://service-manual.nhs.uk/content/a-to-z-of-nhs-health-writing#booster