The power of words during a pandemic

Understanding phrases related to immunisation is important in the age of Covid

So this year’s Oxford Languages’ 2021 Word of the Year is “vax”. No surprise really that a pandemic-related word would top the poll. The use of “vax” – a word that first appeared in the 1980s – surged dramatically, occurring more than 72
times as frequently in September than a year earlier.

“All the other vaccine words increased, but nothing like ‘vax’,” says Fiona McPherson, a senior editor for new
words at Oxford Languages, which publishes the Oxford English Dictionary (OED). “It’s a short, punchy, attention-grabbing word. And, speaking as a lexicographer, it’s also quite a productive one,” she continues. “You see
it used in all sorts of combinations to make new words.”

According to the OED, the word “vaccine” was first recorded in English in 1799, following the British scientist Edward Jenner’s experiments with inoculation against smallpox. And although the shortened form “vax” did not appear until the 1980s, the term “anti-vax” – spelled “anti-vacks” – reared its head not long after Jenner’s discovery. “The anti-vacks are assailing me… with all the force they can muster in the newspapers,” Jenner wrote in an 1812 letter. In a trend toward “expressive doubling”, the OED notes an extra ‘x’ has crept into some of the vax-related neologisms (such as “vaxxie”) that have become common.

Katherine Wu, science writer at the Atlantic wrote recently about how the novel coronavirus has prompted a huge shift in the way we talk with one another, and about one another. It has resulted in a good deal of linguistic “leakage”, she says. Language that was hitherto confined to medical wards and research labs has suddenly appeared in everyday discourse.

And a less than smooth transmission has caused some confusion and misunderstanding. Take the word “asymptomatic”, which scientists use to denote infections that never make people sick. However, many who start off their infection symptomless might not stay that way, and until someone is fully over coronavirus infection, it’s impossible to say whether they were truly asymptomatic or presymptomatic.

Then there is “quarantine”. “Two years into our run with Covid, that’s still one of the terms we most commonly mess up,” Wu writes. “Correctly used, ‘quarantine’ describes the period of time when people who think they’ve been exposed to SARS-CoV-2 are supposed to cloister themselves.” However, if you know you are infected thanks to a positive PCR test, then you’re heading into isolation, not quarantine.

(Interestingly, the term “quarantine” has been in use since the time when ships arriving from plague-stricken countries were cordoned off for 40 days before docking – hence the ‘quar’ part of the word.) “Natural immunity” is another foster-phrase; long before the pandemic started, scientists used it to describe the protection left behind after an infection by a bona fide pathogen. But, Wu says, in the age of Covid, the phrase has become weaponised into a false binary: If infection-induced immunity is natural, does that mean that immunity obtained through different means must be unnatural – artificial, undesirable, a dangerous hoax, or even, for some people, a moral failure?

“But that dichotomy is scientifically nonexistent”, she asserts. “Inoculations are designed to mimic the microbes that cause infections, and often end up tickling pretty similar responses out of immune cells. The main difference is that vaccines deliver their defensive lessons safely, without risking disease.”

The false binary has led scientists to use terms such as “infection-acquired” and “vaccine-acquired immunity”. They have even started using another phrase –”hybrid immunity” – to refer to the heightened protection that’s afforded when people with a prior SARS-CoV-2 infection get vaccinated.

For those who are afraid of the ‘unknown’ technology of Covid vaccines, Wu offers the following: “Vaccines leverage and build on our inborn defences, in much the same way that glasses can enhance vision and good running shoes can speed up a person’s pace. They’re not an indictment of the immune system and its numerous powers, but a tribute to them.”

It’s a point worth remembering for us healthcare professionals. I have no doubt the confusion around Covid-19 terminology has fed into the hands of the anti-vaxxers. It gives them ammunition with which to influence vaccine hesitators, who are genuinely trying to deal with real anxieties around the novel vaccines. But if we can influence the everyday language around immunisation and create reassuring images in patients’ minds, we can move it from a lexicographically interesting aside to an effective weapon in our public health armoury