Language, trust, and the polio endgame: words matter in vaccine communication

Vaccine hesitancy remains a major public health challenge, particularly in the post-COVID-19 era, and is exacerbated by misinformation and social distrust. Terminology used in scientific and public health communication may influence perceptions of vaccine safety and credibility. This Position Paper examines the use of the term 'vaccine-derived poliovirus' (VDPV) and its potential impact on vaccine confidence during the final phase of polio eradication.

We reviewed published epidemiological, virological, and social science literature on circulating VDPV, vaccine hesitancy, and health communication. Institutional guidance from the WHO and the Global Polio Eradication Initiative was also examined. Evidence from qualitative studies exploring community perceptions of the term 'vaccine-derived poliovirus' was considered alongside broader literature on risk communication.

We examine the scientific basis and epidemiology of oral poliovirus vaccine use and circulating VDPV emergence, the evolving landscape of vaccine hesitancy, communication challenges surrounding the term VDPV, historical precedents in vaccine communication, the role of disinformation, and the potential risks and benefits of revising established terminology. We recommend that stakeholders formally evaluate the implications of current nomenclature, consider alternative terms and dual-layer communication strategies that distinguish technical from public-facing language, and ensure that any modification of terminology is accompanied by transparent justification.