Summary of approach to inclusive language in vaccine guidance from the National Advisory Committee on Immunization (NACI).

BACKGROUND

The National Advisory Committee on Immunization (NACI) has been working to develop inclusive language for vaccine guidance related to pregnancy and breastfeeding. Starting with early efforts in 2018, NACI sought to update the language approach in 2023 based on the latest available evidence.

METHODS

Gender-neutral and gender-additive language approaches were assessed using an equity lens focused on inclusion and representation. Evidence was gathered through a jurisdictional scan of National Immunization Technical Advisory Groups (NITAGs) and government organizations, a literature review, and iterative stakeholder engagement. Draft policy options were developed, translated into French, and reviewed by NACI.

RESULTS

The jurisdictional scan across Canada, the United States, Australia, the United Kingdom, and France showed wide variation, with many sources using gendered terms. The literature review identified little original research on language use in immunization settings. A Canadian research initiative examining inclusive language supported context-specific gender-additive terminology. Stakeholders emphasized the need for inclusive and adaptable language. NACI developed recommendations for a context-dependent gender-additive approach, including French language options.

CONCLUSION

In February 2024, NACI endorsed an additive language approach, which has been implemented across NACI statements and relevant Canadian Immunization Guide chapters. NACI and the Public Health Agency of Canada will continue adapting to evolving language needs, recognizing that clinical communication should use terminology that best resonates with each individual. When implementing vaccine recommendations in clinical practice, it is important to use whatever language that will resonate best with the individual being immunized.