Vaccine hesitancy comes in all flavors. It’s not always concerns about safety that causes children, teens, and parents to hesitate or even refuse vaccines. Sometimes it’s about pain. Or simply discomfort. Or anxiety. It’s perfectly natural, of course, to have a fear of needles. It’s rare that a child enjoys the pain of an injection (although those kids, even at young ages, are out there).
Sometimes the fear and anxiety of needles really can manifest itself as a sincere phobia. In those cases, the fear is so overwhelming that it changes family decision-making around vaccinations and leaves children unprotected. It can torture parents when they have to scoop their kids up from under the chair. And parents get embarrassed when their child/teen becomes combative with shots. Sometimes they avoid coming back to clinic simply to avoid the conflict. Makes sense in a hectic world.
However recently in clinic I took care of a teen soon after she’d had a terrible experience with Influenza (the “flu”) and it’s changed how I care for my patients. She was an asthmatic, high school student. Because of her asthma, her doctor had recommended a flu shot. Even though doctors recommend flu shots for all children between 6 months of age and 18 years, we work very hard to get high-risk patients protected. Children and teens with asthma are more likely to have a severe pneumonia after contracting Influenza. We worry about children who wheeze and have asthma (even mild asthma) because it can land them in the hospital and/or can cause a life-threatening illness.
Most parents with asthmatic children get flu shots yearly, early in the season. But not all.
When I saw the girl in clinic she was exhausted and stressed, confused and scared. Through the course of her Influenza illness she had missed 2 weeks of school and lost over 15 pounds. She was still coughing a few weeks later. I looked back to the chart note visit prior to her infection where her pediatrician had recommended the flu shot. “She’d declined,” it said.
“Why?” I asked.
She stated that she was terrified of needles. Because of her persistent asthma, she wasn’t allowed to get the nasal-spray flu vaccination (wheezing is a contraindication) so the shot was her only option. “Had you told the doctor your reason for saying ‘No?'” I asked. “Yup,” she said. But no plan of action was made to support her.
So here’s the thing, we know that fear and anxiety about injections worsens when a parent is scared, too. When I asked her mom if she was scared, she nodded. Often, the declination for vaccination prolongs if parents are scared of the injection. Again, it makes sense. But after the experience of the illness, she and her mom were very motivated to figure out how to get the shot next year.
During the injection, parental demeanor clearly affects the child’s pain behaviors. Excessive parental reassurance, criticism, or apology seems to increase distress, whereas humor and distraction tend to decrease distress.
Tips To Support Your Child When Fear Of Needles Arises
- Don’t make promises for “no shots” any time going to the clinic. You never know what plan will be recommended and what shots you’ve missed. If you make and break that promise, trust is broken. Don’t joke about the doctor or nurse giving a shot as punishment either. NO SINGLE shot is ever given to make a child uncomfortable–don’t create that myth as it sets your child up to believe the doctor may harm them.
- Fear of needles is real. Validate your child when they state they are terrified. And then talk directly with the clinician about ways to support your child during the shots.
- Consider using an anti-anxiety medication (something like Ativan, Valium, or Xanax) when true needle phobia is present. I’ve worked with a pediatric psychiatrist for numerous patients in my clinic to develop a plan for anxiolysis (breaking anxiety) to support them getting recommended care.
- Consider using a numbing cream (something like EMLA or vapocoolant spray) to numb the skin prior to the vaccination. You’ll need a prescription from your clinician to do so but often the cream provides a bit of comfort, a sense of control, and boosts confidence for anxious or fearful children/teens.
- Consider deep breathing and other behavioral modifications including distraction at the time of injections to support your child. Consider seeing a behavioral health clinician as well.
- Consider the “cough trick.” I offer the cough trick to all of my patients and teens nervous about shots. Studies (and reports from my patients) confirm it works brilliantly!
Meagan says
The flu shot ended up being a mild form of aversion therapy for me. I have asthma, so I got th shot unwillingly from age 11, then reluctantly starting in college thanks to free shots in the student center, and by the time I was in grad school, I was actually careful to seek them out each year. A few years ago I felt ok enough about needles to start allergy shots, then got pregnant shortly after and had to deal with insanely frequent blood draws. (Anything in the vein is THE WORST for me.) I still need to look away with needles (even when it’s my son or the freaking cat getting the shot) but there’s just not the same level of anxiety.
Faith gardner says
I am like that to and I just can’t help it every time I see a needle I freak out because I know it hurts I start breathing heavily and i want to run out of the room but I know I need it so I sit their freaking out after it is done I’m fine
Joanna Galuszka says
I experienced this with my infant, and I ended up requesting lidocaine cream. It seemed to help. I wrote about it here: https://www.nscottsdalelifestyle.com/2012/04/28/valley-mom-searches-for-ways-to-reduce-needle-stick-pain/
Caroline says
There is a way to reduce pain that is drug free as well. I work for a company that makes a device called Buzzy. Buzzy is a reusable device that combines vibration and an ice pack to confuse nerves and block needle pain. Research has proven Buzzy to reduce needle pain up to 80%. Buzzy has helped a lot of people reduce pain and needle phobia both children and adults.
Here is our website for more information, https://www.buzzy4shots.com/
jane doe says
As a parent, I treated the vaccination office visit just like any other visit and found that if I didn’t freak out, the kids didn’t. Having tylenol on board helped as well. As a parent AND a RN, I want to throttle the parents who use the “shot” as a threat.
Joanne Faller says
There is a kinder, gentle way to receive an injection. I work for a company called Pharmajet and we manufacture and sell a needle-free injector. You don’t have to endure the stree, anxiety and fear of a needle anymore! Next time you visit your doctor let them know you would like your shot needle-free!
Karen Crisalli Winter says
We have a standard that “poke day is party day” at our house. On “poke days”, they don’t have to do their chores, they got to go out to eat, and they get free movie time. As a result, my kids literally hop up and down in delight when they hear we’ve got a vaccination coming up. They flip coins over who gets to go first. It’s a holiday. While they certainly acknowledge that needles hurt, they’re so focused on the upcoming holiday that the pain is not a source of anxiety for them.
I should probably mention that we did a delayed and spaced out vaccination schedule. They get one shot at a time. For most of my kids’ vaccinations, they were old enough to understand what we were doing and why. They can now give a detailed explanation of what they’re vaccinated against, why, and a comparison of how different vaccines feel. It’s not something that’s being done *to* them. They have given their full and enthusiastic consent.
Mark says
Do they not realize that it’s not just the pain of the needle, it’s everything leading up to the shot, the anxiety of getting the shot, sitting down waiting for the doctor to give you the shot , it’s a phobia that will last into there adulthood, I’m a Blackbelt in karate and can handle pain , I have a fear of needles and don’t give a d… Who knows it.
linda says
we have a 14 yr old autistic grandson, he has a bad phobia of needles, he needs his vaccinations to go to 8th grade he throw tantrums, throws himself on the gloor and kicks….we dont know what to do.he starts school in 3 weeks….please help….
A Warren says
Autism is a totally different beast from just pure needle phobia. What would work for me with severe needle phobia still wouldn’t work for your autistic grandson. Do you have some autism resources? He’ll need some autism support for many other issues anyway… 🙂
Sydney says
I can’t handle needles even hearing about them makes me want to throw up or sometimes blackout, i need 4 to attend school and my mum wants me to get them but i can’t do it i may fill out a form to not get them. They just make me sick. I understand the reason for them and have looked into alternativesbut i wont do it. Ive already postponed it for 2 years. The 1 time i got up the nerve to go after crying all night my doctor told me they couldnt give me them so i went home and i can’t even go to the doctors because i think my parents are tricking me into shots. I can’t focus on anything until i know i wont get them its terrible.my parents want me to go into therapy or something but i know that wont help me.
Sarah says
A few months ago I had surgery to have a tumour removed, it went successful but now they have to test me very often to check up and want me to start taking needles at home 6 days a week. I always stress and have panic stacks just when hearing about needles but I find that if you ask the nurse/doctor for freezing cream it really helps. You can still feel the needle but it at least takes away most of the pain.
Mina Edinburgh says
I really appreciate it when you suggested the use of anti-anxiety medication on the person if we can see that they really are terrified of shots. My brother has been afraid of needles since he was younger, and he never really got over it. Now that his job requires him to have interventional injections, I can see that his struggle is real. Maybe it will be good to suggest using anti-anxiety meds on him to calm him down.
Dino Violante says
It helped me when you suggested validating the fear of the child and speaking with the clinician for various ways to support her during the shot so that she doesn’t get scared. That idea just might work, to be honest, because my daughter can be distracted easily. I will speak with the clinician about her fear as she will have her flu shot next month.
Nathan says
I have a 15 year old friend. I like her so I like to help her in any way I can. She is absolutely terrified of injections. She gets nervous with bloodraws but she is still ok. When she needs to be vaccinated she she will do anything in her power to stall. I walk home with her everyday and when she needs to be vaccinated she either walks slower or asks to go the long way to try to miss her appointment. Sometimes I don’t catch her but sometimes I find out what she’s up to and try to get her to her house on time for her parents to take her to the doctors. One time I picked her up and carried her home and even then she would not stop fighting me. After that she did not talk to me for days. How can I help her without forcing her?
Janelle Wynn says
I’m 30 yrs old & have had needle phobia all my life. I think it’s because I have Autism & with that comes very sensitive skin. To me, a tiny pinprick feels like a stab with a steak knife. My mother used to have to pin me down to get me to get vaccinations, but now, it would take 5 of her to keep me pinned & that’s real traumatic. I was once given Valium prior to a medical procedure that involved an injection. but it didn’t work, I saw the needle & flipped out. My needle phobia is so bad that I refuse to get a flu shot. everyone says getting a shot is no big deal, they should try getting poked with sensitive skin like mine. ONE shot & they will be EXTREMELY sympathetic with me, I guarantee it!!!!!!!!!!!!! If they would make needle phobia a legal disability, medical insurance companies would have to allow doctors to give people with that disability the gas before giving them injections, & I think that would benefit those with needle phobias like mine.
Maria says
Janelle i have needle phobia ,i’m 37 i faint & lose conscious for 3min i really wish to have a therapy program that make us overcome this fear
Janelle Wynn says
I just wish they’d make needle phobia like mine a legal disability. then, the insurance company would have to pay for us to be knocked out via gas before having labs involving needles done. It’s HELL having this needle phobia. (2 weeks ago, I went to the ER for massive right abdomen pain, & I have a family history of gallstones. they kept saying I’d have to have bloodwork done. EVERY time they said “Bloodwork”, my stomach became a giant ice cube & I’d bet cash money that I blanched & was sweating bullets.) {They didn’t do any bloodwork, just a CT scan. found I just had constipation.}