Childhood vaccinations can be stressful for both kids and their parents. The sight of a needle, the anticipation of a shot and the fear of pain can turn a routine vaccine appointment into an emotional experience for the whole family. For some children, that fear can linger long after the appointment is over—and may make future medical visits more difficult.
But vaccinations don’t have to be frightening or unnecessarily painful, according to a revised set of medical guidelines. Researchers say a few simple, evidence-based strategies can help reduce children’s fear and discomfort before, during and after a shot.
The updated recommendations offer parents, caregivers and health care providers practical ways to make vaccination a more comfortable experience. Strategies include using distraction, offering physical comfort, applying numbing medication and, when appropriate, choosing faster or less invasive ways to administer certain vaccines.
The findings were published Sept. 21 in the Canadian Medical Association Journal.
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Needle fear is common among children and adults. Researchers estimate that it affects 33% to 63% of children and 14% to 63% of adults.
That fear can have consequences beyond a single uncomfortable appointment. Researchers say needle fear contributes to vaccine hesitancy or refusal in about one in 10 people, making it important to address the emotional and physical discomfort associated with vaccination.
“Fear and pain — together referred to as distress — are among the most common negative effects of vaccine injections,” lead researcher Anna Taddio, a professor at the University of Toronto, said in a news release. “Research shows there are effective ways to reduce distress, but these strategies are still not routinely built into vaccination programs or practices, even though clinical guidelines recommend them.”
The updated guidance builds on a 2015 guideline and offers a framework called the “5Ps” to help make vaccinations less stressful.
The framework focuses on five areas that can help reduce fear and pain during vaccination.
Process: Parents and health care providers can talk with children about what to expect and discuss ways to tailor the vaccination experience to their individual needs. Giving children age-appropriate information and allowing them to ask questions may help make the experience feel more predictable and manageable.
Procedural: When appropriate, health care providers can use faster or less invasive methods to reduce the potential for pain. This can include rapid injection techniques or nasal vaccines when those options are available.
Physical: Physical comfort can be especially helpful for infants and young children. Breastfeeding or using a pacifier can help comfort infants before their shots. Oral immunizations may also be an option for certain vaccines.
Pharmacologic: Topical numbing medications can be used to help reduce the pain associated with a needle. The guidelines recommend considering these medications for patients who may benefit from them.
Psychological: Distraction can help take a child’s attention away from the needle. Toys, singing, games, music, phones or other age-appropriate activities can give children something else to focus on during the vaccination.
While health care providers play an important role, parents and caregivers can also help children feel more comfortable before and during their appointments.
Depending on a child’s age and personality, that might mean bringing a favorite toy, playing a familiar song, using a phone or tablet for distraction, or simply providing reassurance and physical comfort. Parents can also talk with their child’s health care provider ahead of time about strategies that may help reduce pain or anxiety.
The goal isn’t necessarily to make a vaccination completely painless or eliminate every fear. Instead, the researchers say the focus should be on reducing distress and helping children develop more positive experiences with health care.
“The guideline provides new research-based tools and practical strategies to help health system leaders, health care providers, people receiving vaccines and those supporting them improve the vaccination experience,” Taddio said.
The Canadian recommendations overlap with guidance from other countries, including the United States, on ways to minimize needle-related pain in children.
That focus may be particularly important as health care providers continue working to improve confidence in routine vaccination. Taddio noted that vaccine confidence has declined since the COVID-19 pandemic, while vaccination rates have remained low among both children and adults.
“Since the COVID-19 pandemic, confidence in vaccines has declined, and vaccination rates have been low among both adults and children,” Taddio said. “This makes the updated guidance especially timely for vaccine providers and organizations looking to follow best practices to make vaccination a more positive experience for everyone.”
For parents, one of the biggest takeaways is that fear and discomfort don’t simply have to be accepted as part of getting a shot. Simple steps—from distraction and physical comfort to talking with a provider about pain-relief options—may help children get through the experience with less distress.
Creating a calmer vaccination experience can also help children feel more comfortable with future medical care. A child who learns that adults will listen to their concerns, explain what is happening and help them manage discomfort may be better prepared to approach future health care experiences with greater confidence.
If your child is anxious about an upcoming vaccination, talk with their health care provider before the appointment about age-appropriate ways to reduce fear and pain. A little preparation can go a long way toward making the next shot easier for everyone.
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