From the Mouth of Babes: Getting Vaccinated Doesn’t Have to Hurt

Abstract

BACKGROUND:Analgesic interventions are not commonly administered during childhood vaccination, despite the fact that two-thirds of children are afraid of needles and one-tenth are noncompliant with immunization.OBJECTIVE:To explore children’s experiences of vaccination and preferences for analgesia.METHODS:A total of 17 children (four to 14 years of age) at an independent school in Toronto (Ontario) participated in three focus-group interviews. The majority had previous experience with pain management interventions during vaccination. Thematic content analysis was used to analyze interview transcripts.RESULTS:The findings were categorized into three main themes: experience of vaccination; roles and responsibilities regarding pain management; and impact of pain management. Children easily recalled previous vaccinations and discussed fear and distress experienced by themselves and others. Children believed that parents and immunizers should prepare them ahead of time and use interventions to manage and monitor pain. They also wanted adults to support their efforts to lead pain management. Children discussed benefits of managing pain, including reduced unnecessary suffering, improved vaccination experience, reduced risk of developing needle fears and reduced noncompliant behaviours. They were knowledgeable about strategies for reducing pain including distraction, topical anesthetics and injection techniques. They contrasted vaccination with and without pain management, and indicated a preference for pain management.CONCLUSION:Children reported that managing vaccination pain is important and that analgesic interventions should routinely be used. Incorporating pain management in the process of vaccination has the potential to improve children’s experiences with vaccination and promote more positive attitudes and behaviours.

Reducing pain during vaccine injections: clinical practice guideline

“…The majority of children are afraid of needles and report a preference for analgesics to be used. 2,18 Because topical anesthetics incur additional time and costs, their use requires some planning. In many cases, they can be accommodated in usual clinic waiting times.…”

Exposure-based Interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research

“…We are confident that children, their parents, as well as adults suffering from high levels of needle fear value a reduction in their fear (Taddio, Ilersich, Ilersich, & Wells, 2014 ; Taddio et al, 2012 ). In fact, this recognition was a major factor in determining the strength of our strong recommendations.…”

HELPinKids&Adults Knowledge Synthesis of the Management of Vaccination Pain and High Levels of Needle Fear

“…It is likely that aspects of the environment or setting influence ones experience (eg, consider a 10-y-old boy who is vaccinated in a private, calm room in comparison to being vaccinated in a gymnasium where he is surrounded by staring peers and can witness his friends cry and potentially faint). Unfortunately, beyond focus groups and descriptive research, 19 – 28 no trials were identified that systematically studied relevant environmental factors such as: privacy, presence of peers, ventilation, use of separate entrances and exits to the vaccination area, and concealing distress-provoking items. Consideration of setting and situational factors in future research is important, perhaps particularly for school-based vaccination.…”