Needle phobia? Research shows we can reduce children’s vaccination fears

Taking a young child for vaccinations? It’s often a parent’s worst nightmare, replete with tears, tantrums, and distress guaranteed as many children struggle with anxiety at the sight of a needle.

Negative experiences in childhood can develop into a fear of needles, which can have devastating consequences later in life such as vaccine hesitancy in adulthood — a threat to public health, especially in times of crisis such as outbreaks of preventable diseases.

But new research by the University of South Australia suggests that fear of needles can be addressed early for children when nurses spend additional time supporting them during the vaccination process.

Working with children aged eight to 12, the study tested two new nurse-led techniques during annual flu inoculations.

Published in the European Journal of Pain, researchers contend that even though enhanced nurse training is needed to apply these techniques effectively, “preliminary clinical results appear promising, particularly for reducing needle-related fear”.

They did this using a divided attention game, whereby children’s attention and expectations are drawn away from the needle.

The second technique was positive memory reframing, where a child’s exaggerations about the distress and discomfort of needles are redressed through discussion about positive elements of the experience, so they form more realistic memories of the event.

Preliminary findings showed that while the two interventions did not reduce pain, they were effective in reducing the fear of needles.

Lead researcher Dr Felicity Braithwaite at the Pain and Perception Lab, University of South Australia, said helping children reduce fear and distress around vaccinations was a critical research priority given the Covid-19 pandemic and need for mass global vaccination uptake.

“For many children, undergoing a needle procedure can be painful and distressing. Negative experiences of vaccinations in childhood can often lead to medical avoidance and vaccine hesitancy into adulthood, which can have devastating consequences when it comes to outbreaks of preventable diseases.”

By investing more time into techniques to help children manage their fears about needles, we hope to change these outcomes and deliver better health outcomes for the next generation.

—  Dr Felicity Braithwaite, researcher 

“By investing more time into techniques to help children manage their fears about needles, we hope to change these outcomes and deliver better health outcomes for the next generation,” she said.

The study involved 41 children and their parents, with participants randomly allocated to one of four groups — usual care, divided attention, positive memory reframing, or a combination of the latter two interventions.

Clinical outcomes were assessed at baseline, immediately after vaccination and at two weeks post-vaccination.

The divided attention technique involved a one to two minute distraction game where a nurse tapped the child’s arm above and below the vaccination spot in a random order, with the child focusing attention on guessing which spot was touched each time. The game takes advantage of the potential analgesic effects of distraction.

The positive memory reframing technique involved talking to children about a past injection and emphasising positive aspects, such as how brave the child was and praising specific strategies they used to reduce distress such as deep breathing and looking away. The aim of this technique is to foster a sense of self-efficacy to help children cope better.

Both strategies were tested in non-clinical settings such as schools to maximise the potential of broad vaccination programmes that deliver minimal distress for children.

Researchers said the preliminary findings also provide exciting potential for the application of these interventions to other needle contexts, such as intravenous procedures like drawing blood and other painful medical procedures, including cancer treatments.