How To Help A Child With A Needle Phobia

If you’ve never had to hold down your writhing, screaming 5-year-old while a a nurse works at lightning speed to administer a vaccine, you can rest assured that it is a feat no parent or child wants to endure unless they absolutely have to. With a Covid-19 vaccine now approved for Emergency Use Authorization in kids ages 5 to 11, parents of kids prone to intense shot anxiety are scrambling to prep their little ones for the jab. Here’s how to help kids with a fear of shots get through the ordeal with as few tears as possible.

How Common Is A Fear Of Shots In Kids?

If your child gets especially nervous (or has a full-on meltdown) when it’s time to get a shot, they’re not alone. “At least two-thirds of children and one-fourth of adults have a fear of needles,” reports the American Academy of Pediatrics (AAP).

“Kids can be fearful about shots for a number of reasons, including a prior traumatic experience with vaccinations or other medical procedures; a caregiver's reaction/actions during shots; a developmental stage; or as a result of underlying mental health issues, like an anxiety disorder,” pediatrician Dr. Whitney Casares tells Romper

The thing is, a fear of needles in kids usually doesn’t develop until around age 5, according to pediatrician Dr. Natasha Burgert in a piece for Forbes Health. Which means that the same children in the age group who are now eligible for a Covid vaccination are the ones who could be especially prone to this type of shot anxiety.

Burgert tells Romper via email that one of the most common causes of shot anxiety in kids is anticipation. “Especially with the Covid vaccine, which is nearly painless, kids are more worried about getting the shot than the actual injection,” she says. “It's not uncommon for a child who is very anxious to say, ‘That wasn't bad at all,’ after the shot is done.”

Burgert also reported that the trauma from previous negative experiences with shots can leave kids feeling even more anxiety about any upcoming vaccines, which could lead to an intensified pain response. So, if your child has had a particularly rough go of it with earlier childhood vaccines, it’s likely that they’ll be nervous to get this one, too.

How To Prepare Kids Before The Covid-19 Vaccine

As Romper previously reported, around 1 million kids in the newly-authorized age group have already received their first dose of the Pfizer-BioNTech Covid-19 vaccine. Once you’ve scheduled your child’s appointment, one way to help prepare them for the shot is to reassure them that so many other kids have gone through the process and they have made it through just fine.

The AAP recommends choosing your words wisely when you speak to your kids who are afraid to get shots. Yes, you should be honest with your kids that it will hurt, but you can also use less abrasive terms like “pinch” or “poke” to express what’s going to happen.

It’s crucial never to lie to your kids: “If you know your child will be getting a vaccine, telling them otherwise can compromise the trust between the two of you,” warns The Cleveland Clinic.

Renee Schneider, Ph.D. is the Vice President and Head of Therapy at Brightline, a virtual behavioral health support network for families. She tells Romper that with the Covid vaccine specifically, some children may be worried about side effects or extra nervous thanks to the flurry of attention paid to this particular vaccine by peers and parents. “Many kids have heard their parents talk about or have seen their parents struggle with side effects after receiving the Covid vaccine, so it’s important to talk openly with children in a developmentally appropriate way about side effects,” Schneider says. “Yes, there may be some side effects, but if they happen at all, they’ll likely be small things, like your arm might be sore for a day. And side-effects go away pretty quickly; they don’t stick around for long.”

Some kids actually feel less nervous when they have all of the information ahead of time. If your child is like this, you can talk up the safety aspect of getting vaccinated and remind them that it’s the doctor’s job to help them stay healthy, and that this vaccine will do just that.

Burgert tells Romper that parents should keep their explanations “short and sweet” but also non-apologetic to avoid increasing fears over anticipation. “When shots are discussed, use honest language, make explanations brief, stay calm, keep a matter-of-fact attitude and don’t project a personal concern about discomfort onto the kids,” she explains.

Tips For Keeping Kids Calm During Shots

When the big day arrives, you’ll want to have a plan for how to keep your kid calm throughout the process. With the Covid-19 vaccine specifically, they’ll need to get a second dose to complete their inoculation, so it’s important to ensure that the first one goes as smoothly as possible.

• Lead by example. “Get your shots with your kids in tow,” Burgert recommends. “If they see a parent successfully get a shot, that helps to break down the association of shots with badness.”
• Keep yourself calm. “Children look to their parents or use social referencing to interpret ambiguous or unfamiliar situations,” says Schneider. “A shot isn’t an everyday occurrence and so your child will likely look to you to decide whether to be scared. If you look calm, your child may be able to stay calmer.”
• Distract them. Don’t be afraid to break out the screens for a visual distraction when it’s time for the shot to be administered. Playing a game on an iPad or watching a video can be a great way to keep their minds off of what’s happening. You can also play your child’s favorite music through a pair of headphones to help keep them calm.
• Give the clinician a heads up. For kids who are especially scared to get a shot, it can be helpful to let the nurse or doctor know that they’re nervous. They may have options for pain management available like numbing cream or spray, but a bit of reassurance from the person holding the needle can also go a long way.
• Let kids have a voice. “Above all, giving children a sense of control is the most important during shot administration,” Casares tells Romper. “This can include letting them choose their positioning, giving them options for distraction, or allowing them to pick from tools like cold spray or shot blockers to help them cope more effectively.”
• Try deep breathing. “Grounding exercises can really help relieve the physical symptoms of anxiety, which translates to a calmer experience overall,” Schneider tells Romper. “Guided imagery, deep breathing exercises, and discussions around previous vaccination experiences can be soothing when approaching a new medical situation and can be utilized in any doctor’s office or medical setting without any equipment or setup.”
• Use the “cough trick.” The Cleveland Clinic endorses the AAP’s “cough trick” as a distraction during the jab. To do this, instruct your child to cough once as a “warm up,” then to cough again when it’s time for the needle to go in, and then a third time afterward.
• Comfort them. “While your child receives the shot, use a warm and reassuring tone of voice,” Casares says. “Some kids appreciate a familiar touch — a hand on their hand, or a hand on their shoulder.” If your child is small enough and up for it, they could even sit in your lap while they get the shot. You can also let them bring their favorite stuffed animal to the appointment to squeeze and keep them company.
• Don’t use threats. No matter what your child’s reaction to shots is like, it is recommended to steer clear of threats and lean into reassurance instead.
• Use positive reinforcement. If the promise of an ice cream cone after the appointment to celebrate their bravery helps to get them through, there’s nothing wrong with using this type of treat to stave off a meltdown. As Schneider puts it, “It’s not that you are bribing your child, but rather you are giving them something to look forward to.” You can also verbally praise them for their courage from the beginning of the appointment until well after it’s over to help re-frame the situation.
• Know that you may have to try another day — and that’s OK. “There are some children who will need to be held to administer shots safely. In these instances, we involve the parents to assist in the process,” Burgert tells Romper. ‘If the child is becoming combative and is unable to be safely held, then we reschedule the shot for a different day. Meanwhile, we talk with the parents about different options for anxiety and pain reduction.”

Deep breaths. You (and your kids) have got this.

Experts:

Natasha Burgert, MD, FAAP, pediatrician in South Overland Park, KS

Whitney Casares, M.D., M.P.H., F.A.A.P., author of The Working Mom Blueprint: Winning at Parenting Without Losing Yourself

Renee Schneider, Ph.D., VP and Head of Therapy at Brightline