It's looking to be an anxiety-ridden month for kiddos with a fear of needles: not only are they due for the latest flu vaccine, but with last week's news that the Food and Drug Administration has authorized Pfizer's COVID vaccine for children as young as five years old [1], there's a good chance parents are working overtime to prep their little ones for more than one pesky arm poke.
"Nearly all kids have some level of anxiety about shots, especially if their prior experience with shots was stressful," Dr. Natasha Burgert, a board-certified pediatrician based in Kansas [2], told POPSUGAR.
"Directly addressing their shot anxiety now has the power to improve your child's health care over their lifetime."
Although she said that in her experience, toddlers and preschoolers often have less stress because their memories of shots aren't as deep as those of an older child, Dr. Burgert acknowledges that the issue is both real and treatable — but can lead to a lifelong aversion. "Fostering a calm, positive relationship around shots is so important in young children. For people with needle phobia, the anxiety around getting an injection biologically heightens the pain response. This chemical reaction increases the immediate pain sensation the person experiences in the short-term, while priming long-term memory for additional fear response. This cycle can repeat over time, potentially worsening the fear and anxiety as a person ages."
Not only that, but shot anxiety is a marker for future vaccine hesitancy, Dr. Burgert noted. "Directly addressing it now has the power to improve your child's health care over their lifetime."
For her part, Dr. Burgert keeps many pain-reducing options — like ethyl chloride spray, numbing cream, and Shot Blocker — in her office and walks her patients through their pain-mitigation choices to see which they'd like to try. However, there's far more that parents can do to prepare their child for their next shot:
- Never promise there will be no shots. "It can lead to false reassurance and can threaten parental trust," Dr. Burgert said. "Kids need to know the adults around them will be honest."
- Don't underscore the pain factor. Instead of dismissing their fears or telling them it won't hurt when it very well might, she suggests a different talking point. "I like to say: 'Getting a shot can hurt a little, but it's helping your body get stronger. Any pain you feel will go away quickly. I'll be here to hold your hand, if you like. Or, you can sit at the exam table by yourself. Which would you like to do?'"
- Never use a shot as a threat. "There are few phrases more frustrating to a pediatrician than parents who say, 'If you don't behave, the doctor is going to give you a shot,'" Dr. Burgert said. It happens more than you'd expect, and this statement simply encourages your child to associate shots with punishment. "Plus, associating any medical intervention as a consequence of behaviour sets kids up for mistrust of the medical system."
- Be careful not to belabor the point. Sometimes parents try so hard to sympathize with their child that they do more harm than good. "Apologising about a vaccine and expressing excessive reassurance and empathy increases anticipatory fear," Dr. Burgert said. "When parents talk too much about the shots, kids get more worried and fearful than if fewer words were spoken. So, keep it short and sweet. 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."
- Get your shots with kids in tow. If children see a parent successfully get a shot, that helps to break down the negative association. "I encourage parents to get vaccines with their kids, acknowledging the pain of the injection and the calming technique used to get past the discomfort. For example: 'Ouch, that hurt. But, I can take a few deep breaths to calm my body and now I feel better. I'm safe and I feel OK. Now, let's go get ice cream.'"
Above all, Dr. Burgert said to remember that you know your family best. "Some children do better in the office when they know a shot may be coming," she said. "If they need preparation time, briefly discuss the possibility of a shot beforehand. However, if the knowledge of an upcoming vaccine increases your child's worry, save the conversation until after arriving at the office."
When it comes to the COVID vaccine, Dr. Burgert thinks many parents will be pleasantly surprised at their child's eagerness to get the jab considering how the pandemic has affected their lives — from school closures to cancelled gatherings and delays in sports and clubs — for so long. "I've never seen so many kids eager and willing to roll up their sleeves," she said. "I hear, 'I hate shots, Dr. Natasha. But I was excited to get this one.'"