Helping your kid get through the vaccination process

  • Children Premium
  • Wednesday, 10 Nov 2021

Offer your kids choices during the vaccination process, e.g. whether or not they would like to hold your hand, or to look away or observe the needle going in. — Bloomberg

An estimated 28 million children in the United States are now eligible for a Covid-19 vaccine.

This comes following the recent US Food and Drug Administration’s (FDA) authorisation of the Pfizer/BioNTech shot for kids aged five to 11, and the US Centers for Disease Control and Prevention’s (CDC) recommendation of the same.

The annual flu shot (tailored for the Northern Hemisphere) is recommended for everyone six months and older around this time of the year as well, according to the US CDC.

This is in addition to a variety of immunisations given throughout childhood to protect against potentially life-threatening illnesses.

While getting a shot can be nerve-wracking for many kids, as well as their parents and caregivers, medical experts say certain strategies and coping mechanisms can minimise a child’s anxiety and pain.

Applying some of these techniques can improve the vaccination experience in the moment, as well as arm children with long-term skills to help them handle difficult or scary medical procedures throughout life, said University of Chicago Medicine child life and family education director Jennie Ott.

“It’s very anxiety-provoking, but there’s so much parents can feel empowered to do,” she said.

“We’re really setting a long-term foundation for children’s experiences with healthcare encounters.”

Here are 12 tips on how adults can help calm a child and ease their pain during vaccinations.

1. Make a plan

Talk ahead of time about the upcoming immunisation, relay what the child can expect during the appointment, and allow them to ask questions, Ott said.

Going over various coping strategies beforehand can also help prepare children and give them a greater sense of autonomy, she added.

“What I would encourage parents to do is work with their child to come up with a plan,” she said.

“Talking to them about their vaccine is going to be a critical piece in this.”

That might mean deciding to bring comforting or distracting items, like a favourite television show on a tablet, soothing music, a security blanket, a favourite stuffed animal or a stress ball.

2. Offer choices

This could include decisions about which comfort items to bring to the appointment and if the child would like to squeeze your hand or count during the injection.

Kids might also have a preference of looking away during the shot or watching the process.

Sometimes, adults are inclined to automatically tell children to look away, but for some kids this can spur “a huge sense of loss of control”, Ott said.

Children can also make decisions about how they’d like to be positioned during the shot.

This can range from sitting in a parent’s lap to holding a caregiver’s hand to being embraced.

Experts stress that these choices should be realistic, e.g. refusing to get the vaccine altogether isn’t an option.

3. Don’t lie

This can erode trust between the caregiver and child.

Experts say to avoid statements like “you’re not getting a vaccine today” or “you won’t feel it at all”.

“We always talk about making sure we’re truthful with children,” Ott said.

4. Apply numbing agents

Topical anaesthetics like lidocaine creams or cold sprays can be applied to the skin at the injection site prior to the shot to reduce pain, said pain specialist Dr Diana Bottari.

She says haemorrhoid cream can also work to numb the area.

But Dr Bottari added that the decision to use a numbing agent can depend on the child’s preference.

For example, some kids might dislike the sensation of cold from a spray.

5. Use pain-minimising devices

There’s the ShotBlocker, a small plastic disc with prickly bumps on one side that’s pressed against the skin during the shot, which confuses the body’s nerves and distracts from the injection.

Dr Bottari added that scratching the skin near the injection site – like on the child’s shoulder – can have a similar effect.

There’s also Buzzy vibrating cold packs – devices shaped like ladybugs or bees that use cold and vibration to reduce pain during vaccinations.

6. Validate the child’s feelings

Avoid statements like “it’s just a shot” or telling kids not to cry.

Medical experts say nervousness is a natural reaction to needles and injections, and adults can acknowledge discomfort from the vaccine.

“We say all the time: Feelings are for feeling, not for fixing,” said Ann & Robert H. Lurie Children’s Hospital in Chicago’s certified child life specialist Becca Mitsos.

“Crying is okay. It’s communication. It’s okay to share how you feel.”

Reaffirm that you’ll be there for your child during the injection and that you’ll get through it together, she said.

“Making it clear that they’re not going to have to go through it alone is important for kids of any age,” Mitsos said.

Ott added that praising a child afterward with statements like “you did it” or “I’m so proud of you for doing it” can also help.

“That verbal praise at the end is huge,” she said.

7. Adults, stay calm

Shots can make parents and guardians nervous too.

Ott advised grown-ups to try to keep their own anxiety in check, because it can exacerbate the emotions of their children.

“A lot of children pick up on parental anxiety,” she said.

“We encourage parents to be as calm as they can and really be that sense of support for their child.”

8. Get the jab first

Sometimes, getting the vaccine at the start of a visit helps.

If the shot is part of longer appointment with a medical provider, asking the clinician to perform the vaccination first might minimise a buildup of anxiety during the visit, Dr Bottari said.

9. Blow bubbles

Taking slow, deep breaths can be calming, as opposed to the shallow, fast breathing often spurred by anxiety.

Dr Bottari suggested bringing bubble solution to the appointment and having the child blow bubbles during the injection.

This not only serves as another method of distraction, but also to facilitate deep breathing.

10. Feed your baby

While research on Covid-19 vaccines for children under the age of five years is still underway and little kids aren’t expected to be eligible in the near future, infants get various immunisations at birth and certain milestones, and babies six months and older should get the annual flu shot, according to the US CDC.

Dr Bottari recommends nursing or bottle-feeding infants before and during vaccinations.

When infants suck, their bodies release calming endorphins that reduce pain, she said.

Another strategy is to give the baby a pacifier dipped in sugar water – a solution of one teaspoon of white sugar mixed with two teaspoons of distilled water, she said.

She added that babies and children should be held in a comforting manner, but never held down or overpowered.

Minimising pain and anxiety during infant vaccinations can be critical because it sets the stage for future encounters with needles and injections, according to Dr Bottari.

“It’s really important to start when they’re babies because that needle fear does start when they’re very young,” she said.

11. Therapy can help

Most kids – and even many adults – dislike getting shots and experience heightened anxiety during immunisations.

But some actually suffer from needle phobia – a persistent and deep-seated fear of medical procedures involving needles or injections that goes beyond the typical unease.

For those cases, psychologists can provide exposure therapy, which helps patients conquer their fears through incrementally-difficult exposures to needles, injections and other situations that induce the phobia, according to the American Psychological Association.

12. Prepare for potential side effects

Following the Covid-19 vaccine, some patients report soreness at the injection site, as well as short-term fatigue, fever, chills and other side effects.

Mitsos encourages parents and kids to plan ahead for these possible side effects.

That might mean asking children if they’d prefer applying heat or cold to a sore arm, or asking what movies or books they’d like if they feel sick for a little while during the aftermath.

Packing a bag in advance with stuffed animals, books or other activities can help too, she said.

“There’s research about how if you have an awareness of what might be uncomfortable, your perceived discomfort is lower if you’re prepared for it,” she said.

“The perception of pain or discomfort is significantly lessened when you’re prepared for that pain or discomfort.” – By Angie Leventis Lourgos/Chicago Tribune/Tribune News Service

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