Ask! How to take the sting out of shots

This week, Dr. Steiner talks about how to make vaccinations easier on everyone.

Hello readers! This is the season of buying school clothes, new crayons and pencils and taking those last few trips to the pool. For kids, it’s also a big vaccination time, as the state-required vaccines for 4- to 6-year-olds and the required vaccines prior to sixth grade both are often given last minute as school is getting ready to start. Of course, we are also fighting hard to stop the annual influenza epidemic among children by spreading influenza vaccinations, and that starts in September also.

Kids, and some adults, dread getting "shots." Most of the pain with shots is due to anticipation and anxiety. As we know, vaccines themselves hurt much less than blood draws or other needle-related things (dental work, etc...). For that reason, parents can really help to make vaccines easier and less traumatic. Generally there is no need to discuss vaccinations with children prior to them occurring during the visits. There are some children who will do better with planning for them, but in my experience, most situations work out better when the shot happens quickly and even unexpectedly. Parents should not lie to their children about vaccines, that doesn’t help anyone. If children ask about vaccines, parents should answer honestly but also help to decrease anxiety about them. Finally, parents should not threaten children with vaccines or shots. You’d be surprised how many parents use being in a doctor’s office as a chance to leverage their children's fear by saying "If you don't come here, I'm going to have the doctor give you some shots." That doesn't help anyone.

Your physician and nurses can decrease the pain associated with vaccination by allowing smaller children to sit in a parent's lap during vaccination, and infants do best if breastfeeding during vaccination or using sweetened pacifiers. Needles should stay hidden in a medical jacket or behind the back until the moment they are given. Older children should be seated initially, though lay them down immediately if they start feeling lightheaded. Some children respond well to a distraction, and having a child cough right as the needle is inserted may work to lessen discomfort. Topical anesthetics or cold sprays can be used to lower the actual vaccination pain, but they can worsen the situation if they just make things take longer, increasing pre-immunization anxiety.

There is good news: most children over age 2 can avoid getting a shot for the influenza vaccination now that a nasal spray vaccine is available. This is really important because it is estimated that about 10% of children get the flu every year, and we have children die from the flu in the Triangle most years. Flu vaccine is created specially every year, so it is difficult to stay current, but it’s still very very important to get one every single year.

Vaccines have been one of the miracles of modern medicine. Many of the most common infectious killers of children in the 1940s through 1970s have essentially disappeared from the map of illness in this country. We can extend this further by assuring that parents are as fervent about the newer vaccines for meningococcal meningitis, pertussis in older children, HPV and  varicella as they were before, when measles and polio were the big concerns.

Enjoy the school year. Preventing and avoiding infections is much easier than treating them.