It is common for people to display some angst towards needles. But most people appreciate the benefits of vaccination. Having a conversation with the person and encouraging them to say why they are having the vaccination helps strengthen their commitment.
Needle phobia, or trypanophobia, is the out-of-proportion fear of needles. Needle phobia in the context of vaccination is different as the overwhelming fear leads to vaccine avoidance. Incidence estimates of needle phobia are highly variable, both because it is not a well published area and the population being studied often avoid healthcare settings.
One of the key findings from a 2018 meta-analysis, which included 119 research studies, found that an estimated one in six healthcare workers in long term care facilities and one in 13 healthcare workers in hospitals, avoided influenza vaccination due to fear of needles. This highlighted a significant cause for concern and should prompt healthcare professionals to think- what can we do about this?
Provide clear documentation explaining a person’s needle fear/phobia in clinical notes.
This is helpful for healthcare professionals to know ahead of vaccination. For example, a patient with a known needle phobia might be better contacted by phone rather than through automated appointment so they can talk through concerns and discuss mitigation strategies prior, e.g., time of day, being able to lie down, bringing a support person.
1.Muscle tension exercises
Muscle tension is a safe technique that can be used to counter feeling faint or dizzy when exposed to needles.
2. Tactile stimulation – rubbing or stroking the skin near the injection site with moderate intensity before vaccination can reduce pain at the time of injection. This can be done by the support person.
3. Topical anaesthetics, numbing creams or patches, evidence suggests these do not interfere with the immunogenicity of vaccine. These are available for use prior to vaccination by prescription or over the counter. While typically used in children it may be helpful for adult needle phobia.
4. Vibrating devices have been used to block pain and provide distraction prior to and during needles in medical procedures. The ‘Buzzy4shots’ device is one locally available example.
5. Live/in person exposure methods prior to vaccination may be helpful.
Creams or patches will dull or remove the pain of a needle entering the skin. These do need to be applied 30–60 minutes before the vaccination. Individuals can purchase numbing cream or patches from local pharmacies over the counter without prescription. They are also available by prescription to minimise costs.
The patch should be applied in a 5cm-by-5cm area on the upper arm, midline and in line with the armpit/axillar, preferably by the vaccinator (see opposite).
For a few people, allergic or local skin reactions can happen where numbing creams are applied, paleness or redness of the skin.
The images used to promote vaccination are important.