How to conquer the fear of needles in time for COVID-19 vaccine

Nearly 4,000 Albertans will get their first round of the Pfizer-BioNTech COVID-19 vaccine on Wednesday, and as the process picks up into 2021, many will be eagerly rolling up their sleeves to get immunized.

That eagerness, however, might not extend to everyone — those with needle fear, for instance, could already be dreading the day. 

Dr. Katie Birnie, a clinical psychologist who researches pain management, told the Calgary Eyeopener on Monday that for people who fear needles, the mere thought of getting jabbed can prompt anxiety.

And in a worst-case scenario, she said, that fear can serve as a deterrent for routine medical care.

"We know that people [with needle fear] avoid health care. They avoid situations where they need to get needles, and that can include vaccines," Birnie said. 

Luckily there are methods we can practise to make the entire experience less unpleasant — and help to wrangle needle fears to get them under control, she said.

"One of the major contributors to … needle fear is actually poor management of pain at the time of vaccination," Birnie said. "So if we can manage that pain really well, it can actually make a huge difference."

Needle fear, needle phobia

A degree of needle fear is experienced by more than 60 per cent of children, 20 to 50 per cent of adolescents, and 20 to 30 per cent of adults, according to Birnie's research.

And while "needle fear" describes a range of discomfort or anxiety, "needle phobia" represents the further end of the spectrum, and can cause panic attacks.

It often begins when we are first exposed to needles as kids — or from an experience when our pain was poorly managed, Birnie said. Seeing or hearing someone talk about needles negatively can also make us more fearful.

"The peak onset is actually kind of in that younger school-age child, and which is often a frequent time for immunization," Birnie said. "So how the COVID vaccine is unique is being a new vaccine to all of us, across the lifespan."

But needle fear and phobia can have real consequences for our health, and the health of others.

Research suggests that people who are afraid of needles are less likely to get the flu shot, or have their children vaccinated. 

This means that unless we develop needle-free vaccines, managing the pain from — and the fear of — needles is critical to the success of many of them, Birnie said.

"Those people who will report high levels of needle fear … may still go out and actually try to get vaccinated or other kinds of things," Bernie said. 

"But then there's a smaller group of about three to five per cent that really describe a significant needle phobia, and they will really, absolutely avoid needles at all costs."

Conquering the fear

So, what can we do to quell needle fear and phobia?

For starters, if your child is nervous to get a shot, try having them sit on your lap.

If you're the one rolling up your sleeve, unless you are at risk of fainting, sit upright and comfortably, she said. 

"It used to be that people would lie down, and we actually know that that's kind of a position that can actually make you feel less secure, less safe, in the context of needles," Birnie said.

Steady yourself with deep breaths, distract yourself with your phone, and turn away if watching the process makes you uncomfortable.

And if you are one who tends to feel faint, Birnie said you can try tensing your leg and stomach muscles for 10 to 15 seconds — or until your cheeks feel flush — before releasing for about 20 to 30 seconds and tensing again.

"That can help with the drop in blood pressure and heart rate changes that can happen with fainting," Birnie said.

If the pain is what worries you, an over-the-counter, topical anesthetic or numbing cream applied to the injection site beforehand can help to dull it.

"All [the] ways we know [are] from an abundance of science and even recommendations by the World Health Organization for managing vaccination pain," Birnie said.

And finally, it's helpful for everyone to just admit it is going to hurt while using neutral language, Birnie said.

"Sometimes the anticipation is the hardest part … and we recommend that we don't even pretend that it's not going to hurt at all, but just that we're realistic about it," Birnie said.

"It may hurt like a pinch or a brief period of pain, but then it goes away. And this is really important, especially with the COVID vaccine, because we need to go twice.

"So we want to make sure that we're doing a really good job managing pain throughout both, and managing fears related to that, so we ensure that people are coming back for the second one."

With files from the Calgary Eyeopener.