What Do I Do If My Child is Afraid of Shots?

Shots are a real pain for everyone.  Unfortunately some of us have an intense reaction, called a vasovagal response, to receiving vaccinations and pass out at the sight (or the mere thought) of a syringe and needle.  Heart rate and blood pressure tank.  Blood flow to the brain tanks.  And thud, fainting occurs and there’s a call for smelling salts.  (But I think those are only used in black-and-white movies…)

My son is deathly afraid of his vaccinations.  He doesn’t go vasovagal, though.  I  hate to say it, but I kinda wish he did.  Because he is an otherwise 100-pound, very determined and combative target.  He needed three vaccines at his 11-year-old well check (HPV, meningococcal meningitis, tetanus booster) and he went out of his mind.  The anticipation of getting poked with not one, but three needles sent him into a panic attack of near-epic proportions.  Thankfully, my husband handled that one because I’m not sure I could; our son his almost as big as I am.  But a few months later, when he needed the second HPV vaccine, it was up to me to pull our son off the ledge (and back into the exam room).

As we sat (nearly a half hour) waiting for The Moment, our son became more and more agitated with each knock on the door.  First, the assistant came in to take his temperature.  Next, the physician assistant came in to provide counsel.  Then…it seemed like an eternity before the nurse came in with the actual shot.  Or eternity plus infinity for my freaked-out son.

Of course his polar-opposite twin brother couldn’t be more unaffected by the whole deal; getting a shot is like having an itch he can’t help but scratch.

And I felt so helpless.  I hugged him.  I reassured I’d hold him close when it was time for the shot.  Yes, I promised a milkshake afterwards (the Sonic drive-in is next door…I’m sure that’s no coincidence).  But no words or even a mother’s touch could calm my panicked son.  As I’m sitting with him, silently cursing the very process I advocate for good health, I’m mentally editing a short protocol of how I want this to go next time, so we can avoid this “needle”-less torture but keep my son’s vaccines updated:

~I phone in my son’s temperature to the pediatricians’ office before we leave for the appointment.

~The required consultation with the practitioner is also done over the phone.

~I drive my son to the pediatric clinic.

~After we arrive, I call pediatrics from the parking lot to say we are on our way up.  This signals the needle-wielding assistant to get ready.

~We take the elevator, and waiting for us just outside the sliding doors is the “armed” assistant and perhaps another (remember, my son is 100 pounds).

~The elevator doors open, my son steps out, and the aide(s) jump him.

~Before he knows what hit him, my son has had his shot.

No horrible anticipation in an exam room.  No needless torture.  Just bam, done.

Now I know my plan can’t happen.  The process is what it is and for good reasons.  So what can we actually do to help our frightened kids through the process of getting shots?

Sources give some great “do’s” and “don’ts.”  Or some “don’ts” and “do’s.”  (I’m feeling like bucking the system today…)

Don’t discuss the upcoming vaccinations.  That is, unless your child asks that all-too-common-pre-doctor-visit question Am I getting shots today?  Then answer truthfully.  Keep in mind it’s ok to say you don’t know if you really don’t; but do say “yes,” especially if the office visit is specifically for a vaccine…kids will remember (they always do!) if you said otherwise.  Trust in you is very important when it comes to your child getting shots.  (However, some kids, like my son, hate the the idea of shots being sprung on him:  he wants me to tell him well in advance if he has a shot coming.)

Don’t say “don’t worry” to your child.  Because he will.  (I know I would.)

Don’t say “It’s OK.”  This phrase just rolls off the tongue.  We say it often, in many situations, and it’s human to want to ease tension and anxiety and we do so with these two simple words.  But avoid saying “It’s OK.”  Because, to a child, it isn’t OK.  Instead, reflect her feelings and say something like, “I know you’re worried about getting shots but I promise I’ll be right there (say only if you will be present) and we’ll get a treat afterward.  What would be a fun reward?”

Don’t say “It won’t hurt a bit.”  Because it does, especially if your child is nervous!  Instead say, “It won’t hurt very long.”

And definitely:

Don’t delay vaccines to avoid the multiple “sticks” and their accompanying discomfort.  And as a mom, it’s emotionally painful to witness your toddler receiving several shots at one visit (a reaction I honestly didn’t expect!).  But don’t put off vaccines to temporarily sidestep your or your child’s pain.  Most childhood vaccines are given before a child reaches the age of two and won’t remember getting the shots.  Thank goodness for that.

 

And the “do’s:”

Do try this at home.  Play doctor with your little ones.  Give and receive pretend shots.  When you are on the receiving end, remind your child that everyone, even Mom and Dad, needs shots to stay healthy.

And try this at home, too.  Or better yet, at the doctor’s office.  Try an over-the-counter, topical numbing cream on the injection site before your child receives her vaccine.  Aspercreme is one common brand which contains the numbing agent lidocaine.  However, it may not be appropriate for young children, so read the label carefully before using.  Orajel and Ambesol are two topical gels (that also come in creams) many parents are already familiar with, and used for pain with teething.  Both contain benzocaine and may be more appropriate for your child before getting a shot.  One word of note:  do not use Bengay on children…it contains a chemical similar to that in aspirin (methyl salicylate) and can be toxic to little ones.

As always, ask your child’s doctor before using a topical numbing agent.   Or ask at the doctor’s office what they use for numbing the injection site.  Most have an appropriate numbing cream, a cold “spray” or “Buzzy,” a device that vibrates and fools the nerve endings in the skin around the area where the shot is given, therefore lessening the pain of the shot itself.

Of note:  avoid giving Tylenol (acetominophen) to your child prior to her receiving a vaccination.  There is concern that this pain reliever may reduce the effectiveness of the vaccine.  Does this potential problem extend to ibuprofen-containing products?  Unfortunately, no one knows for sure.  So stay with the topicals before vaccines are given.

Do create a distraction.  Read a favorite book.  Sing, sing a song.  (tap dance?)  Have your child go Zen and simply take deep breathes or even cough…both can lessen pain from getting shots.  Provide your cell phone to play with.  I know my kids are so engrossed by technology they’d miss fireworks going off outside the exam room door.

Do consider a contract.  This may work for an older child.  Have him write out a contract to himself describing how he will get through the experience of getting a shot.  For example:  “I’ll use deep breathing to keep me calm while waiting in the exam room and I’ll play Flow Free on my mom’s phone while the nurse gives me my shot.”  Have him include how he felt after his last vaccine, if appropriate:  “I learned last time that the shot wasn’t so bad, and I promise to remind myself of that tomorrow.”  The power of a written plan, and the gravity of signing his contract can give an older child ownership of his fears and a sense of control.  

Do give a reward.  A sugar rush is our go-to after getting through another doctor’s visit for shots.  (I’ll have mine with bourbon, please…).  But maybe yours is a movie, or an outing to the park (remember that movement after a shot can keep the arm muscles from tightening up and becoming sore.)  No matter what you chose to do with your brave child, give an immediate reward right on the exam table:  a hug, a smile, a big “Good job, you were so brave!”

And above all,

Do be honest with your child.  Trust is so very important in all aspects of parenting and kids have long memories for fibs and white lies, especially when it comes to the pain of getting shots.  And, this is tough for kids to reconcile as shots are painful, but remind your child that getting shots is not a punishment.  You may have to revisit this idea and provide a simple explanation like shots keep us from getting sick.  I’ve even told my son my own personal fears about getting shots.  A favorite of his is that I still, after many years, still get a nervous stomach when we drive passed the landmarks near my pediatrician’s office.

 

No one likes shots.  Even adults.  Even those of us who don’t get an intense emotional or physical reaction.  But we can get through the process with a few easy strategies.  A new strategy of my son’s is his need to flee after his shot is given.  (If it’s fight or flight, I’m happy he choses the latter, and he does it after his vaccine.)  Last time, the bandaid was barely in place when he announced

I’m outta here!

And he bolted from the exam room and into the waiting area.  It was a little funny, actually.  He needed to get away and he did.

Go for it, kiddo.  Just watch out for small children.

[Sources:  WebMD, parents.com, Kidshealth.org]