Vaccination is mostly done in infants and in childhood stages. However today, some vaccines (such as influenza, yellow fever) are delivered in the adult population too.
Vaccinations or immunizations are the most common procedures taken during childhood to prevent serious diseases that cause mortality. According to the Center for Disease Control and Prevention, 17 life-threatening diseases can be prevented if vaccinations are taken. In order to adhere to the recommended vaccination schedule, children receive vaccines at an average of 18–24 injections till 2 years of age. The vaccine schedules are intense. According to the given specific schedule, these vaccinations protect against Hepatitis B, Diphtheria, Tetanus, Pertussis, Measles, Mumps, Rubella, Varicella, Polio, Meningitis, Pneumococcus and in some cases Hepatitis A.
The most common cause of iatrogenic medical pain is the use of needles. The pain caused during these healthcare procedures causes anxiety and distress in children and in their parents. Research has shown that pain experience has permanent changes in the nervous system that affects the future pain experience and development. Vaccine pain is one of the most common things noticed in this regard. It is observed that kids aged between 4 to 6 years, who visit healthcare providers for subsequent shots of vaccines make faces, show sadness, and throw tantrums to indicate that they do not like vaccination. Consequently, parents don’t like to see their children suffer, due to which they t end to avoid vaccination and skip medical check-ups. The unpleasant immunization experience in childhood develops fear of needles. This in turn prompts people to avoid doctors in adulthood too, which can put people at risk of contracting dreadful diseases.
How to Reduce Vaccine Pain?
Although vaccination may hurt a little, but it hurts a lot more when one suffers from diseases (if not immunized). This is evident from the patients suffering from polio who have not been vaccinated and now live a life with disability.
It is observed that vaccine pain can be easily managed with certain techniques can even be reduced to a great extent. Thus, managing immunization related pain is important to avoid future disease. A number of research studies done by Dr. Toddia and other groups revealed the techniques, which need to be employed to make vaccination a comfortable experience for the child and parent.
For different age groups (as infants, children, adolescence and adults), there are various pain relieving interventions available which doctors can provide during vaccinations. These are as follows:
Reducing Vaccine Pain in Infants (age 0-3 years):
- Giving sucrose solution
- Breast feeding after vaccination
- During injections, holding the baby (not too tight is also helpful) and talking or singing softly, provides comfort to them.
- Distracting baby by showing them some toys, noise maker can reduce pain and distress.
- Parent should remain calm, which will lead to less anxiety and distress.
- Rubbing the nearby areas can be helpful to relieve pain, since this light massage distracts the baby from the pain.
- Topical anaesthesia such as EMLA cream can reduce pain.
- Doctors can be asked for:
- Needle free devices such as those which put compressed air in to the skin.
- If combined shots of vaccines can be delivered.
Both sucrose solution and breast feeding have shown to decrease pain effects in infants significantly.
Ways to Reduce Vaccine Pain in Children (age 3-12 years):
- Parents of children till 10 years should be present with them during vaccination procedures.
- Older children should be told that they will get a prick by needle in the arm or leg. It will feel like a pinch/pressure for a few seconds. The child should not be told that it will not hurt them.
- Music can be helpful to distract the pain caused by vaccines esp. in form of a party blower. School going children can be engaged in iPads and tablets for distracting.
- Children should not be in supine (lying down) position. They must be upright.
- Children should be instructed to breathe in and out slowly.
- Application of topical anaesthesia can reduce pain.
- The child should never be scolded during vaccination.
- Both infants and children require extra care and love after they are vaccinated.
Parents should remain calm and understand that the pain with such vaccinations is transient while the protection lasts for years.
Reducing Vaccine Pain in Adolescents:
- They should be distracted by engaging them in discussions related to movies, allowed to listen to music on iPod, before and after vaccinations to relieve pain. Engaging in humorous talks will also help in decreasing the child’s stress. However, during the administration of the vaccine, one must ensure that the child is not moving.
- Topical analgesics can reduce pain.
Ways to Reduce Vaccine Pain in Adults:
- Taking deep breaths and relaxing the muscles will make vaccination less painful.
Tips to Reduce Vaccine Pain for all Ages:
- Aspiration should not be used during intramuscular injections in people of all ages.
- Intramuscular injections should be given with a rapid injection technique without aspiration as more pain is experienced during slow injections.
- The most painful vaccine should be injected at the last, it decreases the overall pain.
- The pH and brand of vaccine does matter. The less acidic vaccine causes less pain and can be administered by combining with other techniques.
- Vaccinations given for all ages should be recorded in the vaccine record.
- Adults should ask for a Vaccine Information Statement (VIS) for each vaccine to be received either for them or for their child.
- Adults must ask questions of concern i.e. if it would cause any side effects so that they can take adequate steps for prevention or for contacting the doctor.
- It has been observed that no single technique may be effective, hence a combination of techniques have to be applied. Applying these techniques may successfully reduce the pain and fear associated with vaccination.
Things to Avoid after Vaccination
Thing to Avoid after Vaccination in case of Infants and Children:
- One should not leave the hospital immediately after vaccination. Instead should wait for at least half an hour to check if any reactions have developed.
- Parents should not panic if they observe swelling, redness and a small hard lump at the site of injection in their infants. These symptoms go away within a couple of days and nothing needs to be done for them.
- Baby should be left alone and should be comforted when they get upset after vaccinations.
- Fever in babies after vaccination should not be ignored. Acetaminophen or ibuprofen may be used for relief.
- The child should be encouraged to move the limb/arm after vaccination. It might be a bit painful initially; however, the movement enhances the working of the muscle where the injection is administered and thus helps in better absorption of the medicine which will help in reducing the discomfort and vaccine pain faster.
- Children below 16 years of age should never be given Aspirin.
Things to Avoid after Vaccination in case of Adults:
- Adults should not engage in drinking alcohol at least till 48 hours after vaccination.
- Some medicines are never to be taken after vaccinations, since they can react with the vaccine and give rise to deleterious side effects. Hence, it is advised to discuss with the physician to check which medicines to avoid after the vaccination.
- Some vaccines make a person dizzy; hence, one should avoid activities such as driving, operating machines until felt better.
However, if something is of concern then one should consult the doctor immediately.
Vaccines are indispensable for our life. Vaccine protects us from various deadly diseases and prevents illness, disability and allows us to live a healthy, disease free life. There are constant researches going on to invent different vaccines for preventing various diseases. It is implied that in future, the number of vaccines to be delivered will keep on increasing. Thus the vaccination schedules during childhood will also increase. The pain caused during this vaccination has psychological harmful effects like fear, anxiety and stress and people fear to visit doctors. Vaccinations are most painful experiences in infant and childhood stages due to which many parents have a tendency to skip the vaccination schedule as they can’t see their child in pain which is risky for future. Hence, for successful vaccination, pain needs to be managed by applying the earlier mentioned and newly researched techniques to comply with the vaccination schedule and reduce pain and discomfort.