Preparing children for immunisations:

While a lot of parents have been anxiously waiting for the additional protections for their 5-12 years old children of a COVID-19 vaccination, there are also a lot of children (and parents!) with some level of anxiety about needles. Needle phobia can be a significant and debilitating problem for children and adults and may need additional intervention from specialised services such as a play therapist or psychologists. For most children however here are some strategies to help prepare and prevent the development of future fears of needles – which is important given we are expecting at least another covid-19 immunisation in the near future for them.

Calm Preparation: Life masks first parents! – first make sure that you have some strategies to remain calm and in control. Perhaps you already use some mindfulness or deep breathing exercises with your children. If not, it is never too late to teach your children some self-calming strategies which will assist them in a range of situations – Depending on the age of your child the following may be helpful:

Simple deep breathing: – breathe in for 3, hold for 1 and breathe out for 3. Do this at least 3 times but as long as you need to.
The additional input of touch can help distract and calm – for example drawing a butterfly on your hand while you breathe in for one wing and out for the other. Or use your hand to breathe up and down each finger slowly
Using a visual image or imagined place to focus on while you’re breathing. For young children parents can help by talking through and describing the place or suggesting some of their child’s favourite things.
Practicing tensing and relaxing before hand can help your child understand the different sensations which will make it easier for them to relax their arm at the time.

Distraction: Prepare some activities that will help distract your child – these can be useful while waiting as well as during the immunisation – depending on the age of your child music, a game like I spy, a toy or a video can be helpful. A clever nurse once suggested to me that a those tightly wrapped lollipops make the best distraction because they take so long to open! Nurses will also often suggest wiggling toes or squeezing a hand or preferred toy as focussing on another part of the body helps distract from the injection.

Talking to your child about immunisations:
Be honest about what’s happening but don’t make a big deal about it. Treat it like a normal experience (a normal trip to the doctor, something that everyone is doing) (This might be where you regret all that complaining about your own sore arm like I did!)
Avoid words like ‘’jab’’ and ‘’needle’’ it might be more helpful to say ‘’immunisation’’ or ‘’arm medicine’’ (depending on age).
Don’t say that it won’t hurt – but there’s no need to mention that it will unless your child specifically asks and then try to keep it specific ‘’it might feel like a pinch’’

Consider how much warning to give your child: – this will depend both on your child’s age and development but also their anxiety levels – if your child is young or an over thinker then giving them limited notice may work better, most children won’t need more than a days notice.
Also consider how much information your child needs – some children will have no questions; some children will have multiple and repeated questions about where/what/when/how – answer these questions simply and honestly but if your child is asking a lot of questions you might like to try distracting them with other things. The Royal Children Hospital have a child’s guide to immunisation – rch.org.au/be-positive/A_childs_guide_to_hospital/Immunisation_Clinic/

Avoid speaking negatively about immunisations or giving sympathy: – Often we can inadvertently suggest that there is something to worry about by reassuring our children. Telling children ‘’it won’t hurt much’’(‘’what is much?’’) or ‘’you need to be brave’’ for example can trigger your children to start thinking ‘’there’s something scary if I need to be brave!’’. Often our own fear of needles impacts on how we think our children will feel about them.

Minimise discussions with others in front of the child: – this might mean preparing ahead with the immunisation clinic if you know that your child is particularly fearful

Routine with a reward: putting the immunisation into your normal routine with a fun and desirable activity afterwards can be helpful in keeping your child’s focus on what’s coming next.

Choice and control: – giving your child some choice and control about what is happening can help – for example they may like to do a countdown to the injection, choose which arm, where they want to sit, who should go with them, or whether they want to look or not.

Rested and ready: – We are all at our best when we our primary needs are met – make sure your child is well rested, has eaten and is hydrated. Think about limiting sugar or extra activity before hand (though some children may benefit from the extra activity before!)

Alternatives: – You know your child best – if you think they aren’t going to cope well then think about ways that you can minimise the stress for them – for example arranging the immunisation with your GP clinic rather than bulk immunisation centres so there are less people around. Numbing cream is an option to the injection site that can be helpful for some people, particularly if there is already a fear about how much it might hurt – speak to your pharmacist for further information. If your child has a disability, you can also contact the Geelong Disability Liaison Office on 0434 856 014 for assistance about supporting your child’s vaccination such as alternative locations, additional support and social stories.
If you have a fear of needles, or you are worried about how you will cope helping your child then don’t be afraid to ask a trusted family member or friend to take them.
Marnie Holden
Paediatric Clinical Psychologist

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