Afraid of needles?

This article is about how to have less fear and pain when getting an injection, so I decided to be kind and use a photo of a different kind of needle... not to further upset anyone! A friend told me that just seeing news reports about COVID upset her because they so often showed needles being given... she was terrified of needles and couldn't watch, even on TV.

And she's not alone. Twenty five percent of people report being afraid of getting an injection and 5 to 10% are reported to actually refuse injections because of needle phobias. But with a deadly disease like COVID-19, we need to have as many people vaccinated as possible to stop the spread of the virus. An ideal scenario would be to have enough people immunized to make the virus extinct, as was done with polio. Perhaps we were so successful with it because they developed an oral form of the vaccine. Remember the drops on the sugar cube? Nothing to fear there!

But, until they find a way to present the COVID vaccine as a sweet treat, we need to remove all barriers we possibly can to getting immunized.

When I started giving injections, I worried about causing pain… I didn’t want to hurt anyone! I knew there had to be something in the administration technique that reduced pain, as some flu shots I’d had in the past were completely painless while others had quite a sting, so I read everything I could about reducing needle pain. I learned there are lots of things both you and the injector can do that help.

This year, after seeing some dubious injection technique in TV news reports, I wrote an article about how injectors can drastically reduce the pain of an injection, making the needle itself almost (or in some cases, completely) painless. Our national pharmacy journal ran my article 3 times, and it was published on an American nurse practitioner website too! I hope the information is helping to lessen the pain of immunization for some people. Injections really can be pain-free—I can honestly say I didn’t feel the needle at all at my second COVID shot. It's all about technique and that nurse was very good! 😊

So, if you're afraid of needles, read on...

Pain-free injections

Some key actions for injectors to take to reduce injection pain are to let the alcohol dry, make sure the needle goes into the belly of the muscle (not too shallow, and not too high or low on the arm), put a little pressure on the skin near the injection site (so your brain will register pressure not pain), insert and remove the needle quickly (avoids pain, just like a quick paper cut is often painless), and put pressure on the injection site (with a cotton ball) immediately afterward. It also helps to do something to distract the person, even if it’s just by telling them to take a deep breath.

As a patient, it’s absolutely your right to ask the person giving you an injection to let the alcohol dry before injecting, or to give the needle at a certain spot if you know where a deltoid (arm) injection is supposed to be given. You could also ask them to make it as quick as possible and offer to hold the cotton ball afterward to continue the pressure on the injection site while the injector completes records and prepares a bandage. If you’re an injector and interested in reading the article I wrote, here’s a link to the post on the Nurse Practitioners for Women’s Health website.

What you, as a patient, can do: Play the “CARD” system…

CARD is an acronym for 4 activities that reduce pain, fear, fainting and other symptoms some people experience when getting an injection or before and after. It stands for Comfort, Ask, Relax and Distract. The system was scientifically tested in schools in Niagra, Ontario, and was found to reduce fear of needles by almost half. The system is easily adapted to work in most settings where injections are given.

Here’s what they suggest:

Comfort—Wear short sleeves so it’s easy to expose the injection site. Bring a snack: eating something can keep you busy and distracted.

Ask—If you’re worried about anything, for example side effects, don’t hesitate to ask. The person giving the injection usually knows the answers to most questions about injections or can easily find the answer for you. Did you know there is a numbing cream/patch you can use? Ask about this before you go if you think it will help (It is available at most pharmacies and has to be applied to the injection site an hour before the injection. Make sure you know exactly where to apply it.). Should you look at the needle or look away? Do you want to be told just before it’s given, or would you rather not know? Tell the injector for your preference.

Relax—If the muscle that is being injected is contracted or tense, the needle is more likely to hurt. Make sure your arm is completely limp and relaxed. Although it’s more difficult right now with COVID restrictions, having a friend accompany you can help you feel more confident and relaxed. Make your appointment at the same time as a friend or family member so you can boost each other’s confidence while waiting. Take a deep belly breath just as the needle is being given to help you to relax. This works as a distraction too (discussed next).

Distract—Distraction can actually reduce the pain you feel. I used to let younger children play a drawing game on my iPad to distract them (especially effective when iPads were new!). After the injection (when they didn’t like me anymore), I would ask if they’d like me to send their drawing to Mommy or Daddy’s computer… that almost always made me a cool person again and distracted them from what just happened! But even chatting with the injector can also help you relax. Tell them your worries—there’s often something extra they can do to help resolve your fears, or just talk about the weather to distract yourself. One elderly gentleman that I gave a flu shot to insisted that I hadn’t given him his injection—he had been busy chatting with an attractive assistant and didn’t even notice when I gave him his needle! It only took me about 2 seconds to give the actual injection, so it was easy to miss, I guess…

In addition to addressing the pain of injections, the CARD system also considers the stress that many people experience when getting an immunization. And it’s not just children and adolescents… adults fear injections too. It’s time for us all to improve injection experiences by working together to make them easier, more comfortable and more pleasant.

Click here to learn more things you can do to squelch your fear of needles… CARD for adults: https://immunize.ca/card-adults