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My 13yo daughter can no longer handle injections, and has missed 2 vaccinations. She wants to have them and willingly goes to the appointment, but once there totally freaks out and is unable to get even close to a successful jab. She sits there panicky and just repeating "can't can't can't".

How do we help her get over this? Rational argument isn't working because her rational brain isn't in control here.

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  • What specifically is she afraid of? The physical pain of the sting? The chemicals in the shot? Only the Covid vaccine ?
    – Hilmar
    Nov 4, 2021 at 11:17

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I am reluctant to suggest what follows, but given the importance of vaccines and the fact that they can be life saving (I can attest to witnessing this myself), I would do all in my power to make sure she gets the vaccine. Since it is an irrational fear that prevents this, you're right that reasoning with her won't help.

Ask her physician to help her overcome her fear pharmacologically to a degree that she can get the shot. IOW, ask for a prescription for a short-acting anxiolytic you can give her when you leave the house to go to the office. If you are reluctant to give an oral medication, you can ask for a topical anesthetic to apply to the area where the shot will be given, but they must be applied for a long time before becoming effective, and sensitization through skin contact - IOW, development of an allergy - is more common than with oral or IV administration. *

I think many people will object to this, as drugs aren't the answer to every little thing, and I agree. But consider that many adults self-medicate with alcohol/other when anxious.

What are some non-pharmacological interventions people use to overcome fears?

  • Desensitization therapy. I can't imagine how this intervention would work with injections, though it can be extremely helpful with fear of flying, driving, and other fears that interfere with life goals. However, it is outlined here.

  • Cognitive Behavior Therapy. Breathing exercises really do work during labor to make the pain more tolerable. If one can focus on a prescribed breathing ritual (something more complicated that "Take a deep breath"), one will focus less on the moment of the jab.

  • Relaxation therapy (as above)

  • Giving the patient some degree of control. I used to do this a lot with kids who were fearful of exams/other. I would make a bargain with them that if they let me examine, say, their ears with an otoscope, I would allow them to hold the wrist of the hand holding the otoscope, and they could pull it away the moment it became too uncomfortable. It would happen occasionally that they pulled my hand away, but mostly not. Once that had been overcome, the rest of the exam was much smoother. Control of an injection could be the patient saying "Now!" when they felt ready. The problem with this is time. Most doctors/nurses don't have the time it takes any more to allow this.

  • Distraction with other stimulus. There are tricks to minimize the pain of an injection. A common one among nurses is to pinch (not too hard) a part of the arm at a trigger point so the patient feels the pinch more than the needle. Similarly, other stimuli include pressure, buzzing, and ice. (A Buzzy Bee uses both buzzing and "ice".)

Good luck, this is a non-trivial problem with a solution. I hope you find it!

*One objection to this approach is that it might create the idea that all anxieties could be treated with meds. Obviously, this would be a bad idea, and some of the other techniques are useful with any anxiety. I had an irrational fear of flying in my 20s. I would fly anyway, but would be panicky the entire flight. (I remember one time during some minor turbulence wondering why everyone else was so calm when it was so obvious to me that we were about to crash!) Once I became aware of anxiolytics, I would take one before every flight. After a few years of doing this, my fear is gone. It was similar to exposure therapy 'with an enhancement'.

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  • Thanks, lots of good ideas. I can say that topical anesthetic has been tried without any help - she's not afraid of the pain, it's the concept of something penetrating her that freaks her out, I think.
    – user42016
    Nov 3, 2021 at 18:01
  • That's helpful to know. Some of these methods will not help, then, and others (like desensitization and talk therapy/CBT) might actually work better. But it's definitely a recognized phobia.
    – anongoodnurse
    Nov 3, 2021 at 20:38
  • Sometimes it's possible to give an injection without the person even noticing, by distracting them enough. That's assuming you have a clear indication that the person wants the injection.
    – gnasher729
    Nov 4, 2021 at 11:01
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    I've spoken with two people who were successfully ambushed this way; both fainted immediately after when they realized what had happened. The first hit the floor hard and was understandably furious and quit her doctor. The second was fine with it, but she had been sitting at the time and the nurse caught her before she fell off the table. Nov 4, 2021 at 17:31
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    A solid +1 for distraction: our needle-phobic 13yo got through her shots due to 1) an extremely patient pharmacist willing to hang out for the 15-20 mins it took for her to come to terms with the needle and 2) reading the Dr. Bronner's label as a distraction. Possibly the use of a cellphone to watch videos/listen to music could help your kiddo soldier through. And no, living through the first shot didn't make the second one easier on ours. Nov 4, 2021 at 20:40

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