How to make shots less stressful

Vaccines represent significant breakthroughs in medical research and disease prevention. When the Centers for Disease Control’s recommended immunization schedule is followed according to plan, it is shown to be the most effective and safest way to protect your child from potentially fatal diseases, according to Dr. Jasjit Singh, medical director of infection prevention and control at CHOC Children’s. However, the process of going to the pediatrician and receiving shots can be stressful, or even anxiety-producing, for young children.

A patient’s relationship with their pediatrician is important, and once you have found the right primary care doctor for your family, it can set the stage for their feelings toward medical professionals or clinical settings later in life. Studies show that preparing your children for vaccinations should ideally include three components: explaining what will happen, how it will feel, and strategies for coping with any related stress or discomfort. Follow these simple steps on how to make shots less stressful.

  • Be honest. Tell children their vaccines may be uncomfortable or bothersome for a second or two, and have them practice slowly counting to two seconds so they get a sense of how long that really is. Tell them what to expect at their appointment, and explain why the procedure is necessary and how it will help keep them healthy.
  • Use neutral language: Request that the health care providers let your child know what will happen and when, using neutral language such as “we’re ready to start,” advises Marni Nagel, a pediatric psychologist.
  • Encourage them to ask questions. Remind them that they can ask any questions they want to of their doctor or nurse.
  • Time the appointment well. For babies and toddlers, scheduling the appointment around their bottle/feeding time may help. Receiving a bottle or feeding right after the shot may help soothe your baby.
  • For infants, engaging in at least 4 of the 5 S’s has been shown to reduce distress after immunizations, says Nagel. These include swaddling, placing on the side/stomach while holding, making shushing sounds, rocking, and sucking. Sucking can be done through breastfeeding, a bottle, or pacifier. For infants, dipping their pacifier in sugar water has been shown to decrease stress associated with immunizations. You can also talk to your doctor about breastfeeding during and/or after the immunization.
  • Topical anesthetics. Ask your pediatrician if topical numbing agents may be appropriate for your child.
  • Control your reaction. Children are increasingly observant as they get older, and they will take careful note of your reaction. Remain calm and be mindful of your demeanor, and it may help send a message to your child that they need not be stressed either.
  • Distraction techniques. These will vary depending on your child’s age and interests, but could include telling stories and jokes, blowing into a pinwheel, looking at a picture book or finding a hidden picture like “Where’s Waldo,” or blowing bubbles.
  • Positive rewards or treats. Consider going out for ice cream, going on a special outing such as to the park or playground, or another small treat after your appointment to encourage good behavior, or to soothe your child.

Nasal Flu Vaccine Not Recommended This Season

An advisory committee of the Centers for Disease Control and Prevention recently recommended that the nasal spray influenza vaccine not be used this upcoming flu season. In this Q&A, Dr. Jasjit Singh, medical director of infection prevention and control at CHOC Children’s, offers an explanation.

Dr. Jasjit Singh
Dr. Jasjit Singh

Q: What does this mean for influenza vaccine recommendations for the upcoming flu season?

A: All individuals over the age of 6 months are recommended to get the influenza vaccine, and that will continue to be the case.  However, for this season at least, the nasal flu vaccine is not an option. Therefore, parents will need to plan for their children to get the flu shot this upcoming season.

Q: How does the standard flu shot differ from the nasal spray version in terms of composition and effectiveness?

A: Both the flu shot and the nasal spray contain the anticipated predominant circulating strains of influenza every year, but the nasal spray strains are made of weakened live virus while the flu shot is made of inactivated viral components. The CDC reviewed data from this past season that suggested that the nasal spray did not perform as well as it had in the past.

Q: Besides ensuring their children get a flu shot, what else can parents do to help prevent the flu?

A: In addition to ensuring their child is vaccinated against the flu every year, there are many things parents and other caregivers can do to help prevent the flu. Use proper hand-washing techniques, use respiratory etiquette, and stay home from work or school if you are sick with the flu, to prevent spreading it to others.

Q: What do you anticipate will be parents’ reactions to this recommendation? Is there anything else you’d like them to know? Is there anything else you’d like to share with parents about the importance of vaccinations?

A:  Vaccinations are one of the most effective public health measures that have been developed and they save thousands of lives each year. Influenza vaccinations are important because young children can get quite sick from the flu, and some even require hospitalization. Every year there are pediatric deaths in the U.S. due to influenza, about half of which occur in normal healthy children. Children can pass influenza on to the elderly or other fragile members of our community. It’s important for adults to get the flu shot too, particularly those who are caring for young children. Even though the nasal spray is not an option for vaccinating this particular season, it is still important to have your child vaccinated for this year.

Related articles:

OC Reports First West Nile Virus Case – What You Need to Know

An Orange County man tested positive recently for West Nile virus (WNV) infection, becoming the county’s first human WNV infection in 2015. The man has CHOC Children's Infectious Diseasenow recovered.

As of August 12, there are 36 human cases of WNV reported in California. Last year, there were 280 reported human infections of WNV and nine WNV related deaths in Orange County. The disease is recurring every year during the summer months and into the fall, according to county health officials.

For answers on how to protect your family from this virus, check out the following Q&A with Dr. Jasjit Singh, pediatric infectious disease specialist at CHOC Children’s.

Q: What is West Nile virus and who is at risk for infection?

A: West Nile virus is transmitted by the bite of an infected mosquito. Serious illness can occur in people of any age. However, most cases of human infection occur in the elderly and in those with impaired immune systems.

Q: What are the symptoms?

A: The vast majority of WNV infections (~80%) are asymptomatic. Most symptomatic patients will have fever, sometimes accompanied by other nonspecific signs such as headache, nausea, vomiting or rash. Less than 1% of infected individuals will develop a neurologic disease, such as meningitis, encephalitis (inflammation of the brain) or acute flaccid paralysis.

Q: What is the treatment?

A: No vaccine or specific antiviral treatments for West Nile virus infection are available. Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms, however. In severe cases, particularly those with neurologic involvement, patients often need to be hospitalized.

Q: How can families protect themselves from this virus?

A:

  • Eliminate standing water on your property, which can serve as a breeding area for mosquitoes.
  • Install door and window screens, to prevent mosquitoes from entering the home.
  • When possible, avoid being outdoors between dusk and dawn when mosquitoes are most active.
  • When outdoors, if possible, wear long pants and long sleeves and use an insect repellent during the summer and fall. Look for repellents containing DEET, picardin or oil of lemon eucalyptus, which often provide longer-lasting protection.

You might also like:

  • Measles outbreaks: What parents need to know
    Measles is one of the most contagious infections. To prevent the spread of measles in a community, about 95% or more of the population must be vaccinated or immune.
  • The Ugly Facts About Measles
    The United States is experiencing a record number of measles cases, with California leading the states in the number of individuals confirmed to have had the disease. While some community ...
  • Protect Your Family From Measles
    Measles has now been confirmed in ten Orange County residents, in conjunction with the recent outbreak affecting California and more than 20 other states. The Orange County Health Care Agency reminds ...