OPINION: Suggestions for how to help the majority of unvaccinated adults who fear needles

Over half of adults unvaccinated for COVID-19 fear needles – here's what's proven to help Though many adults report a fear of needles, most research on needle fear has focused on children. FG Trade/E+ via Getty ImagesIf you’re among the 25% of Americans averse to needles, you’re probably not surprised by the COVID-19 immunization stall. Even for those who want immunity, bribes with beer or lottery tickets may not be enough to override anxiety made worse by pervasive images of needles in the media. As a physician specializing in pain management, I study the impact of pain on vaccinati Amy Baxter, Clinical Associate Professor of Emergency Medicine, Augusta University YahooNews

If you’re among the 25% of Americans averse to needles, you’re probably not surprised by the COVID-19 immunization stall. Even for those who want immunity, bribes with beer or lottery tickets may not be enough to override anxiety made worse by pervasive images of needles in the media.

As a physician specializing in pain management, I study the impact of pain on vaccination. Research-proven adult interventions for pain, fainting, panic and fear can make vaccination more tolerable. At a minimum, understanding the reasons needle fear has become common might make the embarrassment easier to bear.

Needle fear has increased dramatically since a landmark 1995 study by J.G. Hamilton reported that 10% of adults and 25% of children feared needles. In that paper, adult patients who remembered when their fear began described a stressful needle experience around age 5.

The childhood experiences of the patients usually related to an unexpected illness; at the time the Hamilton participants were in preschool, vaccines were scheduled only until age 2. For most people born after 1980, however, booster injections given between ages 4 to 6 years became a routine part of the vaccine experience. The timing of boosters maximizes and prolongs immunity, but unfortunately falls within the age window when phobias form. A 2012 Canadian study of 1,024 children found that 63% of those born in 2000 or later now fear needles. In a 2017 study, my colleagues and I confirmed this increase in prevalence: Half of preschoolers who got all their boosters on one day – often four or five injections at once – were still severely afraid of needles as preteens.

Unsurprisingly, needle fear affects how willing teens and adults are to get vaccinated. A 2016 study found needle fear to be the most common reason teens didn’t get a second HPV vaccine. Health care workers are no exception: A 2018 study found that 27% of hospital employees dodged flu vaccines due to needle fear. And most recently, an April 2021 national survey of 600 not-yet-COVID-19-vaccinated U.S. adults found that 52% reported moderate to severe needle fear.

For children, evidence shows that addressing their fear and pain while distracting them from the procedure is most effective in reducing distress.

While adults are not just big children, combining these concepts with findings from available adult injection studies suggest a few potential interventions. For the many who want a vaccine but need some support, here’s what we know: