"Doctor, will I get any shots today?" "No
shots!!" "I'm ready for my shots! Can I get
them now?"
These are some of the first sentences an
early elementary-aged child will say when the
physician walks in the door for the well
child check. Though all sorts of important
areas are addressed at a well child check,
including assessments of growth, vision, and
hearing, a full physical evaluation, and
discussion of nutrition, school success, and
safety, the young child will most likely
remember the vaccinations. There are many
ways that a parent can help a child to face
this part of their child's medical care. In
this short blurb, some ways to help your
child face the anxiety and pain of
vaccination will be reviewed. (Parents often
have questions about the safety of
vaccinations, another important subject.
Find links on the home page of our website
for information on this topic.)
Preparation : How should a
parent best prepare their child for
vaccinations? A 2 or 3 year old is best told
immediately before or during the visit -
perhaps as you are getting out of the car and
walking towards the building or as the child
is being undressed to get measured.
Something simple, said in a positive tone,
should suffice. "Sweetie, your nurse will
give you some shots today. They are little
pokes that might hurt for a minute, but mommy
(or daddy!) will be here to help you to be
brave. You need them to keep you strong." A
child of 4 years or older should have a
little more advance preparation - maybe a day
or two before, explain that there is a
doctor's appointment coming up, where they
will likely be getting some shots. An
explanation of WHY they need shots might also
be helpful as children do start to have some
more rational thinking. "Sweetie, we will be
seeing your doctor in a few days for your
check up. You will need to get some shots
that day. Shots are special medicines that
will help you to stay healthy. Most children
need some shots before they start
kindergarten. They do hurt, but only for a
short time. I know that you will be okay,
and I will help you to be brave."
Distraction : During the actual
time of vaccination, most children do best if
they do not see the needle. Having them
actively involved in some quiet activity can
help keep their mind off of the pain. Some
ideas include: singing a song, telling
jokes, blowing on a pinwheel.
Speed: Sometimes the event is
too stressful for successful distraction, but
at least the ordeal can be done quickly.
Many children, at the completion of their
shots, will say something like "It's over?"
"That's it?" Their fear and anxiety about
the event is often greater than the pain of
the shots. When a number of vaccinations are
to be given at once, it is best to get them
all completed as quickly as possible, and
then comfort the child at the end.
Reward: The sting of the
booster shots can be lessened somewhat by a
reward, celebrating the completion of this
important childhood milestone. Something
that a child can share with their parent can
be fun - getting ice cream, having pizza for
lunch with some arcade games, or going to the
zoo for the afternoon. A prize that is too
exorbitant may make the child MORE fearful of
their shots, thinking that "it must be REALLY
bad if daddy says he will build me a swimming
pool for getting my shots."
Parental Attitude Check: Try
to have a calm, unapologetic, but warm
attitude with your child. Saying, "I am so
sorry that they have to hurt you?" while
tearfully glaring at the nurse or doctor - is
just not going to help your child. Nor is
your child expected to act like they are
ready for boot camp. If one parent is a bit
needle-phobic, then perhaps the other parent
can accompany the child. If the child has
special needs or is very sensitive, then
perhaps both parents, or one parent and
another support person, could come along.
Remember, your school age child has to learn
how to face a number of necessary but not
always pleasant tasks in their life - that is
part of growing up.
Adjunctive Aides: There is a
topical numbing medication that can help to
slightly reduce the pain of vaccination.
This cream is called ELAMAX and is available
over the counter at most pharmacies, with a
tube costing about $15. The cream needs to
be applied in the appropriate location AN
HOUR before the vaccination. It helps to
reduce pain at the skin level only. Since
many of the vaccinations must be injected
deeper, into the muscle, it is not really
sufficient to block out all pain. Some
families do feel better knowing that they are
doing all that they can to decrease the pain,
though most families in our practice do not
bother with this.
Oral Pain Medicine: A dose of
Tylenol or Ibuprofen can help a child -
especially with some of the soreness they may
experience for a day or two after the DtaP
(diptheria, tetanus, and acellular pertussis)
booster. It would not hurt to give a dose
prior to the vaccinations as well.
