Taking the ‘Ouch’ Out of Shots Five tips to help kids and parents feel better during vaccinations.

“Will it hurt?” is an age-old question that children ask when getting a shot.

Since the Pfizer COVID-19 vaccine was recently approved for children 5 to 11, care teams at Hassenfeld Children’s Hospital have been hearing this question a lot. And teams from Sala Institute have worked hard to make getting this vaccine, and other needles and procedures, as pain free as possible for children.

One of the care teams’ priorities is making sure that children are able to successfully manage the experience, says Chris Brown, director, Therapeutic Recreation, Child Life & Creative Arts Therapies, part of Sala Institute for Child and Family Centered Care. Brown and her team have expertise in providing age-appropriate information and helping to keep children distracted during the procedure. “We always consider what we can do to make the experience positive,” she says.

Tucker, age five, is comforted by sitting on his mother’s lap while receiving a COVID-19 vaccination, part of Sala’s Comfort 5 Plan

“When you think of going to a hospital, it’s rarely something you look forward to, but when it came to getting my kids vaccinated at Hassenfeld Children’s Hospital, the experience couldn’t have been any more pleasant,” says David, who brought his daughter and son to Hassenfeld from their home in Hoboken, NJ, to be vaccinated.

Lessening anxiety before it builds

The COVID-19 vaccination needle is very thin and the vaccine is given very quickly, but of course, some children still get anxious, says Brown. Anxiety can build while waiting.

Since the Vaccine Center is located in the lobby of Hassenfeld Children’s Hospital, Brown and her team use the giant wall mural of Manhattan sights to entertain children, asking them to find different landmarks. Inside the treatment bays where vaccines are administered, kids can play with bubble guns, glitter wands, toys, and other fun items.

“They couldn’t wait to get behind the curtain the instant they saw the bubbles floating,” says David. “When all was done, it was the bubbles, the stickers, and the staff’s distractions that they recalled. They seemed to have missed that a needle was used at all.”

“Once a child is upset, they usually can’t calm down easily,” says Brown, “so it’s best to distract them and give them an alternative to focus on besides the needle.” Distractions also include counting games and singing, according to Brown, who worked with the nurses in the vaccine center on several techniques.

Five steps to maximize comfort

Distraction is one technique in the Comfort 5 Plan, a protocol implemented by the Sala team to decrease pain and increase comfort consistently for all pediatric patients during an invasive procedure. The Comfort 5 Plan includes five steps:

  • Partnership with patient/family
  • Positioning the child for comfort
  • Numbing
  • Distraction
  • Sucrose/Breastfeeding

When the COVID-19 vaccine was approved for children, Ashley Kydes, MD, medical director of Sala’s Pediatric Pain Management Program, collaborated with the nursing staff on a refresher program on comfort measures while giving an injection. A big part of the process is giving children control, Dr. Kydes says.

“A lot of pain and anxiety management rests on letting a child decide how they want to be treated,” she adds “First, we partner with the patient and the family, asking them if there’s anything we can do to make it better for them.

“We ask if the child would like to sit on a parent’s or caregiver’s lap, or sit alone,” she says. “We let them decide if they want to be distracted by a toy or a song, and give them the option of what will make it better. Sometimes the parent will help guide them in a decision.”

Dr. Kydes also suggests that parents begin preparing children beforehand for any type of shot by discussing the benefits. “Explain that it’ll only pinch for a second, but that the lasting effects will protect them from getting sick and prevent future pain,” she says.

The comfort and distraction measures are working, according to the clinicians, who say the COVID-19 vaccine program is going very well.

A Manhattan mother says her children had a very good experience getting vaccinated recently at Hassenfeld Children’s Hospital.

“It was an excellent experience with amazing nurses who were kind, caring, and gentle. They provided activities to distract the children that helped pass the time,” she says. “It was great to be scheduled so quickly, easily, and conveniently.”

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