Needle Hesitancy: Here we are. Now what?

As supply for COVID19 vaccination in the US begins to outstrip demand, the impact of antivax sentiment is becoming evident. The associations with politics, socioeconomic status and education, however, miss the biggest – and PROVEN – cause of antivax sentiment. Needle hesitancy.

 

In “The Big Chill”, Jeff Goldblum notes “when was the last time you tried to get through the day without two to three juicy rationalizations?” People old enough to have seen this movie most likely aren’t anti-vax. We Gen-X folk were born before kids were routinely given boosters at an age when it could be traumatizing. We dismiss needle fear because we don’t remember vaccines, only the rare Bicillin shot for strep, and assume we’re morally superior because we’re tough. But because society values toughness, if you ARE afraid of needles, you’re 3x more likely to decide that perhaps your fear is really because the vaccine is dangerous. A rationalization is much easier than being stigmatized.

 

Anna Taddio was the first to publish that of the 23% of adults who feared needles, 7% said they wouldn’t vaccinate their children because of it. Around the same time, our team researching the Buzzy device for needle pain discovered that the reason for the 3x jump in needle fear was related to the preschool booster experience… and persisted through adolescence at least, impacting HPV adherence. 

 

We found in part of the analysis that kids who got one injection only every time they went to the MD after age 4 did  not have needle fear as teenagers. I do think one at a time builds resilience, kids shake it off, while relentless 3-5 injections at the same time is even hard for an adult. It became clear that when these kids were old enough to drive themselves to the doctor… they wouldn’t.

 

When I became aware of this impending noncompliance tsunami, I tried to make people aware, initially not even discussing  in my paper that perhaps using pain control for these booster shots was an answer. I did a TEDx talk. I cornered Paul Offit, god of vaccinations, at AAP book signings, challenging his contention that “getting them all over with at once is less traumatic.” Where is there data supporting it? Any noncompliance study that doesn’t mention needle fear DIDN’T ASK. Those that do find it is the most compelling reason teens don’t get vaccinated.