Preparation Takes the Sting Out of Childhood Vaccinations

Shots hurt. But there’s a lot parents can do to ease kids’ pain and anxiety about vaccinations. From early childhood through adolescence, the most important thing is to explain to kids in an age-appropriate way that the shots can keep them healthy, says Rita John, DNP, EdD, CPNP-PC, DCC, director of the pediatric primary care nurse practitioner program at Columbia University School of Nursing. Other steps to minimize pain and anxiety at vaccination time include:

Before you go: Give toddlers and preschoolers their own toy medical kit to play with before the visit—letting them give pretend shots to you or to a favorite doll can make them less anxious when the time comes for the real thing, John says. For school-age kids, on the day of the appointment, tell them that vaccines will be part of the visit and make clear that the purpose is to keep them safe and healthy.

“Children need to know that vaccines aren’t a punishment or something negative, but that they are something that keeps them from getting sick,” says John. “When parents are anxious, they pass that fear on to their kids. The best way to talk about vaccines is to keep the conversation positive and focused on the benefits of vaccination.”

Time for shots: Ask if the clinician can use a numbing cream or spray to limit pain, John says. Babies may also be soothed by a bit of sugar water in a bottle or a pacifier. Bringing bubbles or a pinwheel for younger children to blow on during vaccinations can reduce their anxiety. Older children and teens might listen to music, play games, or text on a cell phone to distract them during the shots.

“If the kids think something is going to reduce their pain, there can be a placebo effect where the technique works because they expect it to work,” John says. “It doesn’t matter so much what you use to make your child more comfortable, as long as you do something that acknowledges that they may experience some pain and that they can do something to make it hurt less.”

Reward and praise: There's a reason kids get stickers after a checkup—the treats can go a long way toward removing negative feelings about the exam. When shots are involved, a sticker is a great way to reward younger kids. By the time children are too old to get excited by stickers, they will still appreciate praise for a job well done.

"You want the final part of the experience to make kids feel like even if they suffered some momentary pain, it was worth it," says John. “Good play preparation, a positive attitude about immunization, and bringing something to distract kids during the shots can all help make the experience better.”

Columbia University School of Nursing is part of the Columbia University Medical Center, which also includes the College of Physicians & Surgeons, the Mailman School of Public Health, and the College of Dental Medicine.  With close to 100 full-time faculty and 600 students, the School of Nursing is dedicated to educating the next generation of nurse leaders in education, research, and clinical care. The School has pioneered advanced practice nursing curricula and continues to define the role of nursing and nursing research through its PhD program which prepares nurse scientists, and its Doctor of Nursing Practice (DNP), the first clinical practice doctorate in the nation. Among the clinical practice areas shaped by the School’s research are the reduction of infectious disease and the use of health care informatics to improve health and health care. For more information, please visit: