Putty and ice cream? An expert’s advice on younger kids and the vaccine

By Katie Hurley, CNN

An 11-year-old girl was petrified — her word — of needles, so much so that she didn’t want to talk about it with me. She couldn’t talk about it without becoming visibly upset. Her heart raced, her breathing became rapid, and her stomach hurt when she tried to answer my questions. So, we backed up and started from the beginning.

I first had her look at cartoon images of children getting vaccines. When I asked her how it felt to do that, she rolled her eyes and reminded me that it wasn’t real.

Next, I had her look at photos of medical needles. She reported that she didn’t like the pictures, but she could handle looking at them.

We continued this gradual approach until she gave “vaccines” to an orange (parental supervision required even with toy needles). What she was doing is exposure therapy, learning to tolerate her discomfort and gradually build up to getting her own vaccine.

Using exposure to cope with needle phobia requires time and professional guidance, but many adults are eager to get the Covid-19 vaccine for their vaccine-hesitant little ones as soon as it becomes available. These folks might not have the time or the resources to take a gradual approach to helping their kids overcome this fear, but they need help just the same.

People who have already dealt with their children’s resistance to the chicken pox, flu or other vaccines know that fear of needles is actually fairly common among children. A majority of children suffered from a needle fear or phobia, while needle fear ranged from 20% to 50% in teens, found a 2019 meta-analysis of research studies. Needle fear and needle phobia is more prevalent in females than males, but that needle fear did decrease with age, according to this study.

If your child isn’t exactly cheering about the announcement that the White House plans to roll out vaccines for kids ages 5 to 11, there are steps you can take to help your child prepare.

Kelly Foy and Pat McLarney, both child life education specialists at Connecticut Children’s Medical Center, shared their best tips for easing vaccine fears just in time for the rollout.

Timing is important

You might want to tell your kids the minute you book the appointments, but think carefully before you write it on the family calendar. When is the best time to tell? “A good rule of thumb is one day for every year of life,” Foy and McLarney said via email. “For example, five days for a five-year-old.”

It’s also important to trust your gut and think about each child as an individual. “If you know your child perseverates on information, it would likely be better to wait until closer to the appointment, so they don’t spend days filled with anxiety,” Foy and McLarney warned. If your child needs more time to process and work through it, on the other hand, go ahead and give an earlier warning.

Use neutral language

It’s important for adults to remain calm when presenting the information, as kids look to their parents for cues about how to respond. Beyond that, it also helps to use neutral language. Say “vaccine” instead of “shot” when talking about it, and use “pinch” or “pressure” to replace “poke.”

It’s common for kids to ask a lot of questions as they attempt to gather information and make sense of what’s to come.

Ages 5 to 7:

• Keep it simple. “Think about the people that will be in the room, the sounds they will hear, if there will be any smells or tastes that will be out of the norm, and anything they might feel on their body,” Foy and McLarney said.
• Give a brief step-by-step description of what to expect.
• Rely on the power of play. Little kids process their emotions through play, so send some stuffed animals or dolls to the doctor for their vaccines before it’s time for the kids to go!
• Check in with Sesame Street to learn about vaccines with Elmo and his dad.

Ages 8 to 11:

• Kids in this age group might have more detailed questions. Give honest answers and seek additional information if you aren’t sure how to answer.
• Empathize with them and listen to their concerns.
• Empower your big kids to write a list of questions to ask the nurse or doctor at the appointment to ease their worries.

Build a coping kit

Advanced planning is a huge benefit when it comes to building a coping kit. Foy and McLarney recommended thinking about what worked and didn’t work in the past and building from there. Coping kits should reflect both the ages and the needs of your child, so you might need to consider a few options.

Ages 5 to 7:

• Keep their hands busy and their minds occupied to work through their anticipatory anxiety. “They may want to play with a fidget spinner or pop it or they may want to hold your hands to have something to squeeze,” Foy and McLarney suggested.
• Foy and McLarney also suggested applying ice to the injection site before and after the shot.
• Consider adding competing sensory stimulation, like a vibrating sensation.

Ages 8 to 11:

• Have your child create a playlist to listen to during the appointment.
• Bring a stress ball, slime or thinking putty to work through tension.
• Plan to watch an interesting video (cue it up so you don’t have to search!) or use a favorite app.

Focus on breathing and mindfulness

Deep breathing is an effective tool at any age. “The best way that these techniques work is to practice them ahead of time so you’re not trying to learn in a heightened state of anxiety or fear,” Foy and McLarney explained. “In the weeks leading up to the appointment, take time before bed to do some deep breathing exercises or guided meditation so your child gets used to the steps in the process.”

• Practice square breathing (counting in fours while tracing a square in the palm of your hand) as a family in the days leading up to the appointment.
• Use a mindfulness app together.
• Use the rose/candle technique: While holding up your index finger, take a deep breath in through your nose to smell the rose, and slowly exhale through your mouth to blow out the candle.

Plan for comfort

No matter the age of your child, bring comfort items to the appointment. A favorite stuffed animal, a cozy blanket to wrap up in, or a well-loved book can all bring comfort during a stressful moment. Ask your child what item will help if they feel worried during the appointment.

Choose a reward

“For all children (and adults!), it is a great idea to have a plan for after the appointment so there is something to look forward to,” said Foy and McLarney. Whether it’s an ice cream cone or a family movie day on the couch, planning your relaxation post-appointment gives kids something positive to think about during the visit.

Above all, focus on the positive. This vaccine means a lot of great things to a lot of kids, like play dates with friends and hugs from grandparents, so remember to talk about the exciting things to come once the vaccine takes effect.

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