As the mass vaccination effort against COVID-19 continues across the country, many Canadians are feeling relieved that soon it will be their turn to get the shot.
But for others, the thought of getting a needle or being exposed to photos and videos of others getting vaccinated can be anxiety-inducing.
In fact, a survey conducted in 2012 found needle fear was the reason for seven per cent of immunization non-compliance among adults and eight per cent of children.
The study ultimately found needle fear was present in a quarter of adults and two thirds of children surveyed.
But what is needle phobia and can these feelings of and anxiety be managed during COVID-19 vaccination?
Here’s what experts say.
What is needle phobia?
While many people have a fear of needles, it doesn’t reach the severity that would warrant a clinical diagnosis, said Dr. Mark Berber, a staff psychiatrist at the Markham Stouffville Hospital and assistant professor at the University of Toronto.
Berber said it switches from a “natural or understandable mild fear” of needles to a “clinical anxiety disorder,” when a person’s ability to function is impacted.
“So if you were a person who wants to go and get the vaccine, but is hesitant and avoids getting the vaccine because of your fear of needles, that would warrant a diagnosis of simple phobia or more specifically, needle phobia,” he explained.
Dr. Roger McIntyre, a University of Toronto professor of psychiatry and pharmacology, echoed Berber’s remarks, saying when someone has a phobia of needles, “the level of distress (and) the level at which it affects them is qualitatively quite different.”
McIntyre said while most people don’t enjoy getting a needle, those who have a real fear or phobia will become “preoccupied” with worrying about a vaccination appointment, and may lose sleep in the days leading up to the date.
“You have this level of distress, this level of suffering that really is quite significant for some people, it could be to the point that you actually get panic attacks the day of or in anticipation of it,” he said.
For a lot of people with a needle phobia, McIntyre said they might not get the shot at all because they are so distressed, even though they believe rationally being vaccinated is a good idea.
Having a phobia of needles can negatively impact your health, McIntyre said, because it not only prevents people from getting vaccines, but also from having their blood drawn or from taking medication that might be essential to their well-being.
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Where does needle phobia come from?
Asked why some people are afraid of needles, Berber said it comes down to nature and nurture.
For some people, the fear of needles is learned from watching others, like their parents, be fearful of vaccines. This, Berber explained, would be a nurtured behaviour.
Another example of a nurtured response, Berber said, is if someone were to see several videos of photos of people receiving injections who appear to be in pain or discomfort.
What’s more, Berber said humans are naturally “hardwired” to avoid injuries that would pierce our skin.
“If we go back in history and look at men and women surviving in the wild, they would have to avoid stab wounds or attacks by animals,” he said. “So is a natural instinct for humans not to want penetrating wounds on their skin any way… So that would be the nature.”
McIntyre said for some people, this “completely hijacks their rational thinking.”
He said in some people, this natural instinct is “exaggerated” simply because of the way they are “genetically constituted.”
Treating needle phobia
The good news for those who experience needle fear and phobia, is that it is “very, very treatable,” McIntyre said.
“That is, I think, an important message,” he said. “Not all conditions are highly treatable — but this one is.”
Berber agreed, saying specific phobias can “definitely be worked through.”
“I would say specific phobias are one of the easier and anxiety disorders to treat,” he said, adding that exposure therapy — which is the most common treatment for phobias — has proven to be “very effective.”
Exposure therapy, McIntyre explained, is when a person is gradually exposed to the fear stimulus. In this case it would be a needle.
“Then, in the presence of a therapist, they work through that and they find ways to manage that through distraction techniques, psycho education, reassurance — things like that,” he said.
When it comes to vaccine fear and phobia, Berber said it’s important to clarify what, specifically, the individual is afraid of.
“Are they afraid of the pain effect? Are they afraid they’re going to faint? Are they afraid they’re going to develop one of the rare brain (blood) clots that has been associated with some of the vaccines?” he said.
“So I think that’s important, to identify carefully the specific fear.”
Identifying the specific fear, Berber explained, makes it easier to talk through and address.
Managing fear during vaccination
When it comes time to get a shot, Berber said those who have a fear of needles or needle phobia should focus on practicing relaxed breathing.
“A lot of people, when they go for an injection, they work themselves up, and they start breathing fast and they get themselves into sort of almost a panic attack, worrying about the injections fears,” he said.
“So what one could do is prior to the injection is have the person do some relaxation exercises, especially relaxed breathing.”
What’s more, Berber said bringing a friend who isn’t fearful of needles can be helpful to provide “moral support.”
McIntrye said “mental distraction” is a good way to minimize feelings of stress and anxiety when going to receive a needle.
“That could be just simply by your own ability to distract yourself, think of alternative stimuli when you’re anticipating getting the needle, maybe think about your favourite Netflix show,” he said.
“Others bring their headphones or their iPhones, and they listen to music as a distraction that they feel they can’t mentally distract themselves, or prefer to have musical or other types of distractions.”
Health-care professionals who are administering the shots can play a role in ensuring those who are fearful of needles have a positive experience, too, Berber said.
He said there should be a “very positive, upbeat and happy ambiance at the clinic.”
“In other words, not too medicalized,” he said.
He said workers should be cognizant of the fact that some people may find the process of getting their shot “very upsetting or challenging” and should be patient, and explain things clearly.
Berber said they should encourage people to relax, and reassure them that the pain associated with the needle is minimal.
It is also helpful, Berber said, if they remind those who are fearful to regulate their breathing.
“That sort of encouraging talk, to talk through it in a calm, reassuring, friendly way,” he said.
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