10:10am Saturday 06 June 2020

SickKids H1N1 study suggests ways to manage pain caused by vaccinations

TORONTO – While Ontario’s H1N1 immunization program resulted in lower-than-expected immunization rates, a new study out of The Hospital for Sick Children (SickKids) and the University of Toronto finds several strategies were effective in minimizing pain caused by the H1N1 vaccine, and sheds light on why some people avoid vaccinations. The study is published in the June 4 advance online edition of Vaccine.

Vaccine injections are the most commonly-performed painful medical procedures around the world; however, pain-relieving strategies are not widely used. Experts have found that negative experiences with immunization can lead to needle anxiety and fears. An estimated 25 per cent of adults are afraid of needles. People with needle fears may decline necessary procedures such as vaccinations and blood tests in an effort to avoid pain.

“With H1N1, we learned that sometimes people will need to get vaccinated at a moment’s notice,” says Dr. Anna Taddio, lead author of the study and Adjunct Scientist and Pharmacist at SickKids, and Associate Professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto. “We know that some people avoid getting immunized because of the pain it can cause. This study proves that simple, quick and inexpensive strategies can effectively manage vaccination pain in adults.”

The research was conducted last fall, during the H1N1 vaccination drive for SickKids staff. There were 352 adult subjects enrolled in the randomized study, who were divided into four groups. The first group received topical anaesthesia using liposomal lidocaine, a cream that was administered 20 to 30 minutes before the injection. This is already considered the gold standard in reducing vaccination pain; however, it is rarely used. The other three groups received one of the following: a vapocoolant spray (a mist that causes a cooling sensation and temporary numbness) administered for four to 10 seconds, about a minute before the injection; tactile stimulation (rubbing the arm around the injection site for 10 seconds prior to the vaccination, which causes the brain to pay attention to this competing stimulus); or self-directed distraction (in this case, reading a magazine of their choice before and during the injection).

The research team found vapocoolant spray and tactile stimulation were as effective as – and less costly than – topical anaesthesia in minimizing pain. Self-directed distraction was not as effective.

Participants in the study were asked how much they thought the vaccine would hurt and about their level of anxiety surrounding the injection. The results were similar in all four groups, which means there was no placebo effect, Taddio explains.

Participants were also asked if they would have received the H1N1 vaccine if it had not been part of the pain study. Five per cent said no, while another three per cent reported that they were unsure.

“This information is important from a public health perspective, because more people will get vaccinated if they know their pain is being managed,” Taddio says.

The study was supported by the Gebauer Company and SickKids Foundation.

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system.  SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.

For more information, please contact:

Matet Nebres
The Hospital for Sick Children
[email protected]

Suzanne Gold
The Hospital for Sick Children
416-813-7654, ext. 2059
[email protected]

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