How children and adults can overcome needle phobia

June 2, 2021
Kate Williams turns away as she receives a vaccine at UCHealth University of Colorado Hospital.
Kate Williams, 12, copes with needle phobia by not watching as she gets her vaccine at UCHealth University of Colorado Hospital. Photo by Cyrus McCrimmon for UCHealth.

Many people want the protection of the COVID-19 vaccine but are afraid to get shots because they suffer from needle phobia or fear of needles.

Needle phobia is quite common. But, the good news is that both children and adults can get help dealing with their fears.

Some people can overcome their needle phobia after just a few sessions with a behavioral health expert.

For others, simple calming strategies can make it easier and less frightening to get vaccines.

How you can overcome needle phobia

Vanessa Rollins is a psychologist who cares for patients at UCHeath Family Medicine in Boulder.

Rollins has a doctorate in psychology and together with behavioral health colleagues and primary care providers, she provides mental health and counseling services to patients of all ages, from children to older adults.

Rollins is also the co-author of a study in the medical journal, Evidence-Based Practice, that explored how to help children with needle phobia: Which Psychological Interventions are Effective in Managing Pediatric Needle Pain?

We talked to Rollins about the causes and symptoms of needle phobia and how people of all ages can get help so they don’t have to deal with the fear of needles for the rest of their lives.

Head shot of Vanessa Rollins. She's a psychologist and has studied needle phobia.
Vanessa Rollins is a psychologist who helps people with a variety of mental and behavioral health challenges. While needle phobia is very common among both children and adults, Rollins said many people can overcome their fears. Photo by Cyrus McCrimmon for UCHealth.

Why do people have a phobia of needles?

For many people, fear of needles feels innate, like something they were born with rather than a fear connected to one particularly scary incident.

“There are a variety of causes of needle phobia. Some people say, ‘I’m scared and I don’t know why. I’ve always been afraid,’ while others can clearly connect the fear to some past negative experience with shots or blood draws.” Rollins said.

Pre-existing anxiety, a heightened sensitivity to pain, and having family members with the same phobia are also factors.

How common is needle phobia, and does it result in vaccine hesitancy?

Needle phobia is so common that there’s even a fancy name for it: trypanophobia.

A recent meta-analysis of multiple research studies found that a majority of children suffer from needle fear or phobia, while as many as half of teens and one-third of young adults suffer from needle phobia.

The analysis found that it’s common for people to avoid annual flu shots and other vaccines due to their needle phobia.

What are some of the symptoms of needle phobia?

People with needle phobia can experience rapid breathing or heart rate, anxiety, sweating and trembling. Some feel nauseous while others can’t sleep in advance of a shot or medical procedure. The fear may even trigger what’s called a vasovagal response — a sudden drop in blood pressure that causes dizziness and even fainting.

Is it possible for people to overcome needle phobia so they can easily get vaccines?

Yes. The strategies that work the best ranges from simple distraction to hypnosis or behavioral therapy. People of all ages can go through relatively short-term treatment to improve or overcome needle phobia.

“For many people, once they’ve completed treatment, they’re done and the phobia no longer impacts their life, while others may need regular tune-ups to get back on track,” Rollins said.

“The goal isn’t to learn to love needles. It’s to get to a place where you can get a shot or have blood taken with the mild discomfort everyone experiences.”

She encourages people of all ages to seek help if they need it, especially kids who need to get vaccines frequently.

“All kids can have a one-off experience with a shot where they are way more distressed than usual, but you know it’s turned into more of a phobia when the distress is happening more often than not, when everyone involved feels traumatized afterward, or if the child starts experiencing anxiety well before the doctor’s appointment,” Rollins said.

Vaccines are essential to protect children and people of all ages. And COVID-19 vaccines for children under age 12 are being tested on small groups of children now and could be ready by the end of summer. So, Rollins said now is a great time to think about getting help for children who need it.

“You have time to see someone,” Rollins said. “People can get past needle phobia.”

How can a behavioral health expert help me overcome my phobia of needles?

Rollins uses different types of therapy to help people overcome needle phobia, but most often relies on what’s known as behavioral or exposure therapy.

There are different approaches to exposure therapy, but often the exposure is gradual. First, the patient outlines his or her specific fears about needles and ranks them from least to most scary. This is known as setting up a hierarchy of fears.

“For some people getting the shot is the scariest thing. For others, the anticipation of getting it is worse,” Rollins said.

“We start with the least scary thing first then slowly progress our way to the most scary thing,’’ said Rollins, “All the while, the patient builds confidence that the fear can be confronted and managed.”

The patient might start, for example, by simply looking at pictures of needles or think about going to the doctor’s office and end with a successful shot or blood draw visit.

“The constant exposure decreases anxiety, builds confidence, and changes the way we think,” Rollins said.

“As we’re working on the exposure a patient gets, the experience of watching their anxiety start out as a 10 out of a 10 and slowly decrease to maybe a 7 out of 10 or less, is a huge leap from ‘I can’t stand this’ to ‘Oh, I can tolerate this,’” Rollins said.

There are other therapy approaches that help patients learn relaxation techniques which are then paired with the exposure, Rollins said.

“The type and severity of phobia help us decide what approach might be best,” she said. “But there is something really powerful about the experience of getting through anxious moments head-on.”

“That’s the great thing about being a psychologist in primary care, I’m right in the doctor’s office next to the dreaded needle area so there’s a lot of opportunities to create exposures,” Rollins said.

Does exposure therapy for needle phobia work?

Yes. Rollins encourages early treatment but said many patients can meet with a behavioral health expert for short-term treatment and meet their goals.

“You can make the experience of getting vaccines markedly less anxiety-provoking,” Rollins said.

Most adults and parents of frightened children don’t realize that they can get help.

“Many parents have resigned themselves to dragging kids in kicking and screaming for vaccines and doing the walk of embarrassment afterward, but that’s not the only option,” Rollins said.

Does it work to tell people with a needle phobia that vaccine injections won’t hurt?

No. While getting the COVID-19 vaccine can be relatively painless for many children and adults, some people experience real pain. And kids who get multiple vaccines at each well-child visit can be sore after vaccines. So, it’s best to tell people the truth and not to minimize their feelings.

“Whether or not they’re phobic, kids don’t buy it when you say it won’t hurt because what you experience as a harmless pinch they might feel as a giant pain, so it’s better to give them facts like it will be over fast, and let them talk about things they can do to get through it.” Rollins said.

That’s because the phobia is real. The anxiety is real. And, for some people, the pain is quite real.

Does distraction work if I have a phobia of needles?

Yes. Distraction does work. In Rollins’ review of evidence-based methods for reducing needle phobia, she and her co-author found that children who took advantage of distractions reported significantly less pain while getting shots. Distractions included everything from reading stories to watching videos, listening to music, playing with a toy to holding a comforting object.

For children who are mildly fearful of needles, Rollins advises parents to think in advance about what might help them and involve the child in picking a distraction technique.

Continuing to breathe is important.

“I do always teach people with needle phobia simple paced breathing, in to a count of 5 and out to a count of 5, because breath holding during a fear response is really common. Paced breathing can help avoid that vasovagal response some people get,” Rollins said.

Do bribes or post-vaccine treats work in overcoming a phobia of needles?

Offering children a treat after they get vaccines may work for some older children. But, bribes may not work as well for younger kids.

“For toddlers and preschoolers, rewards have to be pretty immediate to work, they don’t appreciate ‘If you do this scary thing now, you’ll get this unseen reward later,’” Rollins said.

Rather than using bribes or treats to coax kids into getting vaccines, Rollins thinks it’s more effective to encourage children to strategize about good ways to overcome needle phobia.

“Giving kids some control over managing their fear is a far better strategy,” Rollins said.

“But I also want to acknowledge that vaccine time is really hard for parents too and we all just try to do the best we can to get through it, so if a bribe works, use it.”

What is hypnosis?

Hypnosis is a deep state of relaxation in which your mind is more focused and receptive to changing your thoughts Rollins said.

Hypnosis is effective for treating needle phobia, but requires seeing a behavioral health expert specially trained in hypnosis.

The great thing is that any of the treatment options from exposure therapy or hypnosis, are beneficial.  And that makes it much easier to cope with necessary, life-saving vaccines, whether we’re trying to put an end to the COVID-19 pandemic or we’re getting annual flu shots.

Said Rollins: “Vaccines are part of our lives, in my opinion, thankfully, and moving past needle phobia can feel like a huge relief.”

About the author

Katie Kerwin McCrimmon is a proud Colorado native. She attended Colorado College, thanks to a merit scholarship from the Boettcher Foundation, and worked as a park ranger in Rocky Mountain National Park during summer breaks from college. She is also a storyteller. She loves getting to know UCHealth patients and providers and sharing their inspiring stories.

Katie spent years working as a journalist at the Rocky Mountain News and was a finalist with a team of reporters for the Pulitzer Prize for their coverage of a deadly wildfire in Glenwood Springs in 1994. Katie was the first reporter in the U.S. to track down and interview survivors of the tragic blaze, which left 14 firefighters dead.

She covered an array of beats over the years, including the environment, politics, education and criminal justice. She also loved covering stories in Congress and at the U.S. Supreme Court during a stint as the Rocky’s reporter in Washington, D.C.

Katie then worked as a reporter for an online health news site before joining the UCHealth team in 2017.

Katie and her husband Cyrus, a Pulitzer Prize-winning photographer, have three children. The family loves traveling together anywhere from Glacier National Park to Cuba.

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