Amy Watanabe wanted to get the COVID-19 vaccine. She is an assistant college volleyball coach and a person with asthma. She recognized the vaccine would keep her and those she works with safe.

But there was one massive roadblock in the way.

“I’m a self-described ‘hot mess’ when it comes to needles,” Watanabe admitted.

She can’t explain why the severe phobia presented itself about a decade ago. She hasn’t been able to control her reaction to needles — which she describes as an “out-of-body experience with Hulk-like strength’’ — until she discovered an innovative use of virtual reality technology to distract her from debilitating fear.

With help from her primary care provider and UCHealth’s innovation team, Watanabe curbed her phobia long enough to get a single dose of the Johnson & Johnson COVID-19 vaccine.

“It almost feels fake that I actually did it,” Watanabe said about two weeks after she received her shot. “It was the easiest shot I had in 10 years.”

Trypanophobia: A fear of needles

Watanabe is not alone in her fear. According to the Centers for Disease Control and Prevention, about 25% of adults fear needles at differentiating anxiety levels. For Watanabe, the abject fear began in high school and increased in college to the point that she’d have panic attacks before getting her flu or other school-required vaccines.

“I was not in pain, but it was that anticipation of it coming at me — it would freak me out for a solid 30 to 45 minutes,” she said. “And the poor nurses. I’d cry hysterically. Then this Hulk strength takes over. I’d yell, cry and fight. What those incidences resulted in is three people holding me down and giving me the shot. I felt bad because I knew these people were trying to help, and I knew the vaccine would help.”

Her fear went well beyond the school nurse’s office. At the dentist’s office, when nitrous oxide didn’t work, Watanabe endured dental work without pain management intervention.

She has found ways to get around her phobia. She once took a dose of tetanus shot to an already-scheduled surgery where she had the dose administered while she was under anesthesia. Not knowing if she’s allergic to bees or tree nuts — both of which require a blood draw for diagnosis — Watanabe carries an Epinephrine injection (EpiPen) with her everywhere.

When the coronavirus pandemic began Watanabe recognized she would need to address her fear once again.

“When the pandemic started, I knew it would come to a point when the vaccine would be part of the solution,” she said. “We knew that in March (2020), so I thought I should probably start trying to find a therapist who could help me. I didn’t do anything for a year but then started looking this past April. I tried three different therapists and didn’t get anywhere. I also got on a waitlist for desensitization therapy.”

Your primary care office is here for you

In May 2021, Watanabe became a new patient at the Highlands Ranch Medical Center – Primary Care. She met with nurse practitioner Kate Johnson.

“She told me about her phobia and how severe it is, as well as letting me know how much she wanted to manage it so she could get the COVID-19 vaccine,” Johnson said.

After their appointment, Johnson got to work investigating other options for her patient. She made a few therapist referrals, but there was another idea she thought might work: virtual reality.

In the weeks before meeting Watanabe, Johnson had read how physicians in the UK were using VR technology to help those with needle phobias get vaccinated. Having joined UCHealth with the opening of the Highlands Ranch Medical Center in 2019, Johnson wasn’t sure if UCHealth was using the technology. By happenstance one morning while logging onto her UCHealth computer, Johnson saw a photograph on the intranet of Nicole Caputo, a VR headset was resting on her knee.

Watanabe wasted no time tracking down Caputo, senior director of UCHealth’s Innovation and Experience team.

VR technology at UCHealth

UCHealth first piloted the use of virtual reality technology within its outpatient oncology infusion areas throughout the Front Range.

“The response was overwhelmingly positive that we started the program in 2018,” Caputo said.

VR use soon expanded to dialysis, wound care and the burn center.

“We’re continually looking at new use cases for the technology to bring distraction therapy options to more patients across UCHealth,” Caputo said. “We had lab visits on our expansion list for the program, but Amy’s story has catapulted it to the top of the list.

“If we can help more people who are hesitant to get a vaccination to overcome their anxiety, we need to do it.”

Using VR technology to get the COVID-19 vaccination

Caputo met with Watanabe to discuss how VR might be able to help in her situation.

“I was not totally convinced, but I was super open,” Watanabe said. “I wanted a solution, at least for the short term, and Nikki (Caputo) was super-duper nice. I think that’s part of why it worked out — everyone was so kind and didn’t make me feel crazy at all during this whole process. They were understanding and trying to help.”

The two went through different virtual reality options for the headsets: guided meditation on a mountain top, a Northern Lights show, breathing bubbles.

“It was really cool and pretty, but I told her, ‘This isn’t going to work for me,'” Watanabe said. “Then she told me there were games. Being a coach, I’m highly competitive.”

The two settled on a game where Watanabe had to pop specific color balloons.

“Games fall into my personality — I was literally competing with myself trying to pop these balloons,” she said.

The games don’t have music, so Watanabe agreed to bring a playlist of her favorite songs when they met again for a “trial run” of her vaccination.

A few days later, Watanabe arrived at the UCHealth Innovation Center with her mother — her rock and support over the years. Johnson had prescribed anxiety medication to help Watanabe get through the process. Shea Smith, manager of Experience and Innovation at UCHealth, was there with a few other teammates to set Watanabe up with the VR and walk everyone through the mock scenario.

“I was super optimistic,” Watanabe said. “It’s probably the most optimistic I have felt during this whole thing.”

On July 28, 2021, they all returned for the real thing, and it went off without a hitch.

“We set it up just like the role play,” Watanabe said. “I started popping balloons, then I felt it go in and thought, ‘Oh my gosh, it’s happening. Find the red balloons.’ I wanted (the vaccine) so bad — and I let it happen.”

Watanabe celebrated with a five-hour nap.

“It was a journey for sure,” she said. “I did it, and it’s a huge relief. It’s a huge victory.”