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Fear of needles must be overcome before Covid-19 vaccine rollout works



Getting one, however, is still a ordeal for Walker, who has needle phobia. “I start to get really clammy, and then get cold sweats,” she said, describing her reaction to routine injections. “Then I’m going out.”

Walker has lived with the fear of getting injections for years. She remembers being scared at the age of 12 or 13 when she got a flu shot at the doctor’s office.

Fortunately, experts say that treatments for needle phobia can be very effective. Leaving the condition untreated, however, can result in a fear that grows even more intense over time.

What is a phobia?

“Phobia is a fear and anxiety of a particular stimulus,”

; explained Dr. Jeffrey Geller, president of the American Psychiatric Association and professor of psychiatry at the University of Massachusetts Medical School.

About 30% of people will experience an anxiety disorder in their lifetime, Geller said. Of these, between 7% and 9% of individuals have a specific phobia.

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However, anxiety about needles does not have to meet the formal definition of a phobia to cause problems. About a quarter of adults are afraid of needles, and an estimated 7% of adults avoid vaccinations because of that fear, according to the U.S. Centers for Disease Control and Prevention.
Even before the Covid-19 pandemic, fears of needles had a serious impact. Regular vaccinations reduce the risk of death, disability and disease, the World Health Organization wrote in a study of worldwide vaccination programs that have reduced the risk of fatal diseases, including measles and diphtheria.

What’s more, a fear of needles goes beyond vaccinations. People with severe phobias can completely avoid medical attention, even if it means deteriorating health.

Can you handle fear yourself?

For needle-phobic people who get injections despite their fears – like Walker – the experience can be uncomfortable. Common symptoms include dizziness, fainting, insomnia, sweating, muscle tension and increased alertness.

People with relatively mild fear of needles may be able to cope with their anxiety by practicing relaxation techniques alone, Geller explained.

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“There are many meditation techniques that can be taught,” he said, pointing to both meditation and yoga as useful methods.

Distracting yourself can also work. Counting things in your surroundings, doodling, numbering your breaths and imagining a safe, comforting place can shift your focus away from the scary event.

Or you can invite a trusted friend or family member to join you, Geller said, even if they can not accompany you all the way to the procedure room. “Come to the injection with a support person,” he said, adding that practicing relaxation techniques with your support person can help strengthen that coping mechanism.

Anti-anxiety medication is another option. While most are only available by prescription, diphenhydramine is an antihistamine often referred to by the brand name Benadryl.

Although the drug is generally used for allergies, it can have a calming effect that can help reduce anxiety. (Even for non-prescription drugs, it is important to consult a primary care provider before use, Geller said.)

When to seek help for needle phobia

While the above techniques can make a big difference when it comes to soothing nerves around needles, full-blown phobias require professional help.

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Among the most popular approaches is cognitive behavioral therapy, a collaborative process in which individuals work with providers to change their thoughts and behaviors.

Of all the methods he uses to treat phobias and anxiety in his practice in South Pasadena, California, psychologist Jeff Prater said CBT is the most common. Over the course of a series of sessions, Prater teaches patients to use relaxation techniques while gradually confronting their fears.

“The general approach is to create a hierarchy, starting from something that does not cause them any anxiety, and then constructing this hierarchy right up to the most horrible situation they can possibly imagine being associated with their needle phobia,” said Prater.

In the beginning, he said, it can mean practicing relaxation in a room where a needle is enclosed inside a drawer.

“Once they can think of it without any anxiety, I open the drawer,” he said. “Then I put it on the desk. They see it. And then we gradually move closer to the point where they actually pick it up.”

Why it’s important to deal with your needle phobia now

Between four and ten sessions is enough to effectively treat needle phobia for most people, Prater said. As vaccinations for Covid-19 become available in the coming months, this means that it is important to seek help for needle phobia as soon as possible.

If you ignore the problem, you could be exposed to years of anxiety. Leaving your phobia untreated can mean symptoms that worsen over time. While many children lose fear of needles as they move into adulthood, full-blown phobias tend to become more severe with age, Prater said.

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It’s a kind of feedback loop. “What drives anxiety is avoidance,” Prater said. “When you avoid this situation, your anxiety temporarily decreases. But when you face that situation again, your anxiety comes back. And it doesn’t just jump back to the same level – it actually increases.”

Only by facing concerns head-on can a person stop the development of that feedback loop, Prater said.

Walker, the fourth-year medical student, has done that. When she gets a flu shot every year, she is sure to inform the person administering the shot that she may be weak afterwards. But she always goes through it and has found that deep breathing techniques can help.

“Every time I say ‘OK, I’m getting better, I know what to expect, I know how it works.’ It has gotten better, ”she said.

As part of her education, Walker also regularly performs injections, and she said she thinks of work as a kind of exposure therapy. Insertion of intravenous needles triggers her needle phobia, but she has persevered. In that Walker’s education requires her to constantly face her phobia, it is in some ways similar to the therapy that Prater offers her own patients.

Walker plans to become a pediatrician, and she has already worked with many young patients who are afraid of getting their annual vaccinations. Her own experience of needle phobia, she said, is a source of empathy that she can draw on to better connect with them.

“Usually I say to them, ‘It’s okay, I’m getting really nervous too. But I’m still becoming a doctor. If I can be a doctor, you can get this one injection,'” she said. “It’s OK to be scared.”

Referrals to mental health services in your area are available – in Spanish and English – from Substance Abuse and Mental Health Administration (SAMHSA) hotline: 1-800-662-HELP.

Jen Rose Smith is a writer based in Vermont. Find her work on jenrosesmith.com, or follow her on Twitter @jenrosesmithvt.


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