Fear of needles and COVID vaccine hesitancy

[sue_frantz]

According to the CDC, as of December 8, 2021, 83.5% of U.S. adults have had at least one dose of a COVID vaccine. When the unvaccinated are interviewed by journalists, they report a number of reasons for choosing not to get the vaccine, such as being too healthy to need it and not trusting that the vaccine is not harmful (Bosman et al., 2021).

What I have not heard in person-on-the-street interviews, however, is someone saying they are not getting vaccinated because they are afraid of needles. In a pre-COVID meta-analysis, researchers found “[a]voidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities, and 8% of healthcare workers at hospitals” (McLenon & Rogers, 2019, p. 30), and the younger the people, the more common the fear. For young and young-ish adults (ages 20 to 40), approximately 20% to 30% have a needle fear (McLenon & Rogers, 2019).

I wonder how many of the unvaccinated have a fear of needles but are citing other reasons for avoiding the vaccine. All of the photos of healthcare workers jabbing people with needles cannot be helping. For someone who is needle-phobic—or merely needle-averse—seeing a jabbing photo would likely result in them immediately turning away. Not only are they not getting the vaccine, they are not getting good information about the vaccine.

In our Intro Psych courses, we can assume that 20% to 30% of our students have a fear of needles. For our students who do not have a fear, they certainly know someone who does, whether they know it or not. When we cover phobias and treatment for phobias, let’s include needles (but no photos!) as an example.

Where does the fear of needles and shots come from?

It is easy to see how a needle fear would develop. Classical conditioning offers a pretty likely scenario. A young child is approached by a gloved healthcare worker carrying a needle, gets a shot, and the shot hurts! Things that hurt are scary. The hurting is the unconditioned/unconditional stimulus, and the fear is the unconditioned/unconditional response. The needle (and all things associated with it) is the conditioned/conditional stimulus, and the fear of it is the conditioned/conditional response. Observational learning may have been the source of the fear for some, such as seeing a sibling screaming after they got a shot.

As we know, the key to overcoming fear is exposure. For most of us, as we got older and we received more and more shots, the fear began to dissipate. Yes, the shot may still hurt, but by the time we are well into adulthood, we have been hurt in many worse ways. The sting from the jab is a pain that we know is both temporary and manageable. For some, though, that is not the case. The fear has not dissipated, perhaps because they have spent most of their life avoiding needles.

Strategies and Treatment for Fear of Needles

There are several strategies a person with a fear of needles can use (Huff, 2021). Techniques useful for relaxation can help, such as taking deep breaths and picturing serene environments. For some, knowing exactly what is going on as the shot is being prepared is helpful. For others, knowing absolutely nothing and, with headphones on, being completely absorbed in a game or video is preferred. In either case, the person should communicate their preferences with the healthcare provider. A little self-talk doesn’t hurt, either: “I have so got this!”  

For those with more severe fears, working with a mental health provider trained in systematic desensitization would be best (Huff, 2021). Identifying the cause of the fear is first. Is it the needle? The pain? Blood? Next, the mental health provider would work with the client to create a fear hierarchy. If the fear is the needle, then they may start with viewing a drawing of a needle. With the help of say, progressive muscle relaxation, the client relaxes. Once again, the drawing is presented, and the client relaxes. Once the client can look at the drawing without tensing up, they move on to the next item in the fear hierarchy, such as a photo of needle, then perhaps a plastic toy needle, and so on up to a real needle.

Helping our students see that a fear of needles is conquerable may help save their lives or the lives of their loved ones.

References

Bosman, J., Hoffman, J., Sanger-Katz, M., & Arango, T. (2021, July 31). Who are the unvaccinated in America? There’s no one answer. New York Times. https://www.nytimes.com/2021/07/31/us/virus-unvaccinated-americans.html

Huff, C. (2021). How psychologists can help patients with injection fear. Monitor on Psychology, 52(4). https://www.apa.org/monitor/2021/06/injection-fear

McLenon, J., & Rogers, M. A. M. (2019). The fear of needles: A systematic review and meta-analysis. Journal of Advanced Nursing, 75(1), 30–42. https://doi.org/https://doi.org/10.1111/jan.13818