Vaccine Anxiety in Children

Sunday, August 25, 2024, 7:00 AM - Thursday, April 1, 2027, 7:45 AM

AMA PRA Category 1 Credits™ (0.75 hours), CME-Designated Participation Credit (0.75 hours)

This video provides an overview of vaccine anxiety in children and tips for how to support them in a clinic setting. There is a special focus on children who have also experienced trauma and/or parental substance misuse. This information is presented by Melony Williams, LCMHC, from TLC Family Resource Center in Claremont, NH and Torie Miele, MS CCLS, Child Life Specialist at the Children's Hospital at Dartmouth Hitchcock in Lebanon, NH.

Presenters

Melony Williams, LCMHC and Torie Miele, MS CCLS

About our presenters

Melony Williams is the Clinical Supervisor for TLC Family Resource Center in Claremont, NH. She is an experienced Mental Health Counselor who specializes in working with young children and their families and families who have experienced trauma, loss, or grief. She provides direct client care individually and in groups, supervises home visitors who work for the TLC Family Resource Center, and consults with community providers. 

Torie Miele is a Certified Child Life Specialist at the Children’s Hospital at Dartmouth Hitchcock. She works with children and families in the hospital to help them cope with medical and other difficult life experiences. She focuses on the mental, emotional, and social needs of each individual child and family and provides guidance through knowledge of child development, therapeutic play techniques, and family-centered care.

1. Describe at least two strategies to reduce anxiety for children in preparation for receiving injections.

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American Medical Association (AMA)
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Bibliographic Sources

Resources:

• Help Eliminate Pain in Kids and Adults (HELP)- ways to make vaccinations less painful: http://phm.utoronto.ca/helpinkids/
  
  
• CARD: Comfort, Ask, Relax, Distract https://assets.aboutkidshealth.ca/AKHAssets/CARD-StudentHandout.pdf 
  
  
•  
• AAP Toolkit for TIC:
  https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/Pages/Trauma-Guide.aspx
  
  
• AAP Guidance on Supporting Emotional and Behavioral Health Needs of Children during Covid-19:
  https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-on-supporting-the-emotional-and-behavioral-health-needs-of-children-adolescents-and-families-during-the-covid-19-pandemic/ 
  
  
• AAP Guidance on Support Child Welfare Involved Families during Covid-19:
  https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/guidance-for-children-and-families-involved-with-the-child-welfare-system-during-the-covid-19-pandemic/  

General information for vaccinations with children:

• https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Practice-Management/Pages/Vaccine-Administration.aspx 
  
  
• https://www.immunize.org/clinic/administering-vaccines.asp 
  
  
• 2011 Video “The Family Experience with Primary Care” – what it’s like for children with mental illness and their families interfacing with primary care providers- NAMI https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Mental-Health/Pages/Family-Experience.aspx 

For PARENTS: 

• https://www.cdc.gov/vaccines/parents/visit/
  
  
• 9 Things You Can Do For You And Your Baby: https://www.cdc.gov/vaccines/parents/visit/less-stressful.html 
  
  
• Mirror and Match: De-escalation techniques https://childsavers.org/deescalation-techniques/ 
  
  
• Meg Foundation for Pain  https://www.megfoundationforpain.org/ 
  
  
• https://www.childrenscolorado.org/conditions-and-advice/parenting/parenting-articles/fear-of-shots/#:~:text=Focus%20on%20health%3A%20Remind%20your,lie%20down%20for%20the%20shot. 
  
  
• https://www.webmd.com/children/vaccines/features/helping-child-who-is-afraid-of-vaccines#1
  
  
• https://www.psopkids.com/addressing-vaccination-anxiety-in-children/ 
  
  
• https://www.npr.org/sections/health-shots/2016/07/12/485140592/parents-can-help-reduce-pain-and-anxiety-from-vaccinations 

Medical Trauma Resources:

• NCTSN https://www.nctsn.org/what-is-child-trauma/trauma-types/medical-trauma 
  
  
• Pediatric Medical Traumatic Stress Toolkit for Health Care Providers: https://www.nctsn.org/resources/pediatric-medical-traumatic-stress-toolkit-health-care-providers 
  
  
• Center for Pediatric Traumatic Stress (CPTS): https://www.chop.edu/centers-programs/center-pediatric-traumatic-stress
  
  
• Health Care Toolbox, from Center for Pediatric Traumatic Stress (CPTS): https://www.healthcaretoolbox.org
  
  

Resources for Mental Health:

• https://www.cdc.gov/childrensmentalhealth/depression.html
  
  
• https://www.nhs.uk/conditions/anxiety-disorders-in-children/ 
  
  
• SAMHSA’s Guidance for a Trauma Informed Approach: https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
  
  

Where to purchase items:

• Buzzy- https://paincarelabs.com/buzzy 
  
  
• Shot blockers- https://bionix.com/shotblocker.html 
  
  
• Freeze Ease spray- Gebauer's Pain Ease Spray | Skin Refrigerant Anesthetic Spray
  
  
• Stress balls and other fidgets - https://www.playopolistoys.com/product-tag/distraction/ 
  
  
• Comfort position posters- Rainbow Comfort Measures from Rainbow Babies and Children’s Hospital
  Contact: Lissy Zaremba  MA, CCLS; Clinical Educator, Family and Child Life Services, [email protected], Phone: (216) 844-1353
  
  

Journal Articles:

• McMurtry,  C.M., Taddio, A., Noel, M., Antony, M.M., Chambers, C.T., Asmundson, G.J., Pillai Riddell, R., Shah, V., MacDonald, N.E., Rogers, J., Bucci, L.M., Mousmanis, P., Lang, E., Halperin, S., Bowles, S., Halpert, C., Ipp, M., Rieder, M.J., Robson, K., … Scott, J. (2016). Exposure-based interventions for management of individuals with high levels of needle fear across the lifespan: A clinical practice guideline and call for further research. Cognitive Behavioral Therapy, 45(3), 217-35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867871/ 
  
  
• Ahmadpour, N., Weatherall, A. D., Menezes, M., Yoo, S., Hong, H., & Wong, G. (2020). Synthesizing multiple stakeholder perspectives on using virtual reality to improve the periprocedural experience in children and adolescents: Survey study. Journal of Medical Internet Research, 22(7), e19752.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395245/ 
  
  
• McMurtry C. M. (2020). Managing immunization stress-related response: A contributor to sustaining trust in vaccines. Canada communicable disease report, 46(6), 210–218. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343055/ 
  
  
• World Health Organization. (2019). Immunization stress-related response: A manual for program managers and health professionals to prevent, identify and respond to stress-related responses following immunization. Geneva (CH): World Health Organization. https://www.who.int/publications/i/item/978-92-4-151594-8 
  
  
• Sørensen, K., Skirbekk, H., Kvarstein, G., & Wøien, H. (2020). Children's fear of needle injections: a qualitative study of training sessions for children with rheumatic diseases before home administration. Pediatric Rheumatology Online Journal, 18(1), 13. 
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007654/ 
  
  
• Felitti, V.J., & Anda, R.F. (2014). The Lifelong Effects of Adverse Childhood Experiences. In Chadwick’s Child Maltreatment: Sexual Abuse and Psychological Maltreatment, (Vol. 2, pp. 203-216). St. Louis, MO: STM Learning, Inc. 
  
  
• Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14, 245-258.
  
  
• Merrick, M.T., Ford, D.C., Ports, K.A., & Guinn, A.S. (2018). Prevalence of adverse childhood experiences from the 2011-2014 Behavioral Risk Factor Surveillance System in 23 states. JAMA Pediatrics, 172, E1-E7. doi:10.1001/jamapediatrics.2018.2537
  
  
• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  
  

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