How to overcome a fear of needles before your COVID-19 vaccine appointment

While most of us don’t love needles, it’s estimated that at least 10% of the population has a needle phobia that prevents them from seeking out essential medical care. It’s a concern for health experts, looking out for both the health of their patients and the future of the pandemic.

“From a public health standpoint, we don’t have a good number on how many adults are delaying or refusing the vaccine based on blood-injection-injury phobia, but it could be as high as 10-percent, and 10-ish-percent is going to keep us from achieving herd immunity,” says Katherine K. Dahlsgaard, a licensed psychologist board certified in behavioral and cognitive psychology.

“Now is a really great time to confront a fear that has maybe been holding you back for years. Being brave means I’m afraid, and I do it anyway for the greater good.”

If you’re afraid of needles, you’re likely familiar with the feelings of anxiety and dread that come when thinking about medical care involving injections. Perhaps you’ve experienced symptoms like a racing heart, sweating, or sleepless night in the days leading up to an appointment. Some people also experience what’s called a vasovagal response, a sudden drop in blood pressure that leads to dizziness and fainting before, during, or after needle injection. Naturally, this can spark anxiety.

“It’s important to remember that you’re not alone and to acknowledge this is a real fear that many people struggle with,” says Thea Gallagher, clinical director at the University of Pennsylvania Center for the Treatment and Study of Anxiety. “When your brain’s telling you a sharp object is coming at you, and it’s dangerous, it can be really hard to push past that. It’s a natural safety mechanism. But modern medicine is for our overall safety — it’s just sometimes hard to get our brain to cooperate.”

» READ MORE: How to prepare for your COVID-19 vaccine appointment

Getting vaccinated is our best defense against COVID-19. Fortunately, experts say there are ways to overcome a fear of needles, whether it’s preventing you from making an appointment or causing panic when you show up.

Here are some strategies to help you get through your appointment.

It may be time to see a trained professional if your fear is preventing you from routine and essential medical care. They’ll use techniques like exposure therapy to help you learn to tolerate the distress. Exposure therapy includes gradually and systematically exposing you to your fears. You may, for example, be shown photos of needles, then actual needles, and gradually work your way up to videos of people getting shots. Therapists may also teach you applied tension techniques, which can prevent nausea and fainting from a vasovagal response.

“It’s training patients to recognize when their blood pressure is falling and then how to tense their muscles to raise their blood pressure on their own,” says Dahlsgaard.

As Dahlsgaard noted in a recent Inquirer piece, exposure therapy with applied tension can be highly effective. In a 2018 study among adults diagnosed with a phobia of blood, injury, and/or injection, 70% completed a successful blood draw after one session.

To find a professional, start by searching for Cognitive Behavioral Therapists who specialize in anxiety. You can ask if they’re experienced in exposure and applied tension therapy.

Once you show up at your appointment, tell the vaccine administrator about your fear.

“They want to help support you, and may instruct you to lay down, look away, or tense your muscles,” says Gallagher.

Gallagher, who says she passes out usually once a year from a vasovagal response, adds, “The worst thing that could happen is you pass out, and just remember that you’re in a safe place to do that. Don’t let the fear of it get in the way.”

The nurse or vaccine administrator may have you tense your muscles for 20 to 30 seconds, especially if you’ve fainted in the past, to help raise your heart rate and blood pressure. However, try to keep the arm that’s getting the shot relaxed.

“If you tense your muscle, it’s going to hurt more,” says Eric Sachinwalla, medical director of Infection Prevention and Control at Einstein Medical Center Philadelphia.

» READ MORE: You can drink, but don’t go on a bender after your vaccine. Here’s why.

It may help to have a friend or family member by your side. See if you can schedule your vaccine appointments together, or call the vaccine center and ask if it’s OK to bring a support person. You can also ask a buddy if they’ll be available during your appointment time for you to text or even video chat.

“If you really don’t like shots but you get them, give yourself a lot of credit for that,” says Gallagher. “There’s no need to hide it or judge yourself. Tell people and get the help you need. Everyone has things that are difficult for them.”

The actual shot is just a few seconds. But having a distraction can help refocus your mind away from the anxiety, especially in those moments when you’re waiting your turn.

“I would always try to distract people by talking about something else when giving shots, but you could also put music on or listen to a podcast,” says Sachinwalla.

Before heading in for your appointment, it may help to spend a few minutes focusing on your breath, says Gallagher. Count your inhalations and exhalations, breathing in for one, and out for two.

“This can help with the anxiety piece of it. But once you’re there, doing less thinking might actually be beneficial,” says Gallagher.

You’re also encouraged to stay hydrated and have a meal before your appointment. Control what you can so that you don’t feel dizzy or lightheaded for reasons other than the vaccination process.

Finally, remind yourself why you’re getting vaccinated. This is an important moment for you and your entire community.

“It felt like a big party when I went to get my vaccine. You can focus on the excitement and the big picture, and try to expand your attention to things beyond the fear,” says Gallagher.

One suggestion: Think about all the people you’re going to hug once you’re fully vaccinated.

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