Vaccines: 3 Things I'll Do Differently (Ok, maybe just 2)
The new guidelines on reducing distress (and pain) in vaccination are out, and they've got some practice-changing recommendations for adults and children.
1. Skip the alcohol swab
This is the one I found the least compelling in the guideline. It makes sense to skip this if we are trying to make the process as simple as possible for a patient who is extremely anxious. But from the comments on my Tiktok video about this topic, people are pretty hesitant to not clean an injection site before injecting!
2. Start offering numbing cream for adults if they're interested
I was trained that these don't work on adult skin, but "Placebo-controlled trials show that pharmacologic management of distress with topical anesthetics is effective in children and adults." This is in the guideline as a strong recommendation.
3. Bonus #3 on this list, but not a practice-changer for me, is to no longer aspirate ...however this advice has been around for several years from the Canadian Immunization Guide. I've included it here since I still know of some folks who still do this step out of habit, as it's something many of us were taught.
The guideline has multiple other recommendations on devices, video and music distraction, and order of vaccinations, which might also change how you practice.
The bigger picture takeaway for me: every extra step is a potential fear cue, so fewer steps in a smarter order make for a calmer visit.
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Refrences
Reducing distress during vaccine injections: 2026 clinical practice guideline update https://www.cmaj.ca/content/198/32/E1243 Image credit : Image credit: iStock / Getty Images Plus / Inside Creative House
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