With the COVID-19 vaccine now available for kids ages 5-11, parents everywhere are scheduling vaccine appointments for their children. In kids these ages, we see a wide variety of responses to getting shots. Some receive them rather easily, some require a bit more hand-holding, and others have a really hard time facing needles.
As you think about your child receiving the COVID vaccine, doing some prep work in advance can help things go as smoothly as possible. Use these tips below as you prepare your child to get vaccinated.
1. Know how your child feels about receiving the vaccine
In our COVID vaccine clinics here at Cincinnati Children’s, there has been a range of emotions from children who are about to get the vaccine. Some are incredibly happy to receive it, while others are more cautious.
Talk to your child in an age-appropriate way about how they’re feeling about getting the vaccine. Many young children may not think any differently of this than any other vaccine. But some kids may be more tuned in to this vaccine in particular, because they might associate it with being safer, not needing to wear masks, and being able to get together with friends more.
You know your child best. Most children will cope with receiving the COVID vaccine the same way they have for their other vaccines. Monitor your child’s knowledge and their access to information, and discuss any concerns they might have.
2. Ask where your kids are finding vaccine information
This is especially important in older kids who have more access to information online. Make sure they are getting information from trustworthy sources; there is a lot of misinformation about the COVID vaccine on the Internet.
Likewise, some kids might be anxious about what they are hearing from friends or when family members disagree and discuss this content in front of them. Check in with them, ask what they know or what questions they have, and give them accurate answers from trusted sources. Try to avoid having conversations about the controversies about the vaccine in front of them.
Here are two videos that explain COVID-19 and vaccines in kid-friendly terms:
3. Should you tell them they’re getting a vaccine ahead of time?
I would base this decision on how comfortable your child is with getting shots. Some kids do better knowing a few days in advance. Others you might want to tell the morning of the appointment or right before leaving the house.
For most kids, it’s not a good idea to hide it completely and spring it on them once they are at the appointment. While it may ease the child’s anxiety leading up to the appointment, it may increase their lack of trust over time. As they get older, they are more likely to remember those deceptions.
4. Be honest with your child
- It’s OK to say shots can feel like a little pinch.
- Remind them that it is fast and will not hurt for long.
- If your child is bothered by the word “shot,” it can help to call it a “vaccine” or “medicine in the arm.”
Some kids cope by having a lot of information. For those kids, it might help them to know the COVID vaccine is given in the arm, not the leg.
5. Focus on the positive
The big benefit of this vaccine is that it helps keep kids from getting severely ill if they do contract COVID-19. Remind your child that immunizations help keep them healthy and protect them from getting sick.
For younger children, I like to use this explanation: “We’re going to put an army in your arm and that army is going to go out and help protect your body to keep you from getting sick.” That can make kids feel that they are doing something good to help their body.
6. Consider incentives
You may want to provide an incentive for immediately after receiving the vaccine, such as going to the park or another fun outing or special treat. This can help your child focus on that rather than the shot. This may only be needed for children with increased anxiety about vaccinations.
7. Teach and use coping strategies
Before your appointment
The following coping strategies can be helpful in stressful situations. They are most successful when worked on in advance. Practice them often and make them a part of your daily routine.
- Deep breathing. Take a deep breath in through your nose, pretending to “smell the flower” and blow out slowly through your mouth pretending to “blow out the candle.” Practice doing this for 3-5 breaths. To increase interest, this can also be done with a bubbles, a pinwheel or with other items.
- Stress ball. Practice squeezing a squishy ball for 3-5 seconds, then release it. Do this several times. Once they can do this with a ball, they can try to do this with the muscle in different body parts. Choose a part and focus on a 3-5 count squeeze, then relax.
It helps to model these practices at home so your child can see the strategies work. For example, if you accidentally drop a gallon of milk on the floor, state out loud that you’re frustrated and are going to do some deep breathing to help you calm down, then model that breathing and calming strategy.
During the vaccine
- Use ice and/or vibration near the needle injection site. Many pediatrician offices have Buzzy®, a product that offers an ice pack/vibration combination to minimize pain at the injection site. Ask ahead of time if this is an option. The Buzzy can also be used effectively without ice.
- Bring distractions. Bring comforting items, or a favorite book, toy or music to help distract your child and keep them calm.
- Give appropriate choices. Which arm? Count to 3 or just do it?
- Sit up. Often it is helpful to ask the provider if your child can sit up instead of lie down for the vaccine. Sitting up helps many children feel more in control.
- Comfort Hold. If your child needs help holding still, try holding your child in a firm but comforting position on your lap. This works best for a child who is much smaller than the parent and when the parent is sitting in a chair with a back. The best three positions for comfort holding for vaccines include:
- Have your child straddle your lap and hold them chest to chest in a tight hug with their arms secured under your arms. You can talk calmly in their ear to help them cope.
- Have the child sit in your lap with their back to your chest and wrap your arms securely around their core with their arms under your arms.
- Have the child sit on your lap with their side to your chest and wrap your arms around their core with their outside arm under your arms/hands.
- Be a calm and supportive model. Children cope better when parents remain calm, positive and supportive. Stay positively focused and avoid reprimanding them when they are anxious.
- Help your child use the coping strategies above that you practiced at home.
8. Give notice to the nurse
If your child is particularly nervous or fearful, you may want to pull the nurse aside ahead of time and mention that. Nurses face needle fears a lot. Giving them a bit of notice helps them know how to handle the situation and what strategies they should be ready to use.
9. Praise your child
It takes some kids longer than others to be ready to receive a vaccine. Keep encouraging them and being positive throughout the process and afterward. This encouragement can help toward the next time your child needs a shot. Use statements like:
- “You can do this; you’ve got this.”
- “You did it, and you’re ok.”
- “I know you didn’t like it, but I’m excited for you because this is going to keep you healthy.”
10. Use emotional support strategies for kids who are very fearful
Some kids won’t do well receiving a vaccine no matter how much preparation they have. Do not hesitate to pull the nurse aside and let them know this. In this situation, it is best to give the child brief preparation and then get through it quickly, because your child’s fear overtakes their ability to listen to reasonable, rational explanations. Their anxiety may be too powerful to allow them to feel ready. If the child is asking to try to do it on their own, but continues to delay, it can be helpful to set a timer for a minute or two (use your phone) and then move forward to hold if needed.
For these kids, doing the vaccine quickly while providing emotional support may be the best option. In these cases, the following steps may help:
- Make sure your child knows they are not in trouble, and nobody is angry.
- Use the least number of people necessary to hold the child.
- Establish one communicator to the child to provide information and emotional support.
- All others stay quiet and calm.
- Praise the child when finished.
Then, provide choices and support following the vaccine:
- Allow them to choose an appropriate spot to wait their 15 minutes.
- Allow them to choose an activity to do while waiting.
- Praise their success in getting the vaccine, even if they needed to be held, to build confidence for next time.
When to seek help for needle-based anxiety
Any child above the age of 7 who is struggling to cope with vaccines may benefit from treatment to help increase coping with needle-based procedures. Treatment is available and it’s effective. Here’s one family’s story of successful treatment for severe needle phobia.
Cincinnati Children’s agrees with recent guidance from the American Academy of Pediatrics that masks and vaccinations remain the most effective protection against severe illness, hospitalization, and risk of death from COVID-19. For more information about the vaccine, answers to many vaccine questions, and a link to Cincinnati Children’s vaccine clinics, visit our COVID-19 Vaccine FAQs.
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