How to Overcome a Fear of Needles

Is a fear of needles standing between you and the COVID-19 vaccine? You're not alone. Here, medical experts share some helpful hints on how to get through the process without breaking a sweat.

More than a year after COVID-19 sent the world into lockdown, safe and effective vaccines to protect against the virus are being administered across Canada. In addition to reducing your risk for infection, mass vaccination is also the first step towards achieving herd immunity. According to the Canadian government, everyone in Canada who wants to be vaccinated should be able to get their first shot by July, and be fully immunized by September.

For many of us, waiting for things to get back to “normal” is the hardest part, but for others this experience is far more than just a tiny prick. If the thought of needles makes you dizzy, then getting vaccinated can become another source of stress and anxiety. In Canada, about one in four adults report that they’re afraid of needles. Here’s what you need to know about having a fear of needles and what can be done to manage it.

What’s the difference between a fear and a phobia?

Everyone feels scared at some point, from getting slightly startled by a squirrel on your morning run or encountering a grease fire on the stove. A phobia, on the other hand, is a medically diagnosed condition, combining extreme fear, anxiety, and avoidance in a way that interferes with your life, says Dr. Meghan McMurtry, an associate professor in the Clinical Psychology program at the University of Guelph and a specialist in medical procedure-related fear.

It’s estimated that up to four per cent of the general population has a “blood injury injection phobia,” a condition in which someone is likely to faint at the sight of blood, or at the anticipation of an injection or injury. Like a game of dodgeball, people with phobias try to avoid whatever triggers their fear or anxiety at any cost, which can lead to a limitation on daily activities and can put a strain on relationships. With a phobia, the feelings of fear and anxiety are commonly out of proportion to the danger posed. As well, people with phobias don’t benefit from the same pain management strategies often recommended for those with a low level of fear, and usually require professional help.

Close up view of caring female doctor in facial mask touch support elderly patient. Supportive woman GP or nurse in protective facemask comfort unhealthy elderly man at consultation. Corona concept.Photo: Shutterstock

What causes a fear of needles?

There isn’t a single experience or characteristic that causes someone to have a fear or phobia of needles. Instead, it’s a combination of different biological, psychological and social factors that come together, says McMurtry. This could include genetics, an unpleasant memory or witnessing someone else have a negative experience.

Are you looking for the nearest exit during a blood test? A sign that you might have a fear of needles is wanting to escape during medical procedures or avoiding them altogether. You might find it hard to sit still or get incredibly anxious just thinking about or discussing needles. If these feelings start to interfere with your daily life, it’s a warning sign that your fear is turning into a phobia.

How can you manage a fear of needles?

The CARD system

Dr. Anna Taddio, a professor at University of Toronto’s faculty of pharmacy who specializes in pain mitigation during medical procedures, says that the CARD System is a tool that can help a patient through their fear of needles. The acronym stands for a group of interventions addressing pain, fear, or fainting.

  • Comfort: If you’re feeling anxious, sitting upright can make you feel more in control. Comfort can also be found in having a snack prior to the vaccination or bringing along a favourite item.
  • Ask: Asking questions can help alleviate fear by ensuring you know what to expect before, during and after the procedure.
  • Relax: Focusing on breathing can help soothe stressed nerves. Try inhaling and exhaling deeply. Use positive self-talk to remind yourself that you can handle the situation.
  • Distract: A good distraction can go a long way in taking your mind off the procedure. Play a game on your phone, listen to music or talk to someone.

Pain management

The pain associated with getting a needle can be mitigated with a quick trip to a pharmacy. Non-prescription topical anesthetics like numbing cream or patches can be applied to the arm up to an hour ahead of a vaccination, says Taddio.

Exposure-based therapy

For people with a high-level fear of needles or a phobia, McMurtry recommends exposure-based therapy. This is a type of treatment in which the patient is exposed to needles in slow and controlled steps under supervision. It’s delivered by a mental health professional like a psychologist, and begins with a list of everything you fear about the needle, in order from least to most frightening. The patient might start off at their lowest level of fear by looking at a picture of a needle and progress to holding a needle. Each step is repeated “until they realize their fear will come down and that whatever it is they’re most worried about, won’t happen,” says McMurtry. “Or that if it does, they’ll survive it.”

Practitioner vaccinating woman patient in clinic. Doctor giving injection to adult woman at hospital. Nurse holding syringe and inject Covid-19 or coronavirus vaccine.Injection covid vaccine conceptPhoto: Shutterstock

What happens if this fear isn’t addressed?

If you have a fear of needles, you might be averse to medical procedures such as vaccines. For some, this can become a life-threatening situation, like when people who are diabetic fear taking their insulin injections, says Taddio. In Canada, it’s reported that about 1 in 10 people say a fear of needles and pain may influence their decision to get vaccinated.

Healthcare professionals need to take the fear of needles more seriously, says Taddio. This can be done by recognizing cues and being mindful of the ways that the experience can be made less frightening for patients. For example, when setting up vaccine clinics, the needles could be hidden from view until the procedure.

Can you ever fully overcome a fear of needles?

Research shows that a fear of needles does tend to decrease with age. For certain segments of the population, however, that fear doesn’t go away if they aren’t proactive in overcoming it. “The fact that a quarter of adults has a fear of needles and the majority of them are acquired in childhood tells you that they don’t just go away when you do nothing,” says Taddio.

People with a fear of needles should start by speaking with a doctor or psychologist with expertise in cognitive behavioural and exposure therapy, ideally for needle phobias. If you’re looking for a healthcare professional, McMurtry recommends this list of anxiety specialists in Canada. Another resource is Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors and Dentists, which includes exercises to work through at home. Anxiety Canada also has self-help strategies to help you learn how to manage your fear and phobia.

Next, learn what you can (and can’t) do after getting the COVID-19 vaccination.

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