A flu vaccine means a shot this year. How to ease kids' fear, pain

Sorry, needle-hating kids – you will not be able to get your flu shots in nasal spray form this year.

That’s because both the Centers for Disease Control and Prevention and the American Academy of Pediatrics now say the FluMist nasal version has not worked well in recent years. The pediatrics group made their stance official Tuesday, citing a meager 3% effectiveness rate for children getting the nasal version, vs. 63% for shots.

So it’s back to shots for the one third of vaccinated children who got the nasal spray last flu season. Pediatricians – anticipating some nervous kids and parents – are promising to ease the sting.

“In my experience, there’s always a way to make it work,” even if a child walks in feeling very fearful, says Melissa Winterhalter, a pediatrician at Nationwide Children’s Hospital, Columbus.

Distractions such as videos or music can help young children, she says. Older kids might try deep breathing, chatting about a favorite subject or counting down and then coughing just as the needle goes in. The cough technique is backed by research.

Winterhalter also swears by a buzzing bee-shaped device with ice-filled wings that many doctors and nurses use. “If I’m giving a shot in the arm, I put it on the shoulder,” she says. “It really doesn’t relieve pain, but diminishes the sensation because there’s so much sensory input coming in.”

Melissa St. Germain, a pediatrician with Children’s Physicians in Omaha, says she and her colleagues offer kids colorful boxes full of pain-easing devices, including the buzzer, cold sprays and sparkly wands (for distraction).  Babies get sugar water, another research-backed technique.

Such strategies are worth trying, says Wendy Sue Swanson, a pediatrician at Seattle Children’s Hospital and a spokesperson for the pediatrics academy. But, she says, it’s important to be honest with children: “Don’t’ promise that it’s not going to hurt, because it will, but it will be over quickly,” she says. Afterwards, she says, offer a reward.

Some of her other tips:

• Get vaccinated as a family. Try lining up the youngest kids first – no big brother or sister wants to look less brave than the baby.

• If you are anxious, kids will be too. "So if you as a parent are a bit needle-phobic, send your partner, send grandma.”

• Give the child some choices – such as which arm to use.

• But don’t make getting a flu shot a choice. “We are not leaving this decision up to the kids. It’s our job as parents to get it done.”

Fewer than half of U.S. children got a flu shot last year, CDC says. About 20,000 children under age five are hospitalized each year for flu complications and more than 100 die in some years. The agency says everyone over 6 months old should get a flu vaccine every year..

FluMist, from MedImmune, has previously been recommended for children and adults ages two to 49, and may be recommended again in the future, CDC says.


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