Tips For Administering The COVID-19 Vaccine To 5-11 Year Old Patients

What we know: Fear increases a patient’s perception of pain, therefore, building rapport, quick assessment, preparation, and the use of pain management interventions are beneficial to a child’s coping.

Here are ways you can help reduce the patient’s fear and provide an emotionally safe experience:

Build Rapport:

• Speak to both the patient and the caregiver/guardian.
• Validate any observed fear or anxiety, “It looks like you are feeling a little bit nervous, let’s talk about what we can do to make this as easy and comfortable for you as possible.”

Quick Assessment:

• Ask the patient, “How do you typically do with shots/pokes?” “Do you remember the last time you had one?”
• Some patients will have developmental, behavioral, or sensory needs that need to be acknowledged before moving on. Collaborate with the family to come up plan to support the patient’s needs.
• Based on previous experiences, decide what interventions may be helpful in order for the patient to receive the vaccine. “It sounds like last time was pretty scary for you, maybe this time would you like to try some distraction to take your mind off of it and take relaxing breaths?”

Prepare:

• Be honest with the patient and let them know what you are going to do but also let them know they can be a part of the plan.
• Give the patient and caregiver/guardian a job.
  • “Your job is to hold as still as you can, you can watch or look away.”
  • “Let me know if you don’t want to watch so I can give you a heads up before I do it.”
  • “Would you like for me to count ‘1,2,3’ or just do it?
  • “[Caregiver/Guardian], why don’t you sit right here beside [patient] to hold their hand, if they want, or just talk to them to help comfort and distract them.”
• If patient or guardian begins to escalate with fear or frustration, validate and de-escalate. “We need to continue to remain safe while we do this vaccine, your job is to …. And I will do everything I can to help make this as easy and comfortable as possible for you.” “It seems like your [Caregiver/Guardian] really wants for you to be safe and get this vaccine to keep your body healthy. Let’s work together to get this done.” 

Provide Pain Management and Coping Techniques:

• Comfort Position
  • Allow patient to sit up next to or in parent’s lap, laying down is the most vulnerable position. When a child feels in control, they act in control.
• Cold Spray (aka “Elsa Spray” “Mr. Freeze Spray”)
  • Maybe say, “This is a helper so [the patient] doesn’t have to feel the poke as much.”
  • Clean and prepare the vaccine site, spray cold spray for 4-10 seconds and administer the vaccine without delay.
• Take relaxing breaths
  • Encourage the patient to take a breath in through their nose like they are smelling a flower and breathe out of their mouth like they are blowing out a candle.
• Therapeutic conversation
  •  “Describe your idea of a ‘perfect’ day. What would make it perfect?
  • ” “If you could travel anywhere in the world, where would you go, who would you take with you?”
  •  “If you could be president for a day, what would you do?”
• Items for distraction
  • Patient or guardian’s electronic device for listening to music, looking at pictures, etc.
  • I Spy sheet
  • Squeeze ball