Tips for Administering Vaccines to Patients Ages 5-11

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 questions like “How do you typically do with shots/pokes?” or “Do you remember the last time you had a vaccine?”
  • Some patients will have developmental, behavioral, or sensory needs that need to be acknowledged before moving on. Collaborate with the family to make a 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 the 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 the patient to sit up next to or in a 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” or “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 and 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