Flu season is upon us, and if you or your children haven't yet been vaccinated, it’s time to face the needle. (The Centers for Disease Control and Prevention is advising against the nasal spray vaccine for 2017-2018 flu season.)

Fear of shots is a widespread problem—for both children and adults. In a 2012 survey of nearly 2,000 people conducted by University of Toronto researchers, 24 percent of adults and 63 percent of kids reported a fear of needles. Worse, 7 percent of adults and 8 percent of children surveyed don't get immunizations as a result.

Whether the vaccines you're getting are for the flu or another infectious disease, “needles can save your life," says Anna Taddio, Ph.D., R.Ph., a professor of pharmacy at the University of Toronto, who has co-authored guidelines on reducing vaccine pain.

“There hasn’t been enough focus, by either doctors or researchers, on the very real discomfort people experience from needles,” she adds. 

Reducing Needle Fear and Pain

Research on the most effective pain-management strategies for vaccinations is limited. Still, some interventions for reducing discomfort and/or fear are worth trying. Some of what follows is for children only; others are for adults, too.

Model calmness. Parents' behavior is key in reducing kids’ distress when they're getting immunized, suggests research published in 2017 in the journal Pain. So, calmly explain what’s going to happen—for example, that it will briefly sting—and act as composed as you possibly can before and during the vaccination.

Use distraction techniques. Diverting your child’s attention temporarily can be helpful, according to the CDC. Strategies can include playing music or reading a book. Adults can try the same diversions, or others, such as deep-breathing exercises.  

Ask your doctor about numbing cream. Prescription topical creams that contain lidocaine and prilocaine (Emla, Relador, and generic) can cut vaccine pain in half, the University of Toronto's Taddio says, and both children and adults can use these. The creams take anywhere from 20 to 60 minutes to become fully effective, depending on the brand. Taddio suggests bringing cream to the doctor’s office and asking the nurse when you first arrive to show you where the shot will be given, so you’ll be sure to numb the right area in advance.

Keep kids close. Having your child sit on your lap during an injection can provide comfort, says Jen Elliott, R.N., a nurse at Children’s Hospital of Philadelphia. If your child is too young to sit still, work your arm over her arm or leg to stabilize it for the injection—but gently, without pressing so hard that she feels restrained.

Soothe younger ones with sweetness. Young babies can be breastfed through an immunization, because the sucking and sweetness of the milk are comforting, Elliott says. Older babies or toddlers who are no longer breastfeeding may benefit by having something sweet drizzled on their tongue. (Dilute a packet of sugar in a few teaspoons of water and drip a little on just before the shot is administered, Taddio advises.) However, such sweet solutions weren't shown to be effective in relieving vaccine pain for school-age children, a 2015 review concluded.

For multiple shots, pay attention to the order. Depending on their chemical composition, some vaccines simply hurt more than others. If you or your child are getting several shots in one office visit, ask to receive them in the order of least-to-most painful, Taddio advises.  

Consider OTC meds after a shot. Taking an over-the-counter pain reliever such as acetaminophen (Tylenol and generic) or ibuprofen (Aleve, Motrin IB, and generic) won't prevent the sting of a shot, says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser, but it may reduce the arm soreness or fever that can sometimes occur afterward. A cool wet washcloth placed on the spot may help, too.  

Needle Phobia Solutions

For a needle phobia that actually prevents you (or your child) from getting vaccinated, consider several sessions of exposure therapy, which is designed to help people confront their fears, with a cognitive behavioral therapist. A 2015 review by Canadian and British researchers, including Taddio, found that exposure-based psychological interventions are helpful for reducing needle fears.