How patients can overcome needle phobia and get the COVID vaccine

needle phobia
© Leigh Prather

Dr Deborah Lee, Dr Fox Online Pharmacy, explores what can be done to help patients who refuse the COVID-19 vaccination due to needle phobia

I remember seeing a young male patient in a Sexual Health Clinic some years ago. I just casually mentioned he might need a blood test and the next thing I knew he was flat out on the floor! I hadn’t even shown him a syringe or a needle – the mere mention of the possible need for a blood test was enough for him to spark out!

This is true ‘needle phobia’ – an extreme fear of needles, which cannot be overcome by rational explanation, and is so serious that it stops patients from having the tests and the treatments they need.

At the present time, we are trying to vaccinate the whole country against COVID-19, and those with needle phobia will be at a great disadvantage. Even hearing regular news broadcasts about the need for vaccination will induce fear and panic.

Needle phobics are a group likely to refuse the COVID vaccination, which after all, involves not just one jab, but two.

What can be done to help needle phobics at this crucial time? 

What is needle phobia?

Needle phobia has a proper medical name – trypanophobia. It’s a recognised psychiatric condition, where an irrational fear of being pricked by a needle induces severe feelings of dread and anxiety.

Even the thought of an impending procedure which requires venepuncture, induces an acute anxiety response, or a panic attack – a rapid heart rate, faster breathing, sweating, and a drop in blood pressure. The result, not infrequently, is a syncopal episode – fainting and collapse.

Sufferers may fear a vasovagal fainting episode such as they have had in the past, even more than the needle procedure itself.

Those with needle phobia can also develop a fear of being controlled and can become aggressive when challenged. When we hear people arguing against the vaccine, I wonder how many of them are needle phobics.

How common is needle phobia?

Between 3-10% of UK adults suffer from needle phobia (Anxiety UK). Needle phobia is most commonly seen in children but often continues into adulthood. A 2018 meta-analysis, which included 119 research studies, reported needle phobia in almost all children, 20-50% of adolescents, and 20-30% of young people.

Why does needle phobia matter?

Having a fear of needles can have serious, negative, health consequences.

Being needle phobic can deter someone from having blood tests, accepting a blood transfusion, becoming a blood donor, having urgent surgery, or accepting a range of healthcare options including vaccinations, contraceptive injections, and implants. Insulin dependant diabetics have considerable difficulty if they suffer from needle phobia.

5-15% of the population avoid the dentist due to fear of needing a dental injection. A fear of needles can also affect education, the ability to travel, pregnancy outcome and can result in legal issues.

Overall, 16% of adults refuse flu injections because of needle phobia. 27% of hospital employees, 18% of those working in long term care institutions and 8% of healthcare workers, refuse a flu vaccination due to needle phobia.

Why do some people develop needle phobia?

The cause of needle phobia may never be discovered. However, 80% of those affected have a first-degree relative who suffers from the same condition. It may be this is a learned response.

Sometimes, needle phobia may develop following a long period of illness such as treatment for childhood cancer, or witnessing a close relative go through a protracted period of medical care.

There may be genetic differences in people’s perception of pain, meaning some experience far more pain than others being pricked by a needle. Interestingly, needle phobia is more common in monozygotic than in dizygotic twins.

Some have suggested the fear of needles is a primitive response which evolved to help people avoid injuries such as stab wounds, which would have been fatal. 

What to do about needle phobia?

Healthcare professionals need to realise the importance of needle phobia. It can be frustrating in a busy clinic to find a patient with needle phobia. However, this needs to be treated with patience and kindness. Let’s remember that pain management is a human right.

Now, amid the COVID-29 pandemic, is a perfect time to address this problem, help patients overcome their fears, and improve their opportunities for healthcare in the future.

  1. Explain the ‘fight, fright, and flight’ mechanism of anxiety. This is a normal physiological response. However, the patient can learn to control it.
  2. Teach the patient how to perform diaphragmatic breathing. They can be doing this at home before their venepuncture appointment, outside in the waiting room, and even during the procedure.
  3. We can all learn to control our thoughts and emotions. For example, fix your gaze on an object in the room and study it carefully. Focus on that object and don’t allow your mind to wander.
  4. Think positive thoughts … ‘I can do this … I will do this …’ not negative thoughts.

Patients can be referred to the Psychology Team for further help. The technique employed is often to break the process of venepunctures into a series of small steps –

  1. Look at a needle.
  2. Hold a needle in your hand.
  3. Inject an orange with water.
  4. Watch someone having an injection on TV.
  5. Watch another person having an injection.
  6. Have an injection.

(Mood Café 2015)

Managing needle phobia

Patients should be referred to their GP for further help. They may be offered Cognitive Behavioural Therapy (CBT), which is very effective. Patients can even self-refer for NHS talking therapies.

Managing anxiety sometimes requires anti-anxiety medication – beta-blockers, serotonin or noradrenaline reuptake inhibitors (SSRI’s, SNRI’s), benzodiazepines, or pregabalin.

In the short term, if venepuncture is needed, the patient may benefit from the use of Emla cream which can be applied one hour before the procedure. Some may need a single dose of diazepam.

There are a variety of free – NHS apps available for anxiety.

Final thoughts

Needle phobia is a serious condition which deserves attention. By recognising this, and helping patients receive appropriate help, we can help improve their health care and life choices, now and in the future. If patients are refusing the COVID-19 vaccination due to needle phobia, now is the time to take action.

Overcoming needle phobia is vital for a fully successful COVID-19 vaccination campaign.

For more information

11 COMMENTS

  1. Just had my 1st shot. I have a serious fear of needles. Told that to the doctor, she asked me to lay down instead of sitting down. The shot literally felt like somebody’s lightly touching me with their tiny finger. Not even a small pinch. No need to worry, if that’s why you don’t want to get it.

  2. My wife and I are CNHC-registered hypnotherapists. We are currently offering hypnotherapy for needle phobia free of charge. This is a simple one-stop session with which we have had a 100% success rate. We would be happy to discuss how we work with anyone for whom needles are a problem.

  3. I suffer from this severely, as a 22 year old I was almost certainly going to avoid getting the vaccine, or at the very least wait until a single dose is approved for use in the UK so I only have to go through it once, there’s a very horrible and hostile attitude towards people who don’t want the vaccine at the moment which I’m worried about and talk of domestic vaccine passports also worries me, I don’t think people who don’t suffer from trypanophobia have any idea how difficult this is for sufferers,.

  4. Very much agree with MH above. This is keeping me awake at night, and now ruining my life. I’ve tried to overcome this even with using sewing needles (sterilized) to see if I can get accustomed at least, no chance at all. I can hardly bring myself to break the skin. And if your successful with that even, it’s apparently only around 30% of the real thing. People like us are not anti-vaxers, if this were a nasal spray or pill I’d be at the front of the queue. Feels like we have no help, nobody to even talk to and it’s hell.

    • I have the phobia and for years have denied myself the Flu vaccine. I plucked up the courage and went for it as my Cousin’s healthy husband (52) died last month from COVID, this resonated that we MUST be protected.
      I attended the vaccination centre and informed the Nurse of my phobia, I was taken to another area to lie down and as she rubbed the area to clean it, she advised me to take a few deep breaths to relax, I closed my eyes and asked her not to tell me when she was injecting me; wow! no pain whatsoever, the needle is so thin and you don’t feel the liquid going in; totally different to a sewing needle as these are not designed to pierce human skin!
      Please attend and have the vaccination, it has helped me get over my phobia of 30years!
      I honestly have no anxiety attending for my 2nd and final dose.
      Good Luck, you can do it!!

  5. I have had needle phobia for years…..tried hypnotherapy years ago…it helped at the time but i still fear needles or procedures….now wondering how I will cope in the last days of my life,,,,^.^

  6. Its embarrasing. Its hard to explain the feeling to people and they dont understand. For me its the impending puncture, the lead up, knowing its coming. Had to pull out of a meds review blood test recently whilst sat in the nurses chair as i had a panic attack. Felt so stupid. Hate myself, but just cant help it. I have had my vaccine invite and not taken it up. Awful.
    Any hypnotherapy help appreciated, anything worth a try to be freed from these chains.

    Glenn

  7. I am a qualified NCH and CNHC-registered hypnotherapist working online. I offer a very gentle but effective technique whereby we break the phobia down into manageable steps and work through them using hypnosis. I have had a lot of success with many different phobias. I offer a free initial consultation so please just come and have a chat about how I can help. You really don’t have to suffer. https://www.lauraculleyhypnotherapy.co.uk/

  8. I had my Covid vaccine yesterday & I can honesty say it didn’t hurt at all I feel silly now I made such a fuss before having it, I’m needle phobic & had my letter on Friday to say I could have it I was crying, I chucked the letter in the floor got myself in such a state but then remembered my Nan was scared of being locked in anywhere & gif whrse as she got older she was recommended rescue remedy & it helped her relax so I thought right I’m trying it, it says take 3 drops under your tongue I did nothing, took another 3 nothing took 3 more felt very relaxed. I then rang the doctor to say I can’t have it done as I’m needle phobic but as I’m a carer & have teenage kids I want it but just too scared to have it. She prescribed me diazepam & cream for my arm to numb it, just by talking to her & knowing I could have something I felt so much better. Anyway I still didn’t book it as I was only offered the jab in big places not near to where I live, luckily yesterday morning my doctors texted me with an offer of it at my doctors surgery & there was a space available 3 hours later, I got brave & went for it, the cream I put in the wrong place on my arm so they didn’t even do it there but didn’t tell me till after & the diazepam I was a bit worried to take as ive never been offered it before, I was scared I’d be a zombie or tired but no nothing it just helped me relax enough to have the jab, I told the nurses & doctors I was scared they distracted me & they done it without telling me, I didn’t feel anything only a slight touch no scratch nothing I couldn’t believe it. I’d love hypnotherapy please as I’m such a worrier when it comes to needles, I haven’t had my flu jab & im due to have a blood test but couldn’t face it, hopefully either with hydrotherapy or diazepam I will get through!

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