Ah, glad to see they included “the Mary Poppins protocol”. SM
Making vaccines more acceptable - methods to prevent and
minimize pain and other common adverse events associated with vaccines.
Department of Pediatric and Adolescent Medicine, Mayo
Clinic, Baldwin 3B,
200 First Street SW, 55905, Rochester, MN, USA
[Record supplied by publisher]
The growing abundance of highly immunogenic vaccines has
arrived with a burden of pain, distress, and common adverse reactions that in
turn may interfere with parental compliance and aggravate anti-vaccine
sentiment. In a study of 150 children in each of 2 age-groups, we found that
approximately 20% of the subjects suffered serious distress or worse. During
the procedural phase, approximately 90% of the 15-to-18 month old children and 45%
of the 4-to-6 year old children showed serious distress or worse. To address
non-adherence with pediatric vaccine schedules, we must consider all of the
possible issues that might prevent a parent from taking a child to a health
care provider for vaccination. In that same study we identified useful
predictors for both preparatory and procedural distress - predictors that might
be used in identifying children who might benefit from preventive interventions.
Vaccine providers might consider a variety of interventions. Attitude, empathy, instruction, and practice
have all been shown to have a salutatory effect upon pain and anxiety with
medical procedures in general and specifically with vaccinations. Distraction
has also been found to be an effective method for distress and pain prevention
in children. More formal methods of clinical hypnosis which combine a deep
state of relaxation with focused imagery and suggestion have also been found to
be effective in helping children and adolescents prepare for, cope with, and
tolerate the pain and anxiety associated with medical procedures. So-called ‘sugar
nipples’ delivering small amounts of sucrose orally at the time of a painful procedure
in an infant has been not been shown to decrease vaccination pain and studies
on refrigerant topical anesthetics are mixed. Studies have found a eutectic
mixture of 2.5% lidocaine and 2.5% prilocaine (EMLA) effective in providing
adequate local anesthesia in children, but it suffers from problems in
practical application. Studies with various injection techniques have not
identified ready solutions, and although jet injection appears to provoke less
anxiety and cause less immediate pain, studies also indicate a somewhat greater
incidence of delayed local reactogenicity including soreness and edema. Other
measures to prevent or rapidly treat other common adverse events have been
shown effective and should be considered as well.
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.