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In the middle of a pandemic … needle phobia

By Dr. Stephen Fleming, PhD, C. Psych.

In the middle of a pandemic, we often pine for in-person activities, whether at work, with family, or with friends. We’re also aware that to have our population immune to COVID-19 we must achieve community immunity. There are two ways to accomplish this. One way is through exposure to the pathogen, and the other is through vaccines. The World Health Organization (WHO) encourages protection through vaccines versus exposing people to the pathogen in pursuit of herd immunity. 

Unfortunately, not everyone welcomes the opportunity to receive a vaccination regardless of the dangers COVID-19 presents. Wani, Ara, and Bhat, in a paper published in Behavioural Neurology (2014), indicate that blood injury injection phobia, as the psychiatric disorder is called, is prevalent in 3% to 4% of the population. Exacerbating this anxiety and apprehension about injections are the accompanying, distressing physical symptoms which may include dizziness, nausea, sweating, and fainting (which happens when blood pressure and heart rate increase and then suddenly drop, leading to a feeling of light headedness or fainting). Fortunately, when fear and apprehension take over, there are actionable strategies.

What is Needle Phobia?

What exactly is needle phobia? Why do some people have this reaction, and how can we manage it?Avoidance behaviour, fuelled by the intense irrational fear during, or in anticipation of, a procedure characterizes needle phobia. Often, these long-standing fears about needles and injections stem from negative experiences emanating in childhood. Older siblings, parents, and friends can influence younger children by their fearful talk. Even the media’s depiction of needles as sources of pain or infection can reinforce avoidance behaviour. 

Those with a fear of injections may typically avoid needles or the vaccination process but, simultaneously, recognize the criticality of the COVID-19 vaccine. The two-dose regimen associated with most of the COVID-19 injections adds to the stress for needle-averse individuals. 

Managing Needle Phobia

Exposure therapy, likely the most optimal approach, helps a person gradually face a fear until it becomes manageable. Psychologists start by assisting a person in understanding the specifics of their fear – be that pain, the sight of blood, fainting, or the needle itself. They then work with the individual to develop strategies to mitigate and manage the underlying fear. The essence of exposure therapy is repeated and gradual contact with the feared or arousing object (needle) in a controlled setting (e.g., the therapist’s office).

Deep breathing, progressive muscle relaxation, or positive self-talk are additional techniques to ready the individual for their injection. Prior to vaccination day, one can also cognitively rehearse expressing their fears and preferences to the healthcare professional administering the vaccine. Would you prefer to have the nurse talk you through the procedure, or would you be better off distracting yourself by listening to music? Ahead of time, determine if someone can accompany you for support and, of course, you can always look away from your arm. 

Finally, for individuals with low-level fears who are more concerned with pain, topical numbing creams can be applied ahead of time. 

Widespread injections are vital to our healthcare success in managing the COVID-19 pandemic and working together to overcome injection fears can help us achieve community immunity. Psychologists implementing graded, exposure-based treatment strategies for needle phobia can be instrumental in reaching this desired goal.

Wani, A.L., Ara, A., & Bhat, S.A. (2014). Blood injury and injection phobia: The forgotten one. Behavioural Neurology, 2014(471340), 7 pages.

World Health Organization. (2020, December 31). Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19.

In collaboration with: Vic Gladwish, Gladwish on Demand Editorial Services