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Over half of adults unvaccinated for COVID-19 fear needles. Here’s what’s proven to help.

Over half of adults unvaccinated for COVID-19 fear needles. Here’s what’s proven to help.
Photo by CDC on Unsplash

If you're among the 25% of Americans averse to needles, you're probably not surprised by the COVID-19 immunization stall. Even for those who want immunity, bribes with beer or lottery tickets may not be enough to override anxiety made worse by pervasive images of needles in the media.

As a physician specializing in pain management, I study the impact of pain on vaccination. Research-proven adult interventions for pain, fainting, panic and fear can make vaccination more tolerable. At a minimum, understanding the reasons needle fear has become common might make the embarrassment easier to bear.

Why needle anxiety has increased

Needle fear has increased dramatically since a landmark 1995 study by J.G. Hamilton reported that 10% of adults and 25% of children feared needles. In that paper, adult patients who remembered when their fear began described a stressful needle experience around age 5.

The childhood experiences of the patients usually related to an unexpected illness; at the time the Hamilton participants were in preschool, vaccines were scheduled only until age 2. For most people born after 1980, however, booster injections given between ages 4 to 6 years became a routine part of the vaccine experience. The timing of boosters maximizes and prolongs immunity, but unfortunately falls within the age window when phobias form. A 2012 Canadian study of 1,024 children found that 63% of those born in 2000 or later now fear needles. In a 2017 study, my colleagues and I confirmed this increase in prevalence: Half of preschoolers who got all their boosters on one day – often four or five injections at once – were still severely afraid of needles as preteens.


Unsurprisingly, needle fear affects how willing teens and adults are to get vaccinated. A 2016 study found needle fear to be the most common reason teens didn't get a second HPV vaccine. Health care workers are no exception: A 2018 study found that 27% of hospital employees dodged flu vaccines due to needle fear. And most recently, an April 2021 national survey of 600 not-yet-COVID-19-vaccinated U.S. adults found that 52% reported moderate to severe needle fear.

The shame accompanying needle fear can make it difficult to research among adults.CDC/Unsplash, CC BY


Potential solutions for adults

For children, evidence shows that addressing their fear and pain while distracting them from the procedure is most effective in reducing distress.

While adults are not just big children, combining these concepts with findings from available adult injection studies suggest a few potential interventions. For the many who want a vaccine but need some support, here's what we know:

1. Pain reduction

Relieving injection pain may reduce needle fear by giving patients a feeling of control. For example, a group of patients in New Zealand were repeatedly missing their monthly antibiotic injections for rheumatic heart disease. Their doctors created a special clinic, offering either anesthetics, a vibrating cold device or both during the shot. The interventions in 107 adults reduced pain and fear by 50% after three months. Six months later, half the patients still used the interventions, and the special "missed dose" clinic was no longer needed.

Specifically for vaccination, applying a vibrating cold device to the injection site a minute prior to injection, then pressing just above the site during injection, relieved pain and improved satisfaction for adults, and was most effective for those with needle fear. A horseshoe-shaped plastic device using sharp prongs to confuse the nerves also reduced injection pain but increased anxiety, possibly due to discomfort from the prongs themselves.

Cold spray doesn't help reduce vaccination pain for children, but has been shown to be more effective than topical anesthetics for adult injections.

2. Psychological therapy

Exposure-based therapy involves asking a patient to rank anxiety caused by parts of a procedure, like seeing a picture of a tourniquet or thinking about sharp things, and gradually exposing them to these parts in a controlled environment. Free self-guided resources are available for fears ranging from flying to spiders. However, none of the three studies testing this approach on adult needle fear showed long-term fear reduction.

One of the studies that taught techniques to reduce fainting, however, was considered a success. Fainting, or vasovagal syncope, and needle fear are often conflated. While passing out due to injections is more common with anxiety, it is often a genetic response. Tensing the stomach muscles increases the volume of blood the heart can pump, keeping blood in the brain to prevent lightheadedness during needle procedures.

Planning ahead can help make vaccine day more approachable.recep-bg/E+ via Getty Images

3. Distraction

Surprisingly, there are no studies on adults using distraction for injections. Two studies, however, have found that pretending to cough reduces pain from blood draws.

Dropping F-bombs could also help: A recent study found that swearing reduced pain by one-third compared to saying nonsense words. Distraction with virtual reality games or videos has been shown to be more effective in children, although there have been mixed results in adults.

Mentally engaging tasks may also help. A visual finding task given to children during intramuscular shots has been shown to reduce pain and fear, with 97% rating the experience more pleasant than previous blood draws. Adults may need a more complicated task, but a similar intervention could work for them as well.

Use multiple interventions and go in with a plan

To reduce needle fear, research suggests the more interventions, the better. A 2018 study summarizing research on vaccine pain concluded that patient-operated cold and vibration devices combined with distraction techniques were most effective. Canada has implemented a practical national needle fear intervention for their vaccine rollout, emphasizing preparing ahead to help make vaccine day more comfortable.

Adults who don't like needles are in the majority. Taking control of your vaccination experience may be the best way to combat needle anxiety.

Amy Baxter is a Clinical Associate Professor of Emergency Medicine at Augusta University.

This article previously appeared on The Conversation. You can read it here.


Image from Pixabay.

Under the sea...

True
The Wilderness Society


You're probably familiar with the literary classic "Moby-Dick."

But in case you're not, here's the gist: Moby Dick is the name of a huge albino sperm whale.

(Get your mind outta the gutter.)


There's this dude named Captain Ahab who really really hates the whale, and he goes absolutely bonkers in his quest to hunt and kill it, and then everything is awful and we all die unsatisfied with our shared sad existence and — oops, spoilers!


OK, technically, the narrator Ishmael survives. So it's actually a happy ending (kind of)!

whales, Moby Dick, poaching endangered species

Illustration from an early edition of Moby-Dick

Image from Wikimedia Commons.

Basically, it's a famous book about revenge and obsession that was published back in 1851, and it's really, really long.

It's chock-full of beautiful passages and dense symbolism and deep thematic resonance and all those good things that earned it a top spot in the musty canon of important literature.

There's also a lot of mundane descriptions about the whaling trade as well (like, a lot). That's because it came out back when commercial whaling was still a thing we did.

conservation, ocean water conservation

A non-albino mother and baby sperm whale.

Photo by Gabriel Barathieu/Wikipedia.

In fact, humans used to hunt more than 50,000 whales each year to use for oil, meat, baleen, and oil. (Yes, I wrote oil twice.) Then, in 1946, the International Whaling Commission stepped in and said "Hey, wait a minute, guys. There's only a few handful of these majestic creatures left in the entire world, so maybe we should try to not kill them anymore?"

And even then, commercial whaling was still legal in some parts of the world until as recently as 1986.

International Whaling Commission, harpoons

Tail in the water.

Whale's tail pale ale GIF via GoPro/YouTube

And yet by some miracle, there are whales who were born before "Moby-Dick" was published that are still alive today.

What are the odds of that? Honestly it's hard to calculate since we can't exactly swim up to a bowhead and say, "Hey, how old are you?" and expect a response. (Also that's a rude question — jeez.)

Thanks to some thoughtful collaboration between researchers and traditional Inupiat whalers (who are still allowed to hunt for survival), scientists have used amino acids in the eyes of whales and harpoon fragments lodged in their carcasses to determine the age of these enormous animals — and they found at least three bowhead whales who were living prior to 1850.

Granted those are bowheads, not sperm whales like the fictional Moby Dick, (and none of them are albino, I think), but still. Pretty amazing, huh?

whale blubber, blue whales, extinction

This bowhead is presumably in adolescence, given its apparent underwater moping.

GIF via National Geographic.

This is a particularly remarkable feat considering that the entire species was dwindling near extinction.

Barring these few centenarian leviathans, most of the whales still kickin' it today are between 20 and 70 years old. That's because most whale populations were reduced to 10% or less of their numbers between the 18th and 20th centuries, thanks to a few over-eager hunters (and by a few, I mean all of them).

Today, sperm whales are considered one of the most populous species of massive marine mammals; bowheads, on the other hand, are still in trouble, despite a 20% increase in population since the mid-1980s. Makes those few elderly bowheads that much more impressive, huh?

population, Arctic, Great Australian Blight

Southern Right Whales hangin' with a paddleboarder in the Great Australian Bight.

GIF via Jaimen Hudson.

Unfortunately, just as things are looking up, these wonderful whales are in trouble once again.

We might not need to worry our real-life Captain Ahabs anymore, but our big aquatic buddies are still being threatened by industrialization — namely, from oil drilling in the Arctic and the Great Australian Bight.

In the off-chance that companies like Shell and BP manage not to spill millions of gallons of harmful crude oil into the water, the act of drilling alone is likely to maim or kill millions of animals, and the supposedly-safer sonic blasting will blow out their eardrums or worse.

This influx of industrialization also affects their migratory patterns — threatening not only the humans who depend on them, but also the entire marine ecosystem.

And I mean, c'mon — who would want to hurt this adorable face?

social responsibility, nature, extinction

BOOP.

Image from Pixabay.

Whales might be large and long-living. But they still need our help to survive.

If you want another whale to make it to his two-hundred-and-eleventy-first birthday (which you should because I hear they throw great parties), then sign this petition to protect the waters from Big Oil and other industrial threats.

I guarantee Moby Dick will appreciate it.


This article originally appeared on 11.04.15

National Autistic Society/Youtube

"Diverted" educational video shared through the Too Much Information Campaign.

Everyone who lives with autism experiences it somewhat differently. You'll often hear physicians and advocates refer to the spectrum that exists for those who are autistic, pointing to a wide range of symptoms and skills.

But one thing many autistic people experience is sensory processing issues.


For autistic people, processing the world around them when it comes to sight, smell, or touch can be challenging, as their senses are often over- or under-sensitive. Certain situations — like meandering through a congested mall or enduring the nonstop blasting of police sirens — can quickly become unbearable.

This reality is brought to life in a new video by the U.K.'s National Autistic Society (NAS).

The eye-opening PSA takes viewers into the mind of a autistic woman as she thinks about struggling to stay composed in a crowded, noisy train.

It's worth a watch:

The PSA hit especially close to home for 22-year-old actress and star of the video Saskia Lupin, who is autistic herself. "Overall I feel confused," she said, of abrupt changes to her routine. "Like I can't do anything and all sense of rationality is lost."

She's not alone.

According to a study cited in NAS' press release, 75% of autistic people say unexpected changes make them feel socially isolated. What's more, 67% reported seeing or hearing negative reactions from the public when they try to calm themselves down in such situations — from eyerolls and stares to unwelcome, hurtful comments.

The new PSA aims to improve that last figure in particular.

It's part of the organization's Too Much Information campaign — an initiative to build empathy and understanding in allistic (i.e., not autistic) people for those on the spectrum.

Autism Awareness Day, campaign, World Autism Awareness Week

Campaign by National Autistic Society created to share the autistic experience to the world.

Photo from Pixabay

"It isn't that the public sets out to be judgmental towards autistic people," Mark Lever, chief executive of the NAS, said in a statement in 2016. It's just that, often, the public doesn't "see" the autism.

"They see a 'strange' man pacing back and forth in a shopping center," Lever explained, "or a 'naughty' girl having a tantrum on a bus, and don't know how to respond."

Well, now we do.

Instead of staring, rolling your eyes, or thinking judgmental thoughts about the young person's parents, remember: You have no idea what that stranger on the train is going through.

“We can't make the trains run on time," said Lever. But even the simplest, smallest things — like remembering not to stare and giving a person some space and compassion if they need it — can make a big difference.


This article originally appeared on 03.28.18

Joy

Pet cockatiel is obsessed with singing 'September' by Earth, Wind and Fire

Kiki remembers the 21st night of September ALL. THE. TIME. and it's actually quite impressive.

Representative hoto by Saqib Iqbal Digital on Unsplash

Apparently, "September" is all the rage with cockatiels.

“Do you remember…the 21st night of September?” has been one of the most iconic song openings of the past 45 years, as the R&B hit by Earth, Wind and Fire perpetually serves as a catchy favorite for dance clubs, movie scenes and TikTok clips alike.

However, "September" has also gained wild popularity among an unlikely group—pet cockatiels.


One cockatiel in particular has taken a shining to the song to the point of obsession, to the combined delight and chagrin of his owner. You see, Kiki doesn’t just like listening to the song, he sings and dances to it. Loudly. Over and over. At uncomfortable hours of the morning.

Kiki’s owner has shared multiple examples of her pet bird reveling in his favorite song, and it’s hilarious every time.

Watch:

@kiki.tiel

Send help plz wheres the off button on parrot #fyp #foryou #bird #cockatiel #parrotsoftiktok #birdsoftiktok

"Kiki…it's 7 o'clock in the morning…" Yeah, Kiki does not care. Kiki is feelin' the groove.

This isn't just a one-off and it's also not just a random song. Here we can see that Kiki recognizes it and sings it when his owner plays it. (Just after pooing on her leg—the reality of having a bird, in case these videos make you want one).

@kiki.tiel

Babywipes handy at all hours 🫡 #bird #cockatiel #fyp #foryou #september #parrot

But Kiki doesn't even need anyone else around in order to sing his favorite song. Here he is singing and dancing all by himself when his owner left the room and left her camera running to see what he would do.

@kiki.tiel

Partying without me :( #cockatielsoftiktok #birds #fyp #for you

As cute and hilarious as this is, it surely gets old after a while, right? It's one thing to watch in a video—it's got to be entirely another to hear it all the time at home.

It's also not just a Kiki quirk. Apparently, "September" is a "thing" among cockatiels. Other cockatiels have been known to love it and sing it, though not quite as well as Kiki does.

Someone on Reddit asked why so many cockatiels love the song—one person even said it was basically the cockatiel national anthem at this point. No one knows exactly why, but this explanation by Reddit user nattiecakes is as good an explanation as any:

"Yeah, cockatiels genuinely like the song in a way they don’t universally take to many other songs. My cockatiel is 17 and early in life basically seemed to max out his harddrive space learning a little bit of La Cucaracha, The Flintstones theme, the phrase 'pretty bird,' and this horrible alarm clock sound that is similar to the hungry baby cockatiel sound. We thought we could not get him to learn anything else because they do have some limits.

Then 'September' came. Every cockatiel loved it. We decided to see if our cockatiel loved it.

I sh*t y’all not, within a DAY he whistled the first three notes, which is really all that matters. He hasn’t been able to learn more, but he loves it.

Now our African grey whistles it to him constantly. He used to reliably whistle La Cucaracha to our cockatiel when our cockatiel would get angry and upset, and our cockatiel would start singing instead and forget he’d been upset. But almost immediately our grey switched to using 'September' 90% of the time. Like, it’s so plain even to our grey that 'September' is the song to unlock a cockatiel’s better nature. I think the grey likes it a lot too, but he has many other songs he likes better.

As for why cockatiels like this song so much… all I can guess is it really resonates with their cheery vibe. I think the inside of a cockatiel’s mind is usually like a disco."

Rock on, Kiki. Just maybe not so early in the morning.

How to clear a stuffy nose instantly.

With cold season upon us, there's no better time to learn a couple of awesome and easy tricks that will clear up the dreaded and annoying stuffy nose.

Prevention magazine created a short video showing two easy ways to get you breathing free again no matter how stuffed up you might be.


Both tricks take less than two minutes and are certainly worth trying out when it feels like that runny nose might never go away.


Watch the YouTube video below:

This article first appeared on 9.8.17.

Pop Culture

A brave fan asks Patrick Stewart a question he doesn't usually get and is given a beautiful answer

Patrick Stewart often talks about his childhood and the torment his father put him and his mother through.

Patrick Stewart often talks about his childhood and the torment his father put him and his mother through. However, how he answered this vulnerable and brave fan's question is one of the most eloquent, passionate responses about domestic violence I've ever seen.



WARNING: At 2:40, he's going to break your heart a little.

You can read more about Heather Skye's hug with Captain Picard at her blog.


This article originally appeared on 06.26.13.