Pain Free Shots

by Vincent Iannelli, MD

No one likes shots. Kids don't like getting them. Parents don't like watching their kids receive shots, and believe it or not, Pediatricians and nurses don't really like ordering and giving shots to kids.

Of course, they are necessary though. Children need their vaccinations and kids with chronic medical problems, like diabetes, need their regular shots of insulin. Dealing with the pain from shots is also a problem for children who have to get regular shots of growth hormone, such as girls with Turner Syndrome, and other children with growth hormone deficiency, and kids who get allergy shots.

Combination Shots

One way to decrease the pain from immunizations is to simply give fewer shots. That doesn't mean that your child won't be fully vaccinated though. Instead, you just ask for some of the newer combination shots, which combine two or more vaccines into a single shot.

Examples of combination vaccines include Pediarix, which combines the DTaP, IPV, and Hepatitis B vaccines into a single shot, and Comvax, which is a combination of the Hib and Hepatitis B vaccines. These combination vaccines can help to cut back on the number of shots that your child gets at each visit. For example, using Pediarix, your child would only get three shots vs. five if all of the immunizations were given separately.

Alternatives to Shots

Since doctors in the United States no longer give the oral polio vaccine, the only remaining no-shot immunization is the FluMist nasal spray flu vaccine. Introduced last year, many children were excited about the possibility of getting a flu vaccine without a shot, but many parents balked at the vaccine's high price. Fortunately, the price has been reduced this year, so it may be a more economical option for you. Keep in mind that it is only available for healthy children over age 5 years.

EMLA Cream

If you can't get rid of the shot, then you can at least try to stop the shot from hurting. This is where a numbing cream, like EMLA comes in. When applied to the skin about an hour before the shot is given, it will numb the skin and reduce or eliminate any pain the shot might cause.

Available with a prescription as a cream or single use Disc for easy placement, parents can apply it at home before going to their Pediatrician to get vaccines or before they are to get other shots. Ask your Pediatrician and review the placement diagram that comes with your prescription so that you put the EMLA in the right place.

The only downside is that it ads to the cost of your visit, although a generic version of the cream is available and makes it a little less expensive. Also, not all Pediatricians actively recommend it and may even consider it to be an inconvenience. If you ask for your prescription in advance and put it on yourself before the visit, you should be able to convince your Pediatrician to write you a prescription.

Ethyl Chloride

Available as a bottle or spray, Gebauer's Ethyl Chloride is a topical anesthetic that can be sprayed on the area where the shot is going to be given. These cooling sprays are available with a prescription, although the pharmacy may have to order it for you. Your Pediatrician might also have it on hand in their office.

ShotBlocker

Numbing the skin seems like a great idea, but using something like EMLA cream over and over can seem like a pain in itself, especially if your child has to get daily shots. The ShotBlocker, from Bionix, may be an even better alternative for these children with chronic conditions and also for kids who are just getting their immunizations at their well child visits.

With a butterfly shaped design, this small device is placed against a child's skin, stimulating it to block pain receptors and provide instant anesthesia.

So why isn't everyone using the ShotBlocker before giving shots? The main downside with this one is again cost. They aren't reusable between patients, cost about 70 cents each, and your Pediatrician likely wouldn't recover that cost from your insurance company, so many don't have them available. You can order a box of them from the bionix.com website yourself though, and share them among your friends and family members.

New Research

In addition to the techniques that have already been mentioned, new research continues to be done to help reduce the pain from shots. The latest device is called SonoPrep and is an ultrasonic device that is applied to the skin for 15 seconds, making the skin more permeable, and allowing a topical anesthetic to work after just five minutes. Unfortunately, it is expected to have a price tag of $2000, putting it out of reach for most parents and Pediatric offices.

Microneedles, needle-free injections, patches, and oral vaccines may be available in the future to totally take the pain out of shots. Until then, many of the solutions described above can help to make your child's going to his Pediatrician an even more pleasant occasion.

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Important disclaimer: The information on expertpediatrician.com is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.