I'm following this as I have a tween who completely freaks out about getting her shots. Some good things in here I will try. We've tried several of them already and they didn't work. I have learned to plan to take a long time off because for mine it really isn't the shot itself it is the mental part before the shot. Once it is done she always says that wasn't bad. I will try the suggestion of working on listing her fears and figure out solutions to them. We've done a few, but those haven't helped, but just practicing it over and over might be good. I've offered her try my needles (also type1 diabetic) on herself and also on me, but she freaks out over that also, but has no problem watching me inject at all. I'm already preparing for her August appointment for a booster shot. I may just bring one of our electric toothbrushes and use that while they stab to see if it would distract her. Watching YouTube used to work when she was younger, but doesn't anymore.

in addition to what’s already been suggested , I would not have him watch the news videos of the needle going into the arm of others. I’d seen that so many times and it seems to go to the bone (eek) My own was without physical sensation.

Does he listen to music? Use headphones? I use that technique for root canals.

I would suggest you contact his doctor. He/she may have some great ideas! Good luck!

This is a case study of a younger child but I thought it was a useful example of desensitization in practice. I like the idea of seeing if he could work up to injecting an orange!. It’s probably not appropriate for younger people but i do know some people who pop an Ativan...

http://drkarenlevine.com/wp-content/uploads/2016/02/LevineASQ37Fall2013.pdf

Thank you, everyone for your ideas. We will see what we can get to stick. He did inject an lemon with water today. He was not interested in observing his sister get her 2nd dose. Distractions are hard because nobody can fixate like a child on the spectrum! The clinic will be held in a high school auditorium. I am not sure that there are drive thru clinics in NM. We will practice the sequencing including the alcohol swab and see where that gets us. Right now he says he feels 50/50. Hopefully tomorrow we can get to 60/40. I have also contacted the social worker at the school to see if she has any ideas. He is functioning so well at this point that the only services he receives are on social skills. And robo, at 17, I think Ativan might be indicated for him. I was thinking it was too bad he has absolutely no interest in alcohol, just a wee bit might help! I did try to get him to discuss what the actual fears are, but verbalizing emotions, etc. is definitely not his strength. I may need to make him go for a long walk before the clinic, to burn some energy...

How about distracting him with something he can fixate on? 🙂

My daughter had to have surgery when she was 5 and 8 years old. She was deathly afraid of needles and all the other tests that have to be performed prior to surgery. Her doctor recommended headphones with some calming music and some kind of distraction. That was 29 years ago so things may have changed a bit. It seemed to have worked for her and as I remember it didn't go without some tears and anxiety.

My BIL is developmentally handicapped and on the spectrum. We know that for anything upcoming that he is nervous about, we talk through what is going to happen for days beforehand. Then, when it happens, he is ready for what comes next. When he was visiting us on his own, he asked me to go through how he was getting home several times a day, for days. By the third day, I was letting him fill in gaps or tell ME what would happen next. When we headed home, he went through the portions of the script as they came up. He was very nervous about the ferry, but when it came he was a champ and enjoyed it, with still that trepidation.

Will scripting the event help your son?

That's sweet, Bpath.

Would it help if he could get the shot privately? He can't be the only person who might benefit from some accommodation.

When I was 4, I was hysterical about needles because I had very painful injections almost daily during an illness. An ER nurse taught me to distract myself. He asked if I had a pet. "A dog or a cat? What's its name?" If a needle is involved I still say "dog, cat, Inky, dog, cat, Inky," over and over. I don't really need it for injections, but blood draws often go badly so it's essential for those. If you're going to say something aloud, a tongue twister like "red leather, yellow leather" said rapidly might work. That requires some concentration to do it with speed.

Does he like to watch videos on a cell phone? If so, wearing headphones and watching something he likes during the procedure might be helpful.
Does he work with a medical specialist or therapist? Perhaps they might have suggestions. But you know him best. All the best to you and your son.

Moderate to heavy exercise before a jab can make a huge difference in how it is felt. Ask you diabetic daughter if it isn't true that when she has to check blood glucose after, say, playing basketball, it doesn't hurt at all. I think it is due to the endorphins that exercise causes to be released. So if your son could do some fast walking, jumping jacks, stair climbing, or running for 10 or 15 minutes before going in for his vaccine, I think it would help a lot. Exercise is a natural pain preventer. The effect can last half an hour, I'd guess. If he knows that ahead of time, it might help.

I know the issue isn't necessarily the possibility of pain. It's also just the very thought of intentionally making a hole in your body. It's just so instinctual to guard against that!

Is he a kid for whom peer pressure might help? Take a friend along. Some kids would steel themselves up and be their bravest selves in the face of being observed and possibly judge by friends.

Also, I have to say I would not have a problem asking his doctor for a single dose of something to dampen anxiety just for the occasion.

Perhaps a combination of the script idea and a planned distraction of music, game or something on a phone or tablet that he can focus on -- build that into the script. I would also suggest some kind of relaxation into the script. The shot goes easier and is less likely to be painful if your arm is fully relaxed,. Then you want to move that arm frequently afterwards and throughout the day. Anytime I felt any pressure, I would move my arm and it went away, so you might want the script to include that as well. Hope it goes well for all of you.

Tishtosh, I can understand your situation. I have had to deal with similar issues in the past, though my 28-year-old HFA son didn‘t have that exact phobia.

How comfortable are you with a white lie? Here is what I’m thinking: you tell your son that they have an alternate mode of giving the vaccine with just the touch of a pen which works the same way. You tell him the nurse will apply the alcohol swab, just like with the needle, but it will be a pen of some sort.

Just ask him to close his eyes during the process. If you are authorized to act on his behalf (medically speaking), you can explain this to the nurse ahead of time. Given how quick and painless the vaxx shot is, he may not know any different.

again, this is not the most straightforward thing, but I have Done similar things when DS was younger. Later, much much later, definitely after the second shot, if things go well, you could even tell him it was actually a shot, if you think it may help him overcome the phobia.

Just a thought. Good luck, from one aspie mom to another.

IDK. the vax shot hurt more going in than a flu shot. not the needle, but the fluid going in burned a little. it was over super fast, no big deal for an adult, but a needle phobic kid might notice and be mad about the lie.

@nutsaboutplants, Please do NOT lie about medical care, as it causes mistrust. In medicine, trust is paramount.

Interesting, all 5 of us (2 diff vaccines, 3 diff places) remarked that it seemed like an easier shot than most - eg a particularly fine needle?!

@mtnrdredux_gw, Have volunteered giving the vaccination. Yes, the needle is a small gauge, the medication is thin, and volume is quite small. Relaxing your deltoid muscle, by fully supporting arm, also helps. (I have patients rest lower arm on table.)

How about a bribe? An ice cream after the jab, then talk about ice cream instead of the jab. A reward for bravery. I agree about not watching people get their shots. For some reason, that bothered me. The actual event was pretty much nothing.

mtnrdredux_gw FWIW, it was Moderna. sometimes shots slightly burn as the medicine spreads into the muscle, and sometimes they don't for me. I wonder if it partly has to do with who administers them? the actual needle going in felt like nothing at all.

like I said, it was totally NBD for me. but to a kid they might really hate the burn part.

mdln and others, I completely agree with you. I offered a suggestion based on a few experiences I‘ve had with my own son. The autism mom a side of me works slightly differently than how I operate in all other spheres of my life.

I don’t see it as a lie, but something that helps your child get through an obstacle on a critical issue that he/she is unable to overcome on their own because of their condition. If the stakes are not as high as COVID, I wouldn’t suggest it.

I can’t offer any explanation for my suggestion nor can I be defensive about it. Tishtosh has her own parental compass and can decide for herself.

I do appreciate your perspective

Nutsaboutplants, I have absolutely no problem with little white lies when I deem them necessary. Alas, I do not think it would work at all. Some of the usual tools of parenthood just are not useful with this child. I wish bribing would help. He and dad are planning to stop for Blizzards at Dairy Queen afterward. I need to emphasize that the blizzards should happen whether he goes through with the shot or not. He is definitely trying to face this head on and whether he is successful or not, he deserves a reward.

The scripting ideas are quite helpful. I am writing things down so that we can keep everything straight that we need to work on. His social worker at the school is on the case too. If we do not make it through this time, I will probably need to find a behavioral therapist so we can work on this issue in depth before he is an adult and out of the house with other stressors.

FWIW, I think nuts' suggestion might be modified to keep from it being an outright lie. A 'white lie' so to speak, might be saying that it's a very special kind of hypodermic or syringe that's made to be much, much less painful & avoid using the word 'needle', if that's a trigger.

That's not strictly a lie either, judging by mdln's comments.

Tell him the truth about your friend Oakley who hates shots with a passion. I always look away when it happens and while I was sitting in the chair with the nurse at my arm I kept waiting for the shot sod I asked if she gave it to me. Yes she did and I swear I didn't feel a thing. That was a first for me.

I want to add something that could be important regarding how painful the shot could be. I know many who said it hurt and I was surprised mine didn't. I didn't even feel the medicine.

Now I'm thinking if it's because I told the nurse what happened to me last year when I got the flu shot and it was given too high on my arm and I couldn't lift my arm for two months. I asked her if she'd go lower on my arm. I could be mistaken but newer injection protocol is giving shots higher up in the arm and it's causing a lof of people shoulder problems.

@Oakley, many injections are given by NON-nurses (medical assistants, pharmacists, technicians, etc.), who may lack adequate education/training regarding injections. While some things have changed, the site(s) has not.

Yes, injecting too high is a common error and may cause injury (SIRVA - shoulder injury related to vaccine administration). Following article has a good graphic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347325/

The only thing I felt was the cold temerature of the liquid the first time but the second time I didn’t feel anything.

Have you considered making a game or challenge out of it? Because some feel it and some don’t, see if he wants to use a blind fold and tell you if/when he can feel it. If he guesses right you can go for an ice cream or something. That will give him something different to focus on.

I developed frozen shoulder after a flu shot administered by a coworker- we are both hospital RNs. It was extremely uncomfortable for about a year. No fun!
I didn’t really feel anything with either Covid vaccination; I actually could not feel the injections.

It's good to read through this thread. Our 28yo dd is visiting soon and has a huge needle phobia. She has asked us to go with her and hopes to do a drive-thru with her sister's dog on her lap. The last time she was jabbed, maybe 10 years ago, it was ugly. She says it's not the pain that worries her, but the thought of a needle going into her arm and not coming out the other end. (She has a pierced nose.) Thanks for this thread, Tishtosh. I look forward to reading about how your son did.

Tishtosh, there are drive through clinics in New Mexico. I got mine at the local department of health, drive through, but the clinic was being mainly run by the National Guard. This was earlier this month. It was very fast and I sat in my car listening to the radio for the waiting period.

The drive through ones are great, it's so nice to just be able to hang out in your own car. I think, too, that the privacy it affords would be useful for people who are bothered by needles.

The problem with a "needle phobia" is it can be related to a real bad experience. It's not unheard of. But also, one has to realize that it is not necessarily going to happen all the time, that the benefits far outweigh the risk. But that's a rational brain conversation. It would be quite a natural reaction for anyone to not like the idea of being poked with a needle. If the benefits didn't outweigh the negatives, it would be a natural thing to avoid. So one has to develop strategies to overcome one's natural apprehension. I'm not sure what would work for someone who is autistic. I would perhaps ask them? Knowing what the strategy is going to be and practicing it would probably make sense? I'm assuming something soothing as a distraction? And some kind of reward at the end? Works for me and I'm not autistic!

For others, i have to say that the vast majority of my friends said the needle jab was almost imperceptible, due to it being a smaller needle. I get my blood drawn every nine months to test my thyroid levels and let me tell you, that needle is a whole lot bigger and noticeable! So on an "unpleasant shot" scale, this one didn't register very high. It did of course cause me to have a sore arm some time after, but it was long after I was out of the vaccination site. I would think perhaps that the setting might matter to someone with autism, so if a place with a lot of people going in and out, a big echoing gym or something, maybe not the best. More and more options are becoming available. It got mine at a community center, and it wasn't super busy and the fact that there were many good people volunteering I found comforting and encouraging. But I can't imagine that would be a plus for someone who was autistic.

FWIW, another way to distract someone from an emotional reaction is to challenge them with math problems. I've done this with children who were overwhelmed with emotion. It shifts brain activity to a different region and can help calm someone down.

Ooo, carol that is such an interesting idea. I would imagine that only works with children?

@carolb_w_fl_coastal_9b - thank you for that tip. I'm going to have to test that with mine next time. In addition to some situational practice which we've already started in preparation for her August appointment.

I believe it can work with older people too. The areas of the brain are the same AFAIK.

Wonderful!

Yes - that's great!

If it's the 2 dose shot, hopefully the next time will be even easier.

Congratulations! Awesome job mom and dad tishtosh!!! (And tishtosh jr too!)

Tish, what a relief for you! I had my second dose of Moderna yesterday morning and it was the complete opposite of the first shot. The person who did it the first time didn't give me the second one. So was it this person who caused the pain or is it how the 2nd dose is supposed to feel feel at injection time? All I know is it hurt.

Another difference is when I barely touch the area I want to jump out of my skin and it's been over 24 hours.

I was going to suggest that maybe you prepare your son for the 2nd shot, but I'm glad no one told me how much it would hurt. :)

Yay!!

Great news. Bravo to your boy.

Great news! So glad it went well and he must be so relieved. Well done!

After talking to his dad, I did find out that one thing we did not cover in our role playing was to relax the arm. It's hard to communicate that to a kid wearing headphones. We will probably practice for a few days before the second shot and will definitely be adding that in. I mention it for those who were going to be working with others to prepare.

Rather than using the word ‘relax,’ try telling him to let his arm ‘hang down,’ not touching his body. People who are keyed up can’t seem to relax any muscles when asked to do so. Do finds it impossible to relax and I’m going to tell her to try this instead.

YAY! Success breeds success,so these milestones are always helpful I believe!

@sjerin, Best way to relax the upper arm - for an injection is the have arm SUPPORTED by resting lower arm on chair armrest, on a table, or even on your leg if seated - NOT hanging down.

Have given thousands of COVID vax injections (volunteering give ~100/day), this technique relaxes deltoid muscle and makes it less painful. Patients usually comment they "didn't feel a thing."

Oh! I heard this somewhere and thought it was correct info. Thank you for the correction--I appreciate it! And thank you for volunteering(!) to give tons of vaccinations. Wish you lived in my area. :)