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Wed, 2 Dec 2020

Cooling down vaccine fear

Vaccination
Image: Centre for Disease Control

As the world gears up for a massive global vaccination next year, James Cook University scientists have been investigating how best to take the sting out of it.

Professor Clare Heal from JCU’s College of Medicine and Dentistry led a team of researchers, including principal author Dr Leanne Hall, who looked at 13 trials of skin cooling agents used to reduce vaccination pain, involving nearly 700 paediatric and more than 800 adult participants.

Professor Heal said injection-associated pain and anxiety is a contributing factor to people avoiding vaccinations.

“Vaccinations save up to three million lives each year and are the cornerstone of herd immunity. So anything we can do to reduce the pain and anxiety of intra-muscular vaccinations and protect immunisation rates warrants further investigation,” she said.

All of the studies used vapocoolants – “cold sprays" delivered onto the skin just before needle insertion, or ice. Comparisons were made with other techniques including skin numbing cream, breastfeeding of under two-year-olds, distraction techniques and tactile stimulation.

“Vapocoolant reduced vaccination-related pain in all adult studies and six paediatric studies, however the use of ice packs in paediatric patients was not effective,” said Professor Heal.

She said pain associated with immunisation is now recognised as a significant adverse event, and adequate pain management strategies should therefore be incorporated into every vaccination.

“Pain reduction begins at the threshold of 10 C and continues to increase as skin temperature approaches 0 C.  Cooling techniques are considered to be cost-effective, easy to use and have few, if any, side effects when applied correctly. Vapocoolants have the advantage of providing instantaneous cooling effects to the skin,” said Professor Heal.

Whilst the paediatric study findings were inconclusive, the review concluded the use of vapocoolant spray and ice in adults can successfully decrease pain associated with vaccination.

“More rigorous and larger-scale Randomised Control Trials are needed to determine the effectiveness and applicability of skin cooling techniques and to determine the most effective administration techniques in terms of age groups and what vaccine is being delivered,” said Professor Heal.

Contacts

Professor Clare Heal
E: clare.heal@jcu.edu.au