Each night it鈥檚 the same. Story after story on the TV news is about the covid vaccination effort, and they are all illustrated with footage of needles sinking into exposed upper arms.
Could those visuals, ostensibly making this all seem routine, backfire?
More than causing squeamish people to look away or change the channel, researchers say such illustrations could hamper efforts to get a broad swath of U.S. residents vaccinated.
Bottom line: Many people don鈥檛 like needles, and that could further slow vaccination efforts as winter turns to spring when supplies are expected to multiply and efforts to get the hesitant to sign up for a dose will intensify.
鈥淔ear of needles was one of the barriers that was a significant predictor of people saying, 鈥業 don鈥檛 think I will get this vaccine,鈥欌 said Jeanine Guidry, an assistant professor at Virginia Commonwealth University who researches visual communication and conducted a survey of 500 people in July.
And it鈥檚 not just TV news using what could be sensitive video footage.
Disinformation spread on social media often incorporates images of giant syringes, Guidry , which makes recommendations to federal health officials. Social media has been a source of much incorrect information about vaccines in general, and covid specifically, designed to dissuade people from getting shots.
Such 鈥渇ear visuals,鈥 Guidry said, 鈥済et more attention,鈥 and may be remembered longer than other types of illustrations.
Legitimate efforts to encourage vaccination may have also inadvertently sparked fear by showing exaggeratedly large syringes, said Guidry, who urged public health experts to be careful with their messages, too.
鈥淚f you use a picture of a huge syringe that looks twice the size of my head, that makes you go, 鈥極K, that鈥檚 big,鈥欌 said Guidry. 鈥淚 can鈥檛 fathom what that would do to someone who has a needle phobia.鈥
Even attempts to reassure people by showing leaders such as Dr. Anthony Fauci or the president and vice president getting their covid vaccinations on TV can be triggering, said Hillel Hoffmann, an independent communications consultant and freelance writer in Philadelphia.
鈥淚 always turn away,鈥 said Hoffmann, who recently wrote of his near lifelong fear of needles in a piece , an online publication aimed at physicians.
鈥淚 know those pictures are supposed to psych me up for the fact that the vaccine is safe and available, and I鈥檓 not worried at all about the vaccines鈥 safety,鈥 said Hoffmann. 鈥淏ut what I can鈥檛 take because of my fear of needles is looking at a picture of someone with a small-bore needle buried in their deltoid muscle.鈥
Public health experts say it鈥檚 important to get at least 70% to 80% of the public vaccinated to reach what is called herd immunity, when enough people will either have had the covid virus or a vaccination, to severely limit its further spread.
But fear of needles contributes to some people鈥檚 vaccine hesitancy.
An of a broad range of studies from the U.S. and other countries on this topic by researchers at the University of Michigan showed that 20% to 30% of adults studied cited concern about needles, ranging from mild anxiety to a phobia strong enough to keep some from seeking medical care. Even many health care workers cited a fear of needles, according to the research, published in the Journal of Advanced Nursing in August 2018.
鈥淭here鈥檚 a perception that people who work in hospitals would be less afraid of needles, because they鈥檙e surrounded by them all the time, but one study found 27% of hospital employees who did not take the flu vaccine said it was because of needle fear or they did not like needles,鈥 said Jennifer McLenon, an infection preventionist at Henry Ford Hospital in Detroit who completed the study while getting her master鈥檚 degree in epidemiology.
Another study found that 18% of health care workers in long-term care facilities felt the same way, she said.
An extreme fear of needles or medical procedures involving injections is technically called trypanophobia, said Jeffrey Geller, president of the American Psychiatric Association.
鈥淪ome people avoid needles because of fear of pain, some from fear of fainting,鈥 said Geller. 鈥淎nd some people do faint.鈥
It may have an evolutionary basis, said Thea Gallagher, an assistant professor and the director of the clinic at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. 鈥淲e know from evolutionary biologists that seeing a sharp object going into our bodies is not something we are supposed to be cool with,鈥 said Gallagher.
But Geller and Gallagher said barriers created by this fear or phobia could be lowered with careful public health messaging, along with self-help techniques individuals can practice or, in severe cases, professional assistance from a therapist.
Public health messaging should avoid drawings that exaggerate the size of needles or syringes, 鈥渨hich are not helpful,鈥 said Geller, noting that the covid vaccinations involve 鈥渁 small syringe and needle.鈥
But, as to the effect of those TV images night after night? Well, it could go either way.
鈥淔or those with a fear, it could exacerbate it,鈥 said Geller. 鈥淔or those who don鈥檛 have the fear, it could be reassuring to show that it鈥檚 a routine practice.鈥
McLenon, the researcher from Michigan, said she has heard, anecdotally, that those shots on TV 鈥渕ake people more afraid.鈥 鈥淐an鈥檛 we get some pictures of the vials or something else?鈥 she suggested.
For instance, Hoffmann, the writer, said if he were designing the perfect visuals for a covid vaccination campaign, it would not refer to injections directly at all.
鈥淚f I were to drive by a drugstore and it had a poster in the window saying 鈥楥ome get it today for your family. Do it for the nation. Do it for the public good鈥 We would all know what the 鈥榠t鈥 is. They don鈥檛 have to show it.鈥
Still, McLenon and others say no one has yet studied the effect specific images about the covid vaccine have on people because it鈥檚 so new. And the desire to get back to a more normal society may help those with a fear of needles push themselves to get a covid vaccine, whereas they might not feel the same way about, say, an annual flu vaccination.
Hoffmann, who said his fear began after extensive dental work as a child, said he intends to get a shot. But when his turn comes, he said, he鈥檒l likely be very nervous; his heart will race and he will sweat. Unlike some people with a fear of needles, he does not faint, although he understands that reaction.
鈥淎 lot of people assume that what I鈥檓 afraid of is the pain,鈥 said Hoffmann. The worst part for him, he said, is how he can鈥檛 control his fear in that public setting. And it鈥檚 embarrassing. 鈥淚鈥檓 not alone when it happens. The person giving me the injection sees it. I can鈥檛 hide it.鈥
The emergency use authorization granted Feb. 27 by the Food and Drug Administration for the single-dose Johnson & Johnson vaccine is good news for people like Hoffmann. Both the Pfizer and Moderna vaccines currently available require two doses, spaced a few weeks apart. Which means facing fears twice.
Whether it鈥檚 one or two shots, experts suggest a variety of steps to help people who struggle get through the process 鈥 bring a support person, take deep breaths, stay positive, just to name a few.
鈥淚t鈥檚 nothing to be ashamed of. We come by it honestly,鈥 said Gallagher from the University of Pennsylvania. 鈥淎nxiety is likely making it into a bigger monster鈥 than it should be. 鈥淚t鈥檚 not worth beating yourself up about.鈥
Facing the Fear
For the millions of Americans who have some fear of needles, there are ways to help yourself cope, say experts.
鈥 Put it in perspective. Be positive about the reasons you are getting the vaccine and remember that the pain will be short-lived, like a stubbed toe, said Thea Gallagher, director of the clinic at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. For those getting the two-dose regimens, 鈥渂e objective about how the first one went,鈥 she said, 鈥渁nd that you got through it.鈥
鈥 Bring a support person. Some vaccination sites will allow this. Ask.
鈥 Practice deep breathing or other techniques to help stay calm at the site. Eat something and drink water beforehand; it reduces the chance of fainting. And you can request being inoculated in a reclined position.
鈥 Tell your vaccinator of your concerns. 鈥When you get there, you can say, 鈥楲ook, I don鈥檛 like needles.鈥 The health care providers are used to that,鈥 said Dr. Georges Benjamin, executive director of the American Public Health Association.
鈥 Don鈥檛 be afraid to seek professional help if your fear is intense but you feel strongly about getting vaccinated. A therapist can use cognitive-behavioral techniques or exposure therapy to help, said Dr. Jeffrey Geller, president of the American Psychiatric Association.
