Reducing pain at the time of vaccination: WHO position paper – September 2015

Overview

Vaccine injections can be a source of iatrogenic pain. Concern about pain is common among caregivers, vaccine recipients including children, adolescents and adults as well as health-care personnel carrying out the vaccination. Studies from the USA and Canada indicate that 24%–40% of parents are concerned about vaccination-associated pain in children; 85% believe healthcare providers have a responsibility to make vaccinations less painful, and 95% wish to learn how to reduce pain during vaccination of their children.

A recent study in South Africa found multiple vaccinations in one visit to be acceptable by parents and health-care workers, but called for strategies to mitigate pain at vaccination, as pain is one of the primary sources of anxiety for caregivers of children receiving multiple injections in one visit.3 Injectable vaccines, administered with the proper technique and appropriate needle length and gauge, vary in degree of painfulness at the time of vaccination depending on the composition of the vaccine. When multiple vaccines are co-administered, the order of the injections affects the degree of discomfort caused: administration of the vaccines with the most painful given first and the least painful last increases the cumulative pain.