Read on Twitter
I’ve been thinking about needle phobia. Vaccines are the way out of this pickle, but to work we need to vaccinate so many people. Needle phobia is extremely common and a major cause of vaccine hesitancy. #anxietyTwitter what do you think would help? A thread. 
1/12
1/12
Injection phobia is really common. Around 15-20% of people avoid vaccines because of it. It reduces with age, so might only be a small problem at the mo, but could become huge as we move down the age cohorts.
https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13818 2/12
https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13818 2/12
Injection phobias tend to fall into two camps – fear of pain/the injection itself and fear of feinting afterwards or often both. But, there are interventions that work for both, some of them pretty fast.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900415/ 3/12
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900415/ 3/12
In particular, applied tension works well for people who feel faint after injections. It’s ridiculously easy to do, if only people knew about it. 4/12
So, if I was in charge, this is what I would try to do:
1. Tell people they can take someone along if really needed.
2. Offer quiet/slow clinics where people won’t be rushed.
3. Offer longer slots to those who need them.
4. Offer some appts with a known practice nurse/GP. 5/12
1. Tell people they can take someone along if really needed.
2. Offer quiet/slow clinics where people won’t be rushed.
3. Offer longer slots to those who need them.
4. Offer some appts with a known practice nurse/GP. 5/12
5. Have a highly experienced vaccinator available at each clinic, skilled in managing this fear.
6. Tell people about EMLA. It’s a topical anaesthetic and it helps.
7. Have some Janssen one-shot reserved for people who might be able to face doing it all once but not twice? 6/12
6. Tell people about EMLA. It’s a topical anaesthetic and it helps.
7. Have some Janssen one-shot reserved for people who might be able to face doing it all once but not twice? 6/12
Now for the wilder ideas
1. Train someone in all IAPTs to treat injection phobia. Thoughts @notapwpguru?
2. Find out which vaccine is least painful – vaccines really vary, apparently. So far, reports of ‘felt nothing’ predominate, which is good. 7/12
1. Train someone in all IAPTs to treat injection phobia. Thoughts @notapwpguru?
2. Find out which vaccine is least painful – vaccines really vary, apparently. So far, reports of ‘felt nothing’ predominate, which is good. 7/12
We need a website with all this info on it, which is signposted on all vaccine invitations. Maybe it could have a set of videos working people through graded desensitisation, and a video on how to do applied tension. 8/12
While I’m here, could someone have a chat with @BBCNews @ITV @SkyNews @Channel4 etc & ask them to show +ve images of people coping well with vaccinations. Images of terrified people don’t help those who are trying to pluck up courage. In fairness, I’ve not seen many. 9/12
Other mental health factors might also impact uptake. E.g. agoraphobia, panic, social anxiety, disgust/contamination concerns, autistic spectrum conditions could all make it tough to attend and need some thought. 10/12
If you have, treat, or research injection phobia, what would you add? I bet SAGE SPI-B are on this and they have some brill psychologists @ReicherStephen @DrBrookeRogers @ProfJohnDrury but I don't think any anxiety specialists, so come on #anxietytwitter, what would you do? 11/12
This thread was sparked in conversation with @drjameslmurray and @DrFionaCh. Would love to hear what @AnxietyUK @Mental_Elf @BABCP @CADATLondon @psalkovskis @nickdgrey would add, and I know you’re working on vaccines @mountfordjames. 12/12
