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Year : 2016  |  Volume : 30  |  Issue : 2  |  Page : 130-131

Friendly vaccination: Responding effectively to the vaccine associated iatrogenic pain on a global scale

Date of Web Publication24-May-2016

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-4958.182927

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How to cite this article:
. Friendly vaccination: Responding effectively to the vaccine associated iatrogenic pain on a global scale. J Med Soc 2016;30:130-1

How to cite this URL:
. Friendly vaccination: Responding effectively to the vaccine associated iatrogenic pain on a global scale. J Med Soc [serial online] 2016 [cited 2021 Aug 1];30:130-1. Available from:


Worldwide, immunization with vaccines has been acknowledged as one of the cost-effective and life-saving interventions with a potential to save the lives of millions of under 5 years children. [1] However, the pain associated with administration of vaccine has emerged as a significant concern among not only vaccine recipients, but even among caregivers and health professional administering the vaccine. [2] Infact, the findings of various epidemiological studies have indicated that almost one-third of the parents was worried about the vaccine-associated pain in their children, and in excess 85% parents believed that the major onus lies on the health professionals to ensure that administration of vaccine is less painful. [2],[3]

Vaccine-associated iatrogenic pain has played a crucial negative role along with various other determinants in negatively influencing the attitude of people and thus a delay or avoidance in the future vaccinations (vaccine hesitancy). [4] It is a very crucial aspect as one in every five children are still missing the dosage of routine life-saving vaccines, and concerns such as unaddressed pain can further enhance the magnitude of the problem multiple times. [1],[4] Furthermore, due emphasis has been laid on giving special attention to mitigate the pain at times of vaccination so that simultaneously the problem of vaccine hesitancy and bridging of the immunization gap can be simultaneously addressed. [2],[5]

In order to systematically respond to this problem, the World Health Organization has recommended key age-group specific interventions which are feasible, cost-effective, and culturally acceptable, and at the same time can be implemented in heterogeneous settings. [2] It has been recommended that the health professional administering vaccine should be well-informed and avoid language which can enhance anxiety/distrust, proper positioning of the vaccine recipient based on age, discourage aspiration, and administer vaccines in ascending order of painfulness (if multiple vaccines have to be given). [2],[4]

Further, specific measures for infants and young children (viz. the presence of a caregiver during and after vaccination; breastfeeding of infants during or shortly before vaccination session, if acceptable, distractions using a different mechanism for children <6 years; etc.) and adults (distraction by slight coughing) have been also suggested to address the problem effectively. [2],[4] At the same time, routine practices such as administration of topical anesthetics or oral analgesics, warming the vaccine, and manual stimulation of the injection site have been discouraged. [2] However, in order to obtain significant benefits, the policy makers should ensure that the relevant health policies are strengthened, proposed recommendations are implemented, periodic sensitization of the health professionals with regard to pain mitigation is carried out, and even awareness among the general population is improved. [3],[4],[5],[6]

To conclude, no caregiver or health worker wants to see children in pain and thus the implementation of the cost-effective measures will not only make vaccinations more comfortable for everyone but will even assist in achieving sustainable vaccination rates and improvement in the rates of child survival.

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Conflicts of interest

There are no conflicts of interest

  References Top

World Health Organization. Immunization Coverage - Fact Sheet No. 378; 2015. Available from: target="_blank" href="". [Last accessed on 2015 Nov 05].  Back to cited text no. 1
World Health Organization. Reducing pain at the time of vaccination: WHO position paper - September 2015. Wkly Epidemiol Rec 2015;90:505-10.  Back to cited text no. 2
Barrows MA, Coddington JA, Richards EA, Aaltonen PM. Parental vaccine hesitancy: Clinical implications for pediatric providers. J Pediatr Health Care 2015;29:385-94.  Back to cited text no. 3
World Health Organization. Vaccinations Made Friendly; 2015. Available from: target="_blank" href="". [Last accessed on 2015 Nov 05].  Back to cited text no. 4
Nowak GJ, Gellin BG, MacDonald NE, Butler R; SAGE Working Group on Vaccine Hesitancy. Addressing vaccine hesitancy: The potential value of commercial and social marketing principles and practices. Vaccine 2015;33:4204-11.  Back to cited text no. 5
Goldstein S, MacDonald NE, Guirguis S; SAGE Working Group on Vaccine Hesitancy. Health communication and vaccine hesitancy. Vaccine 2015;33:4212-4.  Back to cited text no. 6


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