Many children and parents associate a trip to the pediatrician with shots. There are actually a couple of vaccines that we don’t give as an injection, specifically the oral rotavirus vaccine. It would be great if we could give them all by mouth, but vaccines contain proteins and complex sugars that are digested quickly in the stomach, so the only way to get most of them into contact with the immune system is to inject them into the skin or muscle.
Combination Vaccines
The good news is that pediatricians have gotten better at minimizing or even eliminating the pain of vaccination. For one thing, we can often administer multiple vaccines in a single injection.
Thanks to combination vaccines, the greatest number of injections many children receive at any given wellness examination is 3. We usually give these vaccines in the thighs during the first few years of life and in the shoulder muscles after that. When staff are available, they can use both legs at the same time to minimize the duration of discomfort. Because what pain there is tends to be experienced as a single event, it is discouraged for parents to spread vaccines out over multiple visits. There is no medical reason to do so, and it tends to prolong the discomfort for everyone.
Pain-Control Techniques
A number of pain control techniques are currently available and can make shots much less stressful. For toddlers and school-aged children, the combination of distraction techniques, like blowing bubbles or playing games and numbing creams or sprays can be very effective for all shots and needle procedures.
Numbing agents include:
- A cooling spray which can be applied just before shots are given so there is no poking sensation.
- Topical anesthetic creams that can also be applied ahead of time to make the skin numb when the shot is given.
- A plastic plate covered with small points and a buzzing sensation that blocks pain signals.
For babies who are nursing, breastfeeding during a vaccination can provide significant pain relief. Sucking on a pacifier can also be comforting.
Even without using any of these techniques, most babies calm down very quickly after their shots with being held. The calm in your voice and the firm reassurance of your embrace tell your baby that everything is fine. Remember, the shots may hurt for a moment, but the protection they’re giving your baby is good for a lifetime.
Adverse Reactions
By far the most common adverse reactions following vaccination are fever and fussiness, and sometimes there may be a little redness or swelling at the injection site. Many parents ask if they should give acetaminophen (eg, Tylenol, PediaCare Fever Reducer) or ibuprofen (eg, Motrin, Advil) prior to the vaccine visit. In the past we have encouraged using these medications to reduce any discomfort or potential fever from vaccines. Some newer studies have questioned whether giving acetaminophen might make the vaccines slightly less effective, so some pediatricians are no longer recommending it.
Any medication or vaccine has the potential to cause an allergic reaction, sometimes a severe one. Rates of severe allergic reactions with vaccines run in the 1 per million range, making them quite rare.
When to Call the Doctor
No symptoms after receiving vaccines should be dramatic. If your child has a temperature above 102°F or a fever that lasts more than a few days, or if she is unusually fussy, you should still consult her doctor and not just assume her symptoms are from vaccines.
If you notice your child getting hives, wheezing, or seeming unusually ill shortly after she gets vaccines, alert office staff if you’re still there or call emergency medical services (911) if you’re not.