Inadequate pain management during routine childhood immunizations: The nerve of it

Clinical Therapeutics

Volumn 31, Issue SUPPL. 2, 2009, Pages

  Taddio, Anna ^a,b   Chambers, Christine T ^c,d   Halperin, Scott A ^c   Ipp, Moshe ^b,e   Lockett, Donna ^f   Rieder, Michael J ^g   Shah, Vibhuti ^e,h  

^a UNIVERSITY OF TORONTO   (Canada)

^b HOSPITAL FOR SICK CHILDREN   (Canada)

^c DALHOUSIE UNIVERSITY   (Canada)

^d IWK HEALTH CENTRE   (Canada)

^e UNIVERSITY OF TORONTO   (Canada)

^f Schulich School of Medicine and Dentistry ^*  (Canada)

^g WESTERN UNIVERSITY   (Canada)

^h MOUNT SINAI HOSPITAL   (Canada)

Author keywords

immunization; infant child; pain; pain management

Indexed keywords

ANALGESIC AGENT; EMLA; INFLUENZA VACCINE; LOCAL ANESTHETIC AGENT; PLACEBO;

ANTICIPATORY ANXIETY; ARTICLE; ATTITUDE; BREAST FEEDING; BREATHING EXERCISE; CHILD HEALTH; COGNITIVE THERAPY; COPING BEHAVIOR; DISTRESS SYNDROME; HEALTH EDUCATION; HUMAN; IMMUNIZATION; INJECTION SITE PAIN; LOCAL ANESTHESIA; PATIENT COMPLIANCE; PATIENT POSITIONING; PATIENT SATISFACTION;

ANALGESIA; CHILD; CHILD, PRESCHOOL; HUMANS; IMMUNIZATION; INFANT; INJECTIONS; PAIN; PATIENT COMPLIANCE;

EID: 70349245209     PISSN: 01492918     EISSN: 1879114X     Source Type: Journal    
DOI: 10.1016/j.clinthera.2009.07.022     Document Type: Article

References (120)

1. Ulmer J.B., Valley U., and Rappuoli R. Vaccine manufacturing: Challenges and solutions. Nature Biotechnol 24 (2006) 1377-1383
2. Taddio A., Manley J., Potash L., et al. Routine immunization practices: Use of topical anesthetics and oral analgesics. Pediatrics 120 (2007) e637-e643
3. Taddio A. Proceedings of the Workshop Conquering Pain: The Hidden Cost of Immunization (2008), University of Toronto, Toronto, Ontario, Canada March 20
4. Guideline statement: Management of procedure-related pain in children and adolescents. J Paediatr Child Health 42 Suppl 1 (2006) S1-S29
5. Batton D.G., Barrington K.J., Wallman C., the American Academy of Pediatrics Committee on Fetus and Newborn, American Academy of Pediatrics Section on Surgery, and Canadian Paediatric Society Fetus and Newborn Committee. Prevention and management of pain in the neonate: An update [published correction appears in Pediatrics. 2007; 119:425]. Pediatrics 118 (2006) 2231-2241
6. Taylor E.M., Boyer K., and Campbell F.A. Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Res Manag 13 (2008) 25-32
7. American Academy of Pediatrics, Committee on Psychosocial Aspects of Child and Family Health, Task Force on Pain in Infants, Children, and and Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 108 (2001) 793-797
8. Schechter N.L., Zempsky W.T., Cohen L.L., et al. Pain reduction during pediatric immunizations: Evidence-based review and recommendations. Pediatrics 119 (2007) e1184-e1198
9. World Health Organization. Vaccines and Biologicals. http://www.who.int/vaccines-documents/docsPDF00/www505.pdf Accessed January 9, 2009
10. Giudice E.L., and Campbell J.D. Needlefree vaccine delivery. Adv Drug Deliv Rev. 58 (2006) 68-89
11. Public Health Agency of Canada. Immunization schedules: Recommendations from the National Advisory Committee on Immunization (NACI). http://www.phac-aspc.gc.ca/im/is-cv/index-eng.php#a Accessed January 9, 2009
12. Middleton D.B., Zimmerman R.K., and Mitchell K.B. Vaccine schedules and procedures, 2007. J Fam Pract. 56 Suppl Vaccines (2007) S47-S60
13. Middleton D.B., Zimmerman R.K., and Mitchell K.B. Vaccine schedules and procedures, 2007. J Fam Pract. 56 Suppl Vaccines (2007) C4-C8
14. Rappuoli R. Current developments in new vaccines for adolescents. Biologicals. 25 (1997) 159-163
15. Wilson K. Protecting vaccine programs and the public. CMAJ 176 (2007) 1681
16. Wilson K. Protecting vaccine programs and the public. CMAJ 176 (2007) 1683
17. Woodin K.A., Rodewald L.E., Humiston S.G., et al. Physician and parent opinions. Are children becoming pincushions from immunizations?. Arch Pediatr Adolesc Med. 149 (1995) 845-849
18. Zareba G. A new combination vaccine for measles, mumps, rubella and varicella. Drugs Today (Barc). 42 (2006) 321-329
19. Brennan F., Carr D.B., and Cousins M. Pain management: A fundamental human right. Anesth Analg. 105 (2007) 205-221
20. Anand K.J., Aranda J.V., Berde C.B., et al. Summary proceedings from the neonatal pain-control group. Pediatrics 117 (2006) S9-S22
21. Southall D.P., Burr S., Smith R.D., et al. The Child-Friendly Healthcare Initiative (CFHI): Healthcare provision in accordance with the UN Convention on the Rights of the Child. Child Advocacy International. Department of Child and Adolescent Health and Development of the World Health Organization (WHO). Royal College of Nursing (UK). Royal College of Paediatrics and Child Health (UK) United Nations Children's Fund (UNICEF). Pediatrics 106 (2000) 1054-1064
22. Ellis J.A., Sharp D., Newhook K., and Cohen J. Selling comfort: A survey of interventions for needle procedures in a pediatric hospital. Pain Manag Nurs. 5 (2004) 144-152
23. Hodges F.M., Svoboda J.S., and Van Howe R.S. Prophylactic interventions on children: Balancing human rights with public health. J Med Ethics 28 (2002) 10-16
24. Benin A.L., Wu A.C., Holmboe E., and Shapiro E.D. Communication about vaccines for teenagers: A qualitative study with teens and their parents. PAS. 57 (2005) 1803 Abstract
25. Pain terms: A list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 6 (1979) 249
26. Young K.D. Pediatric procedural pain. Ann Emerg Med. 45 (2005) 160-171
27. Fitzgerald M., and Walker S.M. Infant pain management: A developmental neurobiological approach. Nat Clin Pract Neurol. 5 (2009) 35-50
28. Schneider E.M., and LoBiondo-Wood G. Perceptions of procedural pain: Parents, nurses, and children. Child Health Care. 21 (1992) 157-162
29. Goodenough B., Perrott D.A., van Dongen K., et al. Children's response to vaccine fluid injection versus needle puncture pain during routine immunization. Amb Child Health 6 (2008) 91-100
30. Hart D., and Bossert E. Self-reported fears of hospitalized school-age children. J Pediatr Nurs. 9 (1994) 83-90
31. Broome M.E., and Hellier A.P. School-age children's fears of medical experiences. Issues Compr Pediatr Nurs. 10 (1987) 77-86
32. Megel M.E., Heser R., and Matthews K. Parents' assistance to children having immunizations. Issues Compr Pediatr Nurs. 25 (2002) 151-165
33. Lewis N. The needle is like an animal: How children view injections. Child Today. 7 (1978) 18-21
34. Reis E.C., Jacobson R.M., Tarbell S., and Weniger B.G. Taking the sting out of shots: Control of vaccination-associated pain and adverse reactions. Pediatr Ann. 27 (1998) 375-386
35. Chapman H.R., and Kirby-Turner N.C. Dental fear in children-a proposed model. Br Dent J. 187 (1999) 408-412
36. Kuttner L. Management of young children's acute pain and anxiety during invasive medical procedures. Pediatrician 16 (1989) 39-44
37. Jacobson R.M., Swan A., Adegbenro A., et al., the Vaccine Research Group. Making vaccines more acceptable-methods to prevent and minimize pain and other common adverse events associated with vaccines. Vaccine 19 (2001) 2418-2427
38. Rocha E.M., Prkachin K.M., Beaumont S.L., et al. Pain reactivity and somatization in kindergarten-age children. J Pediatr Psychol 28 (2003) 47-57
39. Bustos T., Jaaniste T., Salmon K., and Champion G.D. Evaluation of a brief parent intervention teaching coping-promoting behavior for the infant immunization context: A randomized controlled trial. Behav Modif. 32 (2008) 450-467
40. Eland J.M. Minimizing pain associated with prekindergarten intramuscular injections. Issues Compr Pediatr Nurs. 5 (1981) 361-372
41. Ipp M., Taddio A., Goldbach M., et al. Effects of age, gender and holding on pain response during infant immunization. Can J Clin Pharmacol 11 (2004) e2-e7
42. Sparks L. Taking the "ouch" out of injections for children. Using distraction to decrease pain. MCN Am J Matern Child Nurs. 26 (2001) 72-78
43. Megel M.E., Houser C.W., and Gleaves L.S. Children's responses to immunizations: Lullabies as a distraction. Issues Compr Pediatr Nurs. 21 (1998) 129-145
44. Broome M.E., and Endsley R.C. Group preparation of young children for painful stimulus. West J Nurs Res. 9 (1987) 484-502
45. Cassidy K.L., Reid G.J., McGrath P.J., et al. Watch needle, watch TV: Audiovisual distraction in preschool immunization. Pain Med. 3 (2002) 108-118
46. Unruh A.M. Gender variations in clinical pain experience. Pain. 65 (1996) 123-167
47. Taddio A., Ilersich A.L., Ipp M., et al. Physical interventions and injection techniques for reducing injection pain during routine childhood immunizations: Systematic review of randomized controlled trials and quasi-randomized controlled trials. Clin Ther. 31 Suppl B (2009) XX
48. Chambers C.T., Taddio A., Uman L.S., McMurty C.M., and the HELPinKIDS Team. Psychological interventions for reducing pain and distress during routine childhood immunizations: A systematic review. Clin Ther. 31 Suppl B (2009) S77-S103
49. Shah V., Taddio A., Rieder M.J., and the HELPinKIDS Team. Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood immunizations: Systematic review and meta-analysis. Clin Ther. 31 Suppl B (2009) S104-S151
50. Blount R.L., Bunke V., Cohen L.L., and Forbes C.J. The Child-Adult Medical Procedure Interaction Scale-Short Form (CAMPIS-SF): Validation of a rating scale for children's and adults' behaviors during painful medical procedures. J Pain Symptom Manage 22 (2001) 591-599
51. Sweet S.D., and McGrath P.J. Relative importance of mothers' versus medical staffs' behavior in the prediction of infant immunization pain behavior. J Pediatr Psychol 23 (1998) 249-256
52. Cohen L.L., Bernard R.S., Greco L.A., and McClellan C.B. A child-focused intervention for coping with procedural pain: Are parent and nurse coaches necessary?. J Pediatr Psychol 27 (2002) 749-757
53. Gonzalez J.C., Routh D.K., and Armstrong F.D. Effects of maternal distraction versus reassurance on children's reactions to injections. J Pediatr Psychol 18 (1993) 593-604
54. Cohen L.L. Behavioral approaches to anxiety and pain management for pediatric venous access. Pediatrics 122 Suppl 3 (2008) S134-S139
55. Frank N.C., Blount R.L., Smith A.J., et al. Parent and staff behavior, previous child medical experience, and maternal anxiety as they relate to child procedural distress and coping. J Pediatr Psychol. 20 (1995) 277-289
56. Ross D.M., and Ross S.A. Childhood pain: The school-aged child's viewpoint. Pain. 20 (1984) 179-191
57. Gonzalez J.C., Routh D.K., Saab P., et al. Effects of parent presence on children's reactions to injections: Behavioral, physiological, and subjective aspects. J Pediatr Psychol 14 (1989) 449-462
58. Stephens B.K., Barkey M.E., and Hall H.R. Techniques to comfort children during stressful procedures. Adv Mind Body Med. 15 (1999) 49-60
59. Madlon-Kay D.J., and Harper P.G. Too many shots? Parent, nurse, and physician attitudes toward multiple simultaneous childhood vaccinations. Arch Fam Med. 3 (1994) 610-613
60. Lieu T.A., Black S.B., Ray G.T., et al. The hidden costs of infant vaccination. Vaccine 19 (2000) 33-41
61. Taddio A. Effects of early pain experience (the human literature). In: McGrath P.J., and Finley G.A. (Eds). Chronic and Recurrent Pain in Children and Adolescents (1999), IASP Press, Seattle, Wash 57-74
62. Taddio A., and Katz J. The effects of early pain experience in neonates on pain responses in infancy and childhood. Pediatr Drugs. 7 (2005) 245-257
63. Weisman S.J., Bernstein B., and Schechter N.L. Consequences of inadequate analgesia during painful procedures in children. Arch Pediatr Adolesc Med. 152 (1998) 147-149
64. O'Brien L., Kemp S., Dupuis L., and Taddio A. Pharmacologic management of painful oncology procedures in pediatric patients. Am J Cancer 2 (2003) 403-426
65. Hamilton J.G. Needle phobia: A neglected diagnosis. J Fam Pract. 41 (1995) 169-175
66. Diagnostic and Statistical Manual of Mental Disorders. 4th ed (1994), American Psychiatric Association, Arlington, Va
67. Chen E., Zeltzer L.K., Craske M.G., and Katz E.R. Children's memories for painful cancer treatment procedures: Implications for distress. Child Dev. 71 (2000) 933-947
68. Cohen L.L., Blount R.L., Cohen R.J., et al. Children's expectations and memories of acute distress: Short-and long-term efficacy of pain management interventions. J Pediatr Psychol 26 (2001) 367-374
69. Taddio A., Goldbach M., Ipp M., et al. Effect of neonatal circumcision on pain responses during vaccination in boys. Lancet 345 (1995) 291-292
70. Taddio A., Katz J., Ilersich A.L., and Koren G. Neonatal circumcision on pain response during subsequent routine vaccination. Lancet 349 (1997) 599-603
71. Taddio A., Shah V., Gilbert-MacLeod C., and Katz J. Conditioning and hyperalgesia in newborns exposed to repeated heel lances. JAMA. 288 (2002) 857-861
72. Taddio A., Soin H., Schuh S., et al. Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: A randomized controlled trial. CMAJ. 172 (2005) 1691-1695
73. Baxter A., Ewing P.H., Manworren R.C.B., et al. EMLA application in triage improves venipuncture success. PAS. 57 (2005) 2902
74. Pate J.T., Blount R.L., Cohen L.L., and Smith A.J. Childhood medical experiences and temperament as predictors of adult functioning in medical situations. Children's Health Care. 25 (1996) 281-298
75. Page A.C. Blood-injury-injection fears in medical practice. Med J Aust. 164 (1996) 189
76. Searing K., Baukus M., Stark M.A., et al. Needle phobia during pregnancy. J Obstet Gynecol Neonatal Nurs. 35 (2006) 592-598
77. Harrington M., Sweeney M.R., Bailie K., et al. What would encourage blood donation in Ireland?. Vox Sang 92 (2007) 361-367
78. Oswalt R.M., and Napoliello M. Motivations of blood donors and nondonors. J Appl Psychol 59 (1974) 122-124
79. McConnell E.M., Harper R., Campbell M., and Nelson J.K. Achieving optimal diabetic control in adolescence: The continuing enigma. Diabetes Metab Res Rev. 17 (2001) 67-74
80. Enkling N., Marwinski G., and Jöhren P. Dental anxiety in a representative sample of residents of a large German city. Clin Oral Investig 10 (2006) 84-91
81. Heimberger T., Chang H.G., Shaikh M., et al. Knowledge and attitudes of healthcare workers about influenza: Why are they not getting vaccinated?. Infect Control Hosp Epidemiol 16 (1995) 412-415
82. Nir Y., Paz A., Sabo E., and Potasman I. Fear of injections in young adults: Prevalence and associations. Am J Trop Med Hyg. 68 (2003) 341-344
83. Sendi P., Locher R., Bucheli B., and Battegay M. Intranasal influenza vaccine in a working population. Clin Infect Dis. 38 (2004) 974-980
84. Tilburt J.C., Mueller P.S., Ottenberg A.L., et al. Facing the challenges of influenza in healthcare settings: The ethical rationale for mandatory seasonal influenza vaccination and its implications for future pandemics. Vaccine. 26 Suppl 4 (2008) D27-D30
85. Barker L., Luman E., Zhao Z., et al., the Centers for Disease Control and Prevention (CDC). National, state, and urban area vaccination coverage levels among children aged 19-35 months-United States, 2001. MMWR Morb Mortal Wkly Rep. 51 (2002) 664-666
86. Meyerhoff A.S., and Jacobs R.J. Do "too many shots due" lead to missed vaccination opportunities? Does it matter?. PAS (2004) 1188 Abstract
87. Mills E.J., Montori V.M., Ross C.P., et al. Systematically reviewing qualitative studies complements survey design: An exploratory study of barriers to paediatric immunisations. J Clin Epidemiol 58 (2005) 1101-1108
88. Yawn B.P., Xia Z., Edmonson L., et al. Barriers to immunization in a relatively affluent community. J Am Board Fam Pract. 13 (2000) 325-332
89. Guerra F.A. Delays in immunization have potentially serious health consequences. Paediatr Drugs. 9 (2007) 143-148
90. Abbotts B., and Osborn L.M. Immunization status and reasons for immunization delay among children using public health immunization clinics. Am J Dis Child. 147 (1993) 965-968
91. Samad L., Butler N., Peckham C., Bedford H., and the Millennium Cohort Study Child Health Group. Incomplete immunisation uptake in infancy: Maternal reasons. Vaccine. 24 (2006) 6823-6829
92. Harrington P.M., Woodman C., and Shannon W.F. Vaccine, yes; injection, no: Maternal responses to the introduction of Haemophilus influenzae type b (Hib) vaccine. Br J Gen Pract. 49 (1999) 901-902
93. Harrington P.M., Woodman C., and Shannon W.F. Low immunisation uptake: Is the process the problem?. J Epidemiol Community Health. 54 (2000) 394-400
94. Askew G.L., Finelli L., Lutz J., et al. Beliefs and practices regarding childhood vaccination among urban pediatric providers in New Jersey. Pediatrics 96 (1995) 889-892
95. Roberts R.J., Sandifer Q.D., Evans M.R., et al. Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine. BMJ. 310 (1995) 1629-1632
96. The measles epidemic. The problems, barriers, and recommendations. The National Vaccine Advisory Committee. JAMA. 266 (1991) 1547-1552
97. Ipp M., Taddio A., Sam J., et al. Vaccine-related pain: Randomised controlled trial of two injection techniques. Arch Dis Child. 92 (2007) 1105-1108
98. Broome M.E., and Endsley R.C. Maternal presence, childrearing practices, and children's response to an injection. Res Nurs Health. 12 (1989) 229-235
99. McGrath P.J., and McAlpine L. Psychologic perspectives on pediatric pain. J Pediatr. 122 (1993) S2-S8
100. Kleinknecht R.A. Acquisition of blood, injury, and needle fears and phobias. Behav Res Ther. 32 (1994) 817-823
101. Ost L.G. Age of onset in different phobias. J Abnorm Psychol. 96 (1987) 223-229
102. Melhuish S., and Payne H. Nurses' attitudes to pain management during routine venepuncture in young children. Paediatr Nurs. 18 (2006) 20-23
103. Lebovits A.H., Florence I., Bathina R., et al. Pain knowledge and attitudes of healthcare providers: Practice characteristic differences. Clin J Pain. 13 (1997) 237-243
104. Parvez E. Mothers' beliefs about analgesia during childhood immunization: A qualitative study. MSc Thesis (2008), University of Toronto
105. Hatfield L., Messner E.R., and Lingg K. Evidence-based strategies for the pharmacological management of pediatric pain during minor procedures in the emergency department. Top Emerg Med. 28 (2006) 129-137
106. Schechter N.L. Treatment of acute and chronic pain in the outpatient setting. In: Finley G.A., McGrath P.J., and Chambers C.T. (Eds). Bringing Pain Relief to Children: Treatment Approaches (2006), Humana Press, Totowa, NJ 31-58
107. Broome M.E. The child in pain: A model for assessment and intervention. Crit Care Quarter. 8 (1985) 47-55
108. Meyerhoff A.S., Weniger B.G., and Jacobs R.J. Economic value to parents of reducing the pain and emotional distress of childhood vaccine injections. Pediatr Infect Dis J. 20 Suppl (2001) S57-S62
109. Taddio A., Nulman I., Goldbach M., et al. Use of lidocaine-prilocaine cream for vaccination pain in infants. J Pediatr. 124 (1994) 643-648
110. Koh J.L., Fanurik D., Stoner P.D., et al. Efficacy of parental application of eutectic mixture of local anesthetics for intravenous insertion. Pediatrics 103 (1999) e79
111. Hansen B.W., and Sørensen P.V. The EMLA cream versus placebo in MMR vaccination of older children in general practice [in Danish]. Ugeskr Laeger. 155 (1993) 2263-2265
112. Lovering S. Cultural attitudes and beliefs about pain. J Transcult Nurs. 17 (2006) 389-395
113. Lewis T., DiLillo D., and Peterson L. Parental beliefs regarding developmental benefits of childhood injuries. Am J Health Behav. 28 Suppl 1 (2004) S61-S68
114. Craig K.D., Lilley C.M., and Gilbert C.A. Social barriers to optimal pain management in infants and children. Clin J Pain. 12 (1996) 232-242
115. Arvidsson S.B., Ekroth R.H., Hansby A.M., et al. Painless venipuncture. A clinical trial of iontophoresis of lidocaine for venipuncture in blood donors. Acta Anaesthesiol Scand 28 (1984) 209-210
116. Petousis-Harris H. Vaccine injection technique and reactogenicity-evidence for practice. Vaccine. 26 (2008) 6299-6304
117. Niederhauser V.P., and Markowitz M. Barriers to immunizations: Multiethnic parents of under- and unimmunized children speak. J Am Acad Nurse Pract. 19 (2007) 15-23
118. Thomas M., Kohli V., and King D. Barriers to childhood immunization: Findings from a needs assessment study. Home Health Care Serv Q. 23 (2004) 19-39
119. Azocar F., Cuffel B., Goldman W., and McCarter L. The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization. J Behav Health Serv Res. 30 (2003) 109-118
120. Barwick M.A., Boydell K.M., Stasiulis E., et al. Knowledge transfer and implementation of evidence-based practices in children's mental health (2005), Children's Mental Health Ontario, Ontario, Canada. http://resources.cpha.ca/CCIAP/data/700e.pdf Accessed January 25, 2009