Doing the right thing in the face of needle-phobia and anxiety
Lessons from the vaccinations of my youth
When I was a teenager, my mum paid for me to have the three HPV vaccinations.
This was a couple of years before they were funded by the government - it cost several hundred dollars. This was a lot of money in general, but also a lot of money for us. On the face of it, I understood cancer was something you didn’t want (my dad had had cancer) but I also fucking hated needles. I’ve had anxiety my whole life and needing blood drawn or needing an injection of any kind would put me on the verge of a panic attack, well into adulthood too. The option of getting a thing done that I feared and hated very much right now, versus potentially getting a bad thing waaaaay way in the future? Teenage me would absolutely have chosen to avoid it - no question about it.
Now, my mum, she’s pretty clever. She told me she had organised it and why it was important to her for me to get it - about how she didn’t want me to get sick and possibly die from something which we could prevent by doing something a little bit painful right now. How paying for and organising it was an act of love from her to me, an act of love that would protect me for my whole life, even after she was gone. Yeah, big oof. So, I wanted to do it - but then we came to the actual act of getting the vaccination. Luckily, my mum is double clever.
I arrived home one day from school, to find her waiting in the car in the driveway. This was obviously very suspicious. “Let’s just go into town” - also suspicious, but the potential we would be going to the craft shop or United Video (yes, that was a very enjoyable memory of my teen years) was worth the gamble. Alas, we were going to the doctor.
Because she had told me about why it was important but she was chill about it (on the surface at least), she hadn’t said there would be a severe punishment if I didn’t do it and hadn’t told me when it would be happening - I didn’t have time to get worked up about it. I was still, obviously, very anxious and hyperventilating while it happened. I focused on how it was an act of love from my mum to me, that (underneath how I was feeling right in the moment) I did want it. I could hold onto that shred of logic while having what was a somewhat illogical response in the short-term, just enough to get through it and come out the other side.
Had she told me earlier in the week that I was getting the vaccination after school on Friday? Absolutely not. I would have been having a panic attack from the day before. Earlier that day? I would have been a wreck by the time I got home from school. Obviously for the second and third vaccinations, I knew when I saw her waiting in the car what was going on, but “once they’re done, you don’t ever need to get them again” was also a solid pitch that worked for getting me through the last ones.
Why am I afraid of needles?
I’m the first to admit it’s not logical. I’m afraid I will have a knee-jerk reaction to the pain and will pull out the needle before it’s done and I’ll embarrass myself and maybe accidentally stick myself or the nurse with the needle and then they can’t get it out again. I’m also afraid of the nurse being mad at me for having this reaction (🤷♀️). Has this ever happened in my 28-years-of-life? No. Am I still afraid of it? Yes. This scenario is not unique to vaccinations. I have to lie down when getting bloods done because I’ve been so worked up I’ve nearly fainted. I’ve been chronically B12 deficient through my mid-20s and that’s a double whammy of needing a blood test to see how low the B12 is, and then needing B12 injections to rectify it. I have been very close to realising my fear with a few of my B12 injections, and it’s not helped by the fact B12 injections can really hurt in my experience (one pharmacist reckoned that they were the most painful ones you could get, but they may have just been being nice).
So how did I fare getting both COVID-19 vaccinations?
Good question. As an operations manager in the COVID-19 vaccination programme, I live every day in the logical zone. I know getting two doses of the Pfizer vaccine means you are much less likely to catch COVID-19, including Delta. I also know that if you are double-dosed and you do get COVID-19, you’re far less likely to get really sick and have to go to hospital, and you’re less likely to pass COVID-19 on to other people. Being vaccinated means I can return the favour of protecting my mum, and also protect my friends and family around me - as well as myself.
The stakes are a bit more immediate with the COVID-19 vaccine than HPV - it’s not something that could happen decades in the future, there are Delta cases in Hamilton right now. I don’t know how I would have coped booking a COVID-19 vaccination, and waiting for that day to roll around. Luckily, for both doses I didn’t even have the drive in to get worked up - I had a leftover vaccination at the end of the day at a clinic I was managing. I was eligible if I did want to book (falling into Group 2 of the vaccine rollout) but there would be days when the number of bookings we had didn’t divide equally by the number of doses in a vial and there would be spare vaccine at the end of the day (if we didn’t use it, would have to be thrown away1). I was the back-up, back-up option if we didn’t have anyone else available to take the spare dose (not everyone hangs around a vaccination clinic every day, ya know).
June 3rd 2021, Te Rapa Racecouse clinic. It took all of about two minutes to work out we had one dose left and no one for it. The thing about spares is that you’re the last vaccination of the day and the sooner you’re done, the sooner everyone can go home (yourself included). I remember filling in the paper form (#cyberattack), and being like - woah, big step? Feeling? Anxious? Don’t really have the brain space to be the kind of anxious I’d usually be? Still on auto-pilot thinking about biking home and dinner and end-of-day reporting?
I also had the inconvenience of not dressing for a vaccination. I was wearing a long sleeve, close-fitting top. This one, in fact. Pro-tip: another good distraction from your anxiety around injections is the cringe of also needing to slightly undress in front of someone you work with every day.
It was also a little bit exciting to get to do the thing you organise to happen every day. To sit down in the booth, to be asked the questions like “do you have any allergies” and make bad jokes like “I have a food intolerance to garlic and onions - don’t tell me there’s garlic in the vaccine!”2 - the sounds that were the backdrop of my working day were all of a sudden things I got to answer for myself.
I generally don’t make eye contact with anyone sitting next to me who I know is holding a needle - it’s one of the things that makes my panic scenario less likely to happen. I was still making small talk to distract myself when I felt a much-smaller-than-usual pinch in my arm (compared to B12 at least), and before I could even grind my teeth together in response, they were telling me to hurry off to observation so they could start the clock.
My main memory of my first COVID-19 vaccination was that I hardly had time to be afraid - it was over before I realised it had started. Replay this exact same situation, same vaccine-inappropriate top, four weeks later when we had another spare left and no one to take it. I can honestly say, I would take a COVID-19 vaccination over a B12 injection any day. Getting my second dose, I remembered that logic - all the rational reasons why I was being vaccinated and why I get up every day and help other people get vaccinated - being much more present than previously (including for my HPV ones so many years ago). Some of my friends have talked about the relief they’ve felt being double-dosed - I can definitely attest to it too. A sliver of assurance and protection in what has been 18 months of a new level of panic and fear.
Those final percentages.
Since June, I’ve also taken on the role of disability lead for the programme in the Waikato. It’s challenging - as a disabled person myself - grappling with how our healthcare system lets people down and how we can make sure that such an important vaccination is an accessible and empowering experience. I often talk with other people who are needle-phobic or have severe anxiety in other ways which creates a barrier to vaccination. So many are eager, absolutely certain they want to be vaccinated but are struggling in an environment where the stakes are high, the pressure is immense, and it’s anxiety-inducing for people otherwise not diagnosed with anxiety, let alone people who are. There’s also a lot of people whose fear comes from a healthcare system and even a government that has consistently harmed them in the past - it’s not just a matter of getting through the vaccination, it’s also about building and rebuilding trust. No one is alone in these experiences and it’s an opportunity every day to create one that offsets a negative experience in the past.
The full attention of Aotearoa seems to be on our yet-to-be-vaccinated population, and I’ve seen people assuming they’re all anti-vaxxers - those who are deep down the rabbit hole of misinformation, aggressive to anyone suggesting otherwise, and very difficult to have a two-way conversation with. But I’ve also spoken often with parents who have a clone of teenage me, who understand why it’s important, are willing to have it done, but struggle with the immediate anxiety of the situation - creating distress for both the person and their parents. Adults too - including ones who are working in jobs where it’s becoming mandated to have both doses. I have a lot of empathy for the people right now who want to be vaccinated but aren’t sure how to go through with it. It doesn’t matter if your fear is rational or not, it’s still real and valid and can be a tangible barrier to accessing healthcare.
It’s important, in my mind, that we don’t assume anyone not vaccinated yet is an anti-vaxxer (that’s a very different reason for not being vaccinated), and to be very careful about using anyone as an outlet for our pandemic frustrations. Shame and judgement wasn’t going to get me across the line for my HPV vaccinations - it was someone helping me face my fears and reminding me of why I wanted to do it: because it was an act of love. While mandates are needed in my opinion, and are certainly increasing the urgency for people to get both doses, we need to balance that pressure with creating opportunities for vaccination that are centred in empathy and kindness. As we reach the final percentages, I hope that we can all keep this in mind - an act of love in helping someone get vaccinated is felt ten times over as it helps keep them and everyone else they come in contact with safe from this pandemic.
Note: Opinions expressed are my own, not that of my employer.
Some options if you are needle-phobic or have severe anxiety:
Do you have a friend or family member who can be your vaccine buddy? Who’s job is to point out if you’re passing by a walk-in clinic (so you don’t have to book and then dread it) and can support you to go in? Who can be an advocate for you and help you go through with it?
Can you get your buddy to call ahead to walk-in clinics and see what support they have? Do they have a buzzy-for-shots on site (a sensory distraction that multiple DHBs use)? They probably have a room where you can be vaccinated out of sight of other people if that would help. Could you get a longer booking slot or go in during a quiet time so there’s no pressure? Remember - lots of people are in the same boat as you are.
Let the nurses know what’s going on when you get there - having anxiety (for any reason) is more common than you think and if you let them know how you’re feeling they can work with you to support you. I’ve seen some nurses work some real magic on people who absolutely thought their anxiety wouldn’t allow them to get vaccinated that day.
Could you talk to your GP about whether they could prescribe an oral sedative or anti-anxiety medication for you to take before the vaccination? Make sure you’ve got someone with you to help you get to and from the clinic and look after you until the sedative wears off too.
Would a familiar location like your local shopping centre, or your GP or pharmacy be a location that makes you feel more at ease?
If your anxiety is very severe, have you considered booking an in-home vaccination? This can be organised by calling the COVID Vaccination Healthline on 0800 28 29 26 (including getting your vaccine buddy to do it if phone calls aren’t your jam).
Remember - you can have multiple goes at getting it done and there is no shame in trying again if the first time it didn’t work out.
There’s specific requirements around how long you can keep vaccine once it’s made up as a dose. During my time at Te Rapa Racecourse, we never wasted a single spare dose.
There is no garlic in the vaccine.