Choose a pediatrician you trust. A good doctor will have good nurses, and together, they will know how to administer shots quickly and correctly.
Present a blase, everything-is-routine attitude, and your child will be more relaxed during pediatrician visits. Trying to reassure her before she gets a shot is not terribly effective, especially for children under 8.
Let the doctor and nurse handle your child. Don’t cling to her. The doctor and nurse know what they are doing, and their competence will instill confidence in your child.
Understand that the injection will most likely be given in the thigh because the fat in the thigh eases the discomfort of the shot.
Make a fun little noise to distract her from her shot.
Put special adhesive bandages over the injection site. Most pediatricians and hospitals apply child-friendly bandages, such as ones with Pokemon or Elmo pictured on them.
Give stickers as a reward.
Praise your child when you leave the pediatrician’s office. Don’t say, I know how awful it is to get a shot. Instead, say, You acted so grown-up in the doctor’s office. I am so proud of you.
Keep some fun adhesive bandages in the bathroom cupboard. If she wants a fresh bandage over the injection site, give her one.

Parents are constantly concerned about the health and safety of their children and they take many steps to protect them. These preventive measures range from child-proof door latches to child safety seats. In the same respect, vaccines work to safeguard children from illnesses and death caused by infectious diseases. Vaccines protect children by helping prepare their bodies to fight deadly diseases.

There are a series of steps that a person’s body goes through in learning how to fight off a vaccine-preventable disease:

First – A vaccine is given by a shot or liquid by mouth. An alternative needle-free route is the use of inhalation by aerosol and powder. Most vaccines contain a weakened or dead disease germ or part of a disease germ. Other vaccines use inactivated toxins. Some of the bacteria that cause disease do so by producing toxins that invade the bloodstream.

Next – The body makes antibodies against the weakened or dead germs in the vaccine.

Then – These antibodies can fight the real disease germs, which can be lurking all around ? if they invade the child’s body. The antibodies will know how to destroy them and the child will not become ill. Most vaccines don’t cause the diseases that are usually caused by viruses and bacteria.

Finally – Protective antibodies stay on guard in the child’s body to safeguard it from the real disease germs.

After exposure to a live, weakened, or dead germ, the antibodies or memory cells fight infectious diseases and usually stay in a person’s immune system for a lifetime. This protects a person from getting sick again. This protection is called immunity.

It is true that newborn babies are immune to many diseases because they have antibodies they got from their mothers. However, this immunity only lasts about a year. Further, most young children do not have maternal immunity from diphtheria, whooping cough, polio, tetanus, hepatitis B, or Haemophilus influenzae type b.
Immunizing individual children also helps to protect the health of our community. People who are sick will be less likely to be exposed to disease germs that can be passed around by unvaccinated children. Immunization also slows down or stops disease outbreaks.
If a child is not vaccinated and is exposed to a disease germ, the child’s body may not be strong enough to fight the disease. Before vaccines, many children died of diseases vaccines prevent, like whooping cough, measles, and polio. Those same germs exist today, but babies are now protected by vaccines and so we do not see these diseases as often.

CDC, National Immunization Program: http://www.cdc.gov/nip

May 7, 2007 — An evidence-based review published in the May issue of Pediatrics provides recommendations to help reduce the pain children experience during immunizations.

The pain associated with immunizations is a source of anxiety and distress for the children receiving the immunizations, their parents, and the providers who must administer them.

The current Centers for Disease Control and Prevention schedule recommends immunizations against 14 diseases, which translates into 14 to 20 separate injections before the age of 2 years, depending on the number of combination vaccines available. Therefore, immunizations are the most frequently occurring painful procedures performed in pediatric settings.

The recommendations divide the injection process into 2 periods: before the injection and during the injection. Before the injection, important aspects of the immunization include preparing the child and family, selecting the site for the injection, selecting the needle length and gauge, and specific properties of the injectate.

During the injection itself, key elements include parental demeanor, use of sucrose, use of topical anesthetic agents, nonpharmacologic and physical strategies, and specific aspects of administration technique. Before the injection, preparation of a child older than 2 years reduces anxiety and subsequent pain. For children younger than 4 years, the preparation should be done in close chronological proximity to the injection itself. Based on limited data available, intramuscular immunizations should be given in the vastus lateralis (anterolateral thigh) for infants and toddlers younger than 18 months and in the deltoid (upper arm) for children older than 36 months. Although site selection for 18- to 36-month-old children is still controversial, some studies suggest that the ventrogluteal area is the most appropriate for all age groups. Using longer needles usually causes less pain and less local reaction. During the injection, parental attitudes clearly affect the child’s pain behaviors. Excessive parental reassurance, criticism, or apology appears to increase distress, whereas humor and distraction may reduce distress. The age, temperament, and interests of the child, as well as personal style of the parents, will determine which distraction techniques will be most effective. These techniques may include storytelling, reading to the child, deep breathing, and blowing. Although it seems counterintuitive, children often are more distressed when parents are more rather than less involved, the authors write.

Therefore, a matter-of-fact, supportive, nonapologetic approach is endorsed. In children younger than 6 months, sucrose solution given directly into the mouth or on a pacifier reliably reduces evidence of distress and should be used routinely, in part because it is relatively inexpensive. Given the high cost and time needed for administration, routine local anesthetic administration is not necessarily appropriate. Despite the absence of a perfect topical anesthetic available at this time, selective use is recommended for children who are particularly fearful, who have had previous negative experiences, or who will require multiple procedures in the future.

Pressure at the immunization site decreases pain, whether applied with a mechanical device or manually with a finger. Furthermore, it is noninvasive, inexpensive, and without adverse effects.

Although properties of the injectate itself can exacerbate pain, there has been almost no sophisticated research in this area, and this issue should be pursued further. In the era of multiple injections, it seems that parents prefer that multiple injections be given simultaneously, rather than sequentially, if there are enough personnel available, the authors write. Immunizations are stressful for many children; until new approaches are developed, systematic use of available techniques can significantly reduce the burden of distress associated with these procedures.

However, they also note that dread evoked by painful immunization procedures may create feelings of persistent tension in future clinical encounters, thereby interfering with optimal delivery of healthcare. Pediatrics. 2007;119:e1184-e1198.