Teen's phobia of shots debilitating, help.

My teen has a severe prohibitive phobia of shots, and is unable to get them. My teen would need to be restrained, let alone the emotional damage that would be caused and that he is big and strong. What do I do? We've done therapy, and for several years while we tried to process the situation he was able to receive waivers that allowed him to go to school, but not any more. My child has some vaccines, but 3 years ago something changed - and contrary to our persistence, he has not been able to overcome the fear. Any suggestions on how to deal with this huge obstacle? Does anyone know of a doctor that would give laughing gas additionally to vaccinating? A doctor that would work with us and be understanding? Most of our Kaiser doctors have not taken the phobia serious and not perceived it as a valid impediment. I'd like my child to get fully vaccinated, and to be able to return to high school next year (10th grade). Any suggestions appreciated, thank you.

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I completely empathize with you and your son. My daughter also (has/had) a phobia about shots but fortunately we were able to work through it. It started when she was about 12 years old...she would faint. Fortunately our pediatrician was very patient and understanding. They would have her lay down on a table and (despite her age) give her a "buzzy bee" vibrating ice pack before the shot to help. I would stay with her and try to help as well. She is now 18 and has mostly worked through her phobia. She had to have major surgery last year so was poked and prodded so many times just the exposure to everything forced her to deal with her phobia head on. She is now able to get shots and IVs without the paralyzing fear or fainting. I would suggest cognitive behavior therapy if you have reached a point where nothing is working. Good luck.

This sounds very difficult and I'm so sorry you are experiencing it. Our teen's therapist specializes in anxiety and phobias. She is very good. She has a lot of teen and young adult clients. Her name is Anatasia Kim (correct spelling) and she is at The Wright Institute in Berkeley. She has spoken to us specifically about needle phobia in our therapy sessions when she talks about how CBT/DBT works. She sent us an email saying she'd be out of the country for a couple of weeks but I think she will be back next week. Her fees are worth every cent. Also you've probably tried this, but when our kid was having trouble with injections, they had someone call us and advise us. We ended up applying burn gel skin numbing cream an hour before the injection and wrapping it with plastic wrap until the injection. Also at Kaiser Oakland in the pediatric building (tall one by Mosswood Park) there is a person in the injection clinic who takes anxiety over injections very seriously. She has been there since our kid was a baby. She has a small, strong frame, short grey hair and is likely in her 60s. She had our kid lie down, instructed us in breathing, had us wait for 15 minutes on the exam table before leaving and do a particular movement to get the blood flowing so there would be no fainting. She noted that our kid was pale and clammy, really observed the state they were in, and treated them carefully and with thoughtfulness and seriousness so if you can ask for her I know she would be understanding and helpful. She takes it seriously. I wish you the very best of luck. What a good and loving mom you are.

Sorry to hear what you are going through.

I’m a nurse working in pediatrics and have given hundreds of shots to little and big kids. I have seen a lot of extreme anxiety over the years so I know the fear is real. Usually getting past the first one helps.

I’d be willing to talk to you if you’d like.

I’m surprised that the doctors aren’t taking this seriously, since their nurses or other staff are the people who have tried to administer the vaccinations. I haven’t had this problem but I have a couple of ideas:

1. Are there vaccinations he needs that are available in oral or nasal form? Do some research, and if Kaiser tells you something isn’t available that you know is made, push as hard as you need to get that in an alternative form.

2. Have you considered a mild sedative and/or an anxiety medication? Talk to a psychiatrist about your son’s problem and ask for appropriate prescriptions. Explain that therapy hasn’t helped.

3. Consult with a pharmacist who specializes in compounding medications to find out if there are other delivery options for the needed vaccines.

Good luck! I hope you find a solution so your son can attend school for the remainder of high school.

Somatic Experiencing therapy may be able to help.  This form of therapy focuses on the body and can be useful in resolving acute traumas.  Peter Levine's books provide background on this kind of treatment and how it is used.  There are practitioners in the Bay Area that you can look up.

Would the doctor be willing to bring him in and have him take a sedative ahead of time, and then a strong sedative or laughing gas at the office, so he's super relaxed and semi-conscious when he gets the vaccinations?  Seems like this is a life-altering disability, and Kaiser should be willing to take measures to get him vaccinated.  Does he need his wisdom teeth removed?  Could a doctor give him shots while he's under for some other medical procedure?  My kid hates shots too, she'd run away and scream, and shots would take FOREVER, up until mid-high school.  The good news...she is now able to deal with needles a young adult (19), and actually got a TATTOO, as soon as she turned 18.  I wish you the best.  

As a pediatrician, I have had success with teens with shot phobia: using EMLA (a numbing cream) with Tegaderm, and having the teen experiment with using beforehand on their forearm and poking themselves (lightly) with a needle or safety pin (with parental supervision) to see that their skin is numb and they can handle a needle, having them work with a therapist to envision their skin being a metallic protection or other self-hypnotic vision that helps them deal with shots, practicing diaphragmatic breathing prior to and during the appointment, and taking an anit-anxiety med such as alprazolam 30 minutes prior to the appointment. If you have Kaiser, I would have a psychiatrist (who can prescribe) consult about this.

My teen has a serious needle phobia too : (. Adding on to the advice you received I wanted to recommend that you reach out to the Child Life Specialist at Kaiser Oakland. The person in that job helped us get my son a blood test and shot in a private room with a lot of support. (I think the child life specialist mostly supports kids who need inpatient care, but I made a few calls and was able to connect with her. Sorry I don’t have a phone number for you. This was about 5 years ago.)  We also had prescription numbing cream and Valium. Sorry you’re dealing with this!

Good luck!!

Have you tried ERP therapy for your teen? (Exposure and Response Prevention therapy) It is the "gold standard" for OCD (not saying your teen has OCD, but this type of phobia reminded me of an OCD situation..... some people with OCD are extremely scared of certain medical situations/procedures and ERP therapy can completely change that.) It is not easy but it changes lives. 

You would want to find a CBT therapist who does a lot of ERP.... a good resource is the San Francisco Bay Area Center for Cognitive Therapy -- http://sfbacct.com/