What You Say to Your Child Minutes After Vaccination Can Calm Them

This fall, getting children their routine and COVID-19 vaccinations will be crucial as they gear up for in-person schooling. A new study shows how parents can best soothe their kids while they get their shots at the physician's office.

This new research, published in the journal PAIN in July, shows that what is said to a child after vaccination can impact a child’s distress levels. 

Researchers from York University in Toronto, Ontario followed preschool-aged children aged four to five years old and tracked verbalizations during their vaccination appointments. The group consisted of 760 caregiver-child duos from three pediatric clinics in the greater Toronto area.

Senior study author Rebecca Pillai Riddell, PhD, professor of psychology at York University in Toronto, Ontario, Canada, tells Verywell that there were two types of verbalizations: coping promoting and distress promoting.

“Coping promoting are statements that have been found in the literature to promote coping,” Pillai Riddell says. Examples of coping-promoting statements include "you can do this" and "it will be over soon."

Based on the study’s findings, in the first minute after vaccination, coping-promoting statements caused higher distress.

“When the child is in peak distress, it’s not a good idea to start telling them what to do,” Pillai Riddell says. However, in the second-minute post-vaccination, coping-promoting statements helped calm the children down faster.

The reason for that one-minute time difference is peak distress, according to Pillai Riddell. “We are speculating that when the child is in peak distress, they’re not open to verbal commands from their parents,” making it difficult for a child to get vaccinated, Pillai Riddell explains. “So it’s kind of waiting until the child is calm or open to proper requests," she adds.  

They also examined the impact of distress-promoting statements, such as criticizing the child, or reassuring them that they were fine post-vaccination. What Pillai Riddell and her team found was that there was no relationship of child distress when distress-promoting statements were used during that first minute. However, in minute-two, the distress-promoting commentary led to higher stress in kids. 

According to Norman Blumenthal, PhD, director of trauma, bereavement, and crisis intervention at Ohel Children’s Home and Family Services, who was not involved with the study, said it implies children have to toughen up to make them feel criticized.

“They’re being criticized by the most important people in their lives and that’s not going to help the situation,” Blumenthal tells Verywell. 

Reducing Distress During Vaccination 

The study found a pain domino effect: kids who were more distressed before the shot were also more distressed after.

These findings suggest that allowing children to be approached for the shot in a calm way will allow them to be less stressed afterward.

Rather than encouraging coping right away, the study suggests that parents should use physical strategies first.

Research finds that physical interventions, such as swaddling and warmth decrease distress among infants. “The best thing to do is to actually hold them in a calm, close cuddle, and then go on once their distress is lower,” Pillai Riddell says. For children under six months of age, oral stimulation, such as using a pacifier and breastfeeding, has also been found to be effective.

Older infants, who are in the process of learning object permanence–the understanding that objects continue to exist when they cannot be seen or heard–benefit from distraction items, such as rattles, beads, or a flashlight.

Because school-age children are capable of complex learning, studies suggest allowing age-appropriate discussions and questions. Blumenthal says that combatting distress among school-aged children requires communication between the parent and child. 

“We have to let them [children] know that they’re going to get a shot and create an atmosphere that reduces distress as much as possible,” Blumenthal says. 

As schools begin to open, Pillai Riddell hopes this study will inform conversations regarding pediatric vaccination appointments.

“This fall, we think that children less than 12 will get vaccinated for COVID,” Pillai Riddell says. “The best things that we can recommend is for parents to go with physical strategies first, and then go to coping second when the child is calm, and then for pediatricians to ensure that they’re vaccinating calm children.”