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Is Fear of Needles Keeping Some People from Getting Vaccinated?

Trypanophobia can be debilitating, but it is treatable.

Key points

  • Approximately 10 percent of people in the US — more than 33 million — have trypanophobia, or a fear of needles.
  • Many people who have trypanophobia are told they need to "toughen up," but it is a genuine phobia that needs to be taken seriously.
  • There are both immediate and long-term treatments, such as using numbing cream before an injection and hypnosis.

Caution: If you have a fear of needles, you may experience heightened anxiety from reading this post.

Approximately 10 percent of people in the U.S. have a fear of needles, also known as trypanophobia. That is over 33 million people. That percentage may even be as high as 24 percent (Taddio, et al. 2012). There is a stigma associated with reporting a fear of needles, which may lead to underreporting. If you have trypanophobia, you are not alone.

Approximately 75 percent of people with trypanophobia pass out (also known as vasovagal syncope) when they see a needle, or when a blood draw or injection is attempted (Jenkins, 2014). Heart rate and blood pressure drop due to extreme stress. Fear of or embarrassment about a vasovagal response can prevent a person with trypanophobia from attempting a blood draw or getting an injection again.

A few of my clients have cited a fear of needles as why they have not received the Covid-19 vaccine. They have also expressed that they feel embarrassed to bring this up, as they have been ridiculed in the past about their fear. Many people who have trypanophobia have been told they need to "toughen up" or "stop being a baby" about getting shots or having blood drawn. However, trypanophobia is a genuine phobia and needs to be taken seriously. It has prevented people from being able to access the medical treatment they need.

What Causes Trypanophobia?

While a fear of needles has existed for decades, it was not listed as a diagnosable phobia until the 1994 edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Trypanophobia is listed as a "specific phobia," meaning that it is an excessive and irrational fear. As one client said, "I was asked why I have a fear of needles. I told them I don't know; that's why it's called an irrational fear."

Trypanophobia can be so strong that a person may have an extreme reaction of fear about his child or pet getting vaccinated or having blood drawn. Trypanophobia of a parent can cause a similar fear in children, mainly because children intently watch their parents in order to determine their reaction to a situation (McMurtry, et al., 2015). Approximately 80 percent of people with trypanophobia report that a first-degree relative (parent, sibling, or child) also have a fear of needles, leading to a theory that a fear of needles may develop from observing it in a parent (Du, et al., 2008).

Trypanophobia is in part attributed to anticipatory fear. It's possible that, for some, it's not the needle itself that may trigger the fear, but the knowledge that an injection or blood draw is imminent. Other stages to injections or blood draws can cause vasovagal syncope, such as application of the tourniquet or the smell of an alcohol wipe. Many people with trypanophobia can't tolerate someone touching the inside of their elbow (cubital fossa).

Treatments for Trypanophobia

Immediate treatments of trypanophobia include the application of a prescribed numbing cream to the inside of the elbow approximately 30 minutes before an injection or blood draw. This can at least reduce the "pinch" associated with the needle. Other techniques include having a patient put his hand in ice water during an injection or blood draw to distract the brain. You can also request getting a smaller "butterfly needle" in your hand for a blood draw rather than on the inside of your elbow. Being adequately hydrated can increase the chances that a blood draw can go more smoothly. Notify medical personnel if you are prone to passing out and request that you lay down while getting an injection or blood draw. If a lab refuses to grant this request or you feel you are not being treated in a respectful and compassionate way, walk out and go to another lab.

Long-term treatments of trypanophobia include cognitive-behavioral therapy, systematic desensitization, and clinical hypnosis (Brackenbury, 2020). Discussing the root cause of trypanophobia with a therapist has helped in many cases. Some people had a bad experiences with needles when they were children, either because the staff had limited experience, the person had small veins, or they were intimidated by adults when they became upset about the procedure. Some were coerced or held down during injections or blood draws, compounding their fears.

Trypanophobia needs to be taken as seriously as diabetes, a broken bone, or any other medical condition. It can severely impact quality of life, and the stigma attached to it leads to many people to be reticent to disclose their fear. Luckily, there are both immediate and long-term treatments available.

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Brackenbury, J. (2019). Managing patients with needle phobia in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 160-165.

Du, S., Jaaniste, T., Champion, G. D., & Yap, C. S. (2008). Theories of fear acquisition: the development of needle phobia in children. Pediatric Pain Letter, 10(2).

Jenkins, K. (2014). II. Needle phobia: a psychological perspective. British Journal of Anaesthesia, 113(1), 4-6.

McMurtry, C. M., Riddell, R. P., Taddio, A., Racine, N., Asmundson, G. J., Noel, M., ... & Shah, V. (2015). Far from" just a poke": Common painful needle procedures and the development of needle fear. The Clinical Journal of Pain (31): S3-S11.

Taddio, A., Ipp, M., Thivakaran, S., Jamal, A., Parikh, C., Smart, S., Sovran, J., Stephens, D., & Katz, J. (2012). Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine, 30(32), 4807–4812.