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There’s a hidden reason some individuals who are eligible for the COVID-19 vaccine are turning down their chance even if it increases their odds of survival. Hint: It’s not anti-vaccination attitudes. This specific group of people have typically suffered in fearful silence with a condition that typically begins in childhood or adolescence. Most will overcome the condition as they age; however, statistics still find that 10 out of 100 adults continue to struggle with its embarrassment throughout their lives. What could cause this type of reaction? Hint #2: As more children, teens, and young adults become eligible to receive the COVID-19 vaccine, the answer will appear organically. This post will also discuss the solution to the issue.
What is a specific phobia?
Have you solved the mystery by now? It’s called “specific phobias.” The NIH defines a specific phobia as “an intense, irrational fear of something that poses little or no actual danger. Although adults with phobias may realize that these fears are irrational, even thinking about facing the feared object or situation brings on severe anxiety symptoms.”
Fear of vaccines most likely consists of a phobia surrounding needles or blood, or worse, both. A Blood-Injection-Injury Type phobia is an excessive and unrealistic fear of being in situations that involve blood, injury, or injections. Naturally, as humans, we tend to avoid that which we find frightening and potentially unpleasant or painful. However, the defining attribute of a phobia is distress, interference, and impairment in everyday life. For example, if you have an underlying illness such as diabetes and refuse the vaccine out of fear of seeing blood or the pain of the injection, that could be a sign of a phobia.
Other scenarios that are avoided because of needle or blood phobia:
- Visiting hospitals
- Doctor and dentist appointments
- Media that entails violence or medical procedures
- Medical careers such as nursing or dentistry
- Blood drives/donating blood
- Medical tests
- Surgeries
In extreme circumstances, some may even avoid getting married, starting a new job, and prefer to undergo medical procedures without anesthesia to prevent receiving injections. Surprisingly, one 2019 meta-analysis (an impressive word for a statistical analysis that combines the results of multiple studies) found that avoidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities, and 8% of healthcare workers at hospitals.
Disgust and fear of fainting
In some phobia cases, feelings of extreme disgust when exposed to injuries, blood, or images illustrating these situations maybe even more significant than the emotion of fear. This intense emotional reaction is also an indicator of a potential specific phobia. Unlike most other phobias, fear of fainting or a “vasovagal response” can all co-exist as well. A 1992 study found that more than 67% of people with blood phobias reported fainting history when exposed to blood. Knowing why we faint is just as important as knowing how to prevent it, which will be discussed later. Fainting is caused by a sudden and substantial drop in blood pressure and or heart rate. One theory posits that humans developed fainting as a response to prevent blood loss upon injury. For needle phobics, when presented or exposed to needles, our brain anticipates an impending “injury.” As such, our clever bodies decrease blood pressure to prevent us from experiencing excessive blood loss, which increases our chances of survival. Inconvenient but genius, right?
How to treat it?
First and Foremost, it’s highly recommended that specific phobias be treated with the help of a mental health professional specializing in cognitive behavioral therapy, specifically exposure therapy. Phobias persist for several years or even decades in 10-30% of cases. They are also highly likely to co-occur with other anxiety, mood, and substance use disorders. The University of Pennsylvania offers a list of certified Prolonged Exposure therapists throughout the U.S. here.
Self-help
Some self-help techniques can quell the debilitating anxiety around needles and blood and prevent fainting in the interim.
Prevent fainting
As previously mentioned, fainting is caused by a sudden drop in blood pressure. Naturally, the remedy for a decrease in blood pressure is an increase in blood pressure. How do we do this holistically? You can use progressive muscle relaxation techniques to keep blood pressure up, or a technique called applied tension.
*Disclaimer* Please consult with your physician before practicing these techniques and do not utilize them while operating heavy machinery.
Applied Tension—four-minute watch
Progressive Muscle Relaxation—five-minute watch
Distraction
One of the absolute worst decisions to make during an injection is to watch the injection as you are receiving it. Watching gives us a false sense of control but it also increases and intensifies anxiety and pain. The best option is to bring earbuds, headphones, cellphone, hold an ice pack, and watch a humorous or pleasant video during the injection. The ice will serve to distract your attention from the perceived pain or feared sensation and redirect focus onto the freezing temperature of the ice pack.
Devices
Finally, there are devices available on the market that are specifically created for children, teens, and adults with a Blood-Injection-Injury type phobia. These devices come in a variety of kid-friendly shapes and utilize sensory stimulation in the form of ice and high-speed vibration. The sensory stimulation has the potential to block pain signals traveling up the spinal cord.
You can do hard things,
Dr. K
References
Antony, M. M., Craske, M. G., & Barlow, D. H. (2006). Treatments that work. Mastering your fears and phobias: Workbook (2nd ed.). Oxford University Press.
