Dealing with needle phobia and why our stomachs are the reason why we have injectable vaccines

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  • The fear of needles is an anxiety disorder
  • It is a phobia that can be treated with counselling
  • Enzymes in the stomach make oral vaccines difficult to absorb

Needle phobia is when one feels anxious about a needle being inserted into your body, whether to administer medication, vaccines or draw blood. It is an anxiety disorder that can lead some people to faint or send their blood pressure skyrocketing, according to a Health24 article.

As South Africa and other countries are inoculating their citizens with Covid-19 vaccines, many people are having to face their fear of needles to get protection against SARS-CoV-2. Health24 spoke to two experts about helping people cope with their needle phobia and why most vaccines are administered through injections.

How needle phobia is handled 

Dr Anthonet Koen was the principal investigator of, among others, the Oxford and Novavax trials in Soweto. She says that during the trial, patients who fear needles were prepared and counselled so that they could understand that the benefits of the process.

In most cases, this succeeded in outweighing their fear. She says that there are three crucial factors that help patients with needle phobia: Education, building trust and training.

"Educating the participant is about preparing them for what to expect because if you know what to expect, you won't be so scared and be prepared to take what's coming more readily than surprised by it," she says.

Koen adds that building trust between clinician and patient is essential as it makes the process easier, especially in a trial where people not only get vaccinated, but also have blood drawn.

"Be honest with them on what to expect during the process. Go into as much detail as possible and then address all their concerns. Don't just look at them as a number, but spend time with them to address their specific concerns and fears. This is quite often all they need," she explains. 

She also says that having well-trained, experienced staff makes the process smoother as they know how to be gentle with patients and make the experience less traumatic.

In addition, the Covid-19 vaccine programme has made healthcare workers more able to relate to ordinary people as they themselves have had the vaccine. They can talk to patients about their own experiences with the vaccines, which helps to remove fear.

Why vaccines are mostly injected

Like most vaccines, the current Covid-19 vaccines are in an injectable form. Although there are trials to test an oral or pill form of the Covid-19 vaccines, oral vaccines are rare, says Professor Patrick Arbuthnot, director of Wits Univerisity's Antiviral Gene Therapy Research Unit.

Arbuthnot explains that oral vaccines are challenging to produce because of the way they behave in the digestive system.

"When vaccines go into the stomach, they encounter the digestive enzymes in the very acid environment of the stomach, which will degrade them. The vaccines, therefore, wouldn't survive the interaction with the enzymes and digestive acid, which would render them useless. So to bypass that harsh environment for a vaccine, the injection route is the way to go," he says.

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