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Coronavirus FAQ: I'm Afraid Of Needles. Does The COVID-19 Vaccine Hurt?

Malaka Gharib/ NPR

Each week, we answer "frequently asked questions" about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions."

I hate shots. Tell me the truth: How much is this vaccination going to hurt?

The honest, and short, answer appears to be: Not much! That's according to people who have already been jabbed including Vice President Kamala Harris, who said she "barely felt it," Dr. Anthony Fauci, who didn't flinch when he got his inoculation on live TV, and my needle-averse son, who is in Moderna's adolescent trial and says the poke hurt way less than any other he's gotten.

"From my own experience, I didn't even feel the needle go in," says Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine.

Experts say the coronavirus vaccine should feel about the same as any other intramuscular vaccine shot when the needle pierces your skin en route to your deltoid, a muscle that has been deemed an easy target. But there's some evidence to back up the anecdotal accounts that the Pfizer and Moderna vaccines hurt less: There is a range in the CDC's guidelines for needle size, and vaccine administrators may be opting for the smallest length and diameter within those limits in order not to waste any amount that clings to the needle, says Dr. Abinash Virk, co-chair of the COVID vaccination allocation and distribution for the Mayo Clinic in Rochester, Minn.

Previous research has shown that smaller needles are more tolerable, Weatherhead says. And in case you're a numbers nerd, the diameter range, which likely matter more than length in terms of potential pain, is 25-28 gauge— skinnier than a pencil point.

"I've heard people say, I didn't feel it!'" Virk says. "But it is a needle piercing through your skin, inserting a little bit of liquid into a spot that normally doesn't have [liquid], so your body has to adjust: 'What do I do with this .3 ml ?' So it just causes a little bit of pain."

Of course, people's perceptions of pain vary widely.

"There's so much individual variation," Virk points out. "I've seen kids who don't blink and others who bring the house down. Interestingly, I ran the trial clinic at Mayo Clinic for 17 years, and it was usually the young, very fit guys who were not doing well. For the most muscular, tough guys, here comes the needle and you hold on to them to make sure they don't fall off the table."

So what can the needle-phobic among us do to ease the experience? We asked Drs. Virks and Weatherhead for tips:

Look away

If you're not a fan of needles, don't watch, Weatherhead says. "Many do not like the look or feel of needles, so look away to quell fears and anxiety related to needles."

Of course, it's fine to keep your eye on things if you tolerate shots well. "My 5-year-old loves to watch," Weatherhead says. "It's all personal. Whatever makes you feel more comfortable and confident to get this done, do it."

Don't take a pain reliever beforehand (but afterward is fine if needed)

Some research on other vaccines suggests there could be "a slight blunting of the immune response" in kids who took Tylenol before their shots, Dr. Virk says. Even though a different study of older adults did not back that up, most experts are erring on the safe side and recommending not to take any pain relievers beforehand.

"You don't want to be taking medicine you don't need," Weatherhead says. "If you develop symptoms afterward, then at that point it's certainly OK to take some sort of pain relief to help control symptoms."

Be honest with jittery offspring

If it's your child who is nervous, the best strategy is honesty, Weatherhead says.

"Be honest with kids upfront that you're going to get a vaccine that's a shot in your arm, that it may hurt initially, but it's helping your body get stronger to protect you from illnesses," she says. "Give children honest answers. When they're empowered around their own health, it's really helpful."

Chill (metaphorically)

In terms of potential pain, you don't need to worry too much about whether your arm is tensed or relaxed, Weatherhead says, but "just being relaxed in general is helpful," she says. If you relax your arm by your side, you're less likely to flinch it or move it during the jab. That means the vaccinator can get the needle in and out in a flash.

Trust in nurses

Doctors are the first to admit that experienced nurses are expert at delivering painless jabs.

"Nurses are definitely the most talented and very valued, especially in the pediatrician world," Weatherhead says. "It does take some practice to be fluid and quick. There's a little hand coordination and muscle memory. The faster and smoother you can do it, the less discomfort and more tolerable it will be to the patient."

This isn't to say that there is no pain associated with the COVID-19 vaccine, doctors stress. Most side effects, including arm pain, begin hours after the poke – that's when the actual immune response begins. To prevent as much interference with daily activities as possible, there are a few things you can do:

Offer your non-dominant arm

The vaccine instructs your cells to mimic the spike proteins of the SARS-CoV-2 virus to provoke an immune response. That will occur with equal efficiency in your left or right arm. But arm pain will likely be less annoying in your left arm if you're right-handed and vice versa, says Weatherhead.

Most people will have some arm pain after getting the shot, Weatherhead stresses, and it's really up to you which arm you'd rather experience it in.

Chill (literally)

If you rely on ice to ease other types of pain, you can certainly try it for a shot. There isn't any data on it, Weatherhead says, but if it makes you feel better, go for it.

In conclusion...

If COVID-19 vaccines become an annual event, you can take some comfort knowing that there are oral vaccines in development. (No nasal sprays thus far.) There's no guarantee they'll come to fruition, however, and doctors remind us that any pain associated with the vaccine is a fraction of what many people experience with COVID-19.

Of course, many people have never been so excited for a vaccine, and that may outweigh any fear of being poked. Few people are complaining about sore arms in the vaccination clinics Dr. Virk has seen. The word nurses used to describe the scene, she says? Joy.

Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She's written about COVID-19 for Medscape, Mpls.St.Paul Magazine, Science News for Students and TheWashington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Corrected: February 5, 2021 at 9:00 PM PST
An earlier version of this story incorrectly stated that the diameter range of the needles used for vaccination is 25-28 mm. The measurement is 25-28 gauge.
Sheila Mulrooney Eldred