In 2012, the University of Toronto in Canada conducted a survey of 1,204 children and 883 parents and found that the fear of needles was a factor in discouraging some from getting vaccinated. Sixty-three percent of the children surveyed reported they were fearful of needles, while 24 percent of the parents expressed fear of them. According to the survey, seven and eight percent of parents and children respectively said they were reluctant to get vaccinated due to this fear.1
This study was referenced recently in an article by Meryl Davids Landau in Consumer Reports titled “How to Reduce the Pain of Vaccines.” The article provides seven “tips” that might help alleviate peoples’ angst over getting jabbed and, thereby, encourage them to get vaccinated. The tips include (1) having parents model calmness for the children; (2) distract them or (3) hold them close. That’s three. A fourth tip is “soothe younger ones with sweetness.”2
Older babies or toddlers who are no longer breastfeeding may benefit by having something sweet drizzled on their tongue. (Dilute a packet of sugar in a few teaspoons of water and drip a little on just before the shot is administered, Taddio advises.)2
These days, babies and young children often get eight or more vaccines at the same time in different combination shots.3 So a fifth tip is to ask the person administering multiple shots to give them in the order of least painful to most painful.
Sixth, parents are advised to consider giving over-the-counter pain relief drugs such as acetaminophen or ibuprofen.4 5 (Please read the following article before contemplating the pain relief tip: “Doctors Prescribe Acetaminophen for Fever After Vaccination. Really?”)6
In the same vein as the aforementioned tip, Davids Landau suggests asking your doctor about “numbing cream”—creams that contain the anesthetics lidocaine (Xylocaine®) and prilocaine (Citanest®).7 8 Such medications can supposedly”cut vaccine pain in half.”
The creams take anywhere from 20 to 60 minutes to become fully effective, depending on the brand. Taddio suggests bringing cream to the doctor’s office and asking the nurse when you first arrive to show you where the shot will be given, so you’ll be sure to numb the right area in advance.2
Apparently, it is not uncommon for doctors to recommend numbing creams before vaccinating children. Kirstin (Lee) Campbell, MD of St. Louis Children’s Hospital in St. Louis, MO starts if with numbing cream on her list of suggestions to “minimize your child’s experience of pain with needles.”9
Application of a numbing cream to the skin prior to insertion of the needle for a vaccine or a blood draw will decrease the pain your child experiences. It will not take it away completely, but will decrease it significantly, to the point they may not care.9
Pediatrician Wendy Sue Swanson, MD of Seattle Children’s Hospital in Seattle, WA offers:
Another idea for pain relief during shots includes using prescriptions for numbing medications like Emla cream or vapocollent spray that can be applied to the skin prior to a shot. Research and some children feel this can be very helpful!10
Two numbing creams specifically mentioned by Davids Landau are Emla and Relador.3 Each gram of numbing creams such as these contains 25 milligrams of lidocaine and 25 milligrams of priolocaine, polyoxyethylene fatty acid esters, carboxypolymethylene, sodium hydroxide, and purified water. The polyoxyethylene fatty acid esters are used as emulsifiers and the carboxypolymethylene as a thickening agent. The sodium hydroxide is used to adjust to a pH acid/alkaline balance of 9.8
What Davids Landau, Dr. Campbell, and Dr. Swanson failed to provide were the side effects associated with these creams containing chemicals that are absorbed through the skin into the blood. Here are a few of them: “severe burning, stinging, or sensitivity where the medicine is applied; swelling or redness; sudden dizziness or sleepiness after medicine is applied; bruising or purple appearance of the skin; unusual sensations of temperature.”11
Numbing creams that contain lidocaine and prilocaine can also lead to irregular heartbeat, difficulty breathing, seizures, and coma and death.11 12 On Feb. 6, 2007, the U.S. Food and Drug Administration (FDA), issued a Public Health Advisory “alerting consumers that the skin creams can cause life-threatening side effects, including irregular heartbeats, seizures and even death.”13 14 15
So it is clear that lidocaine and prilocaine can be toxic and harmful to humans and, just like there is increased individual susceptibility to vaccine reactions, some children may be more susceptible to reacting to the chemicals in numbing creams. What is unclear are the synergistic toxicity effects of any single ingredient or combination of ingredients in lidocaine and prilocaine creams and any single ingredient or combination of ingredients in the vaccines that are given following application of the numbing creams. It is known, for example, that administering certain amounts of lidocaine and cocaine together can have a unusually severe toxic effect, resulting in seizures.16 At Drugs.com, there is a list of medications and disease conditions that may increase topical lidocaine risks.17
Where are the studies that demonstrate the safety of administering lidocaine and prilocaine and then injecting numerous vaccines with dozens of different neurotoxic ingredients—any one of which might enhance the toxicity of these topical anesthetics?
1 Taddio A, Ipp M, Thivakaran S, Jamal A, Parikh C, Smart S, Sovran J, Stephens D, Katz J. Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine July 6, 2012 6;30(32):4807-12.
2 Davids Landau M. How to Reduce the Pain of Vaccines. Consumer Reports Dec. 10, 2017.
3 Centers for Disease Control and Prevention. Immunization Schedules for Infants and Children. CDC.gov 2017.
4 National Library of Medicine. Acetaminophen. NIDDK Oct. 16, 2017.
5 National Library of Medicine. Ibuprofen. NIDDK Oct. 16, 2017.
6 Cáceres M. Doctors Prescribe Acetaminophen for Fever After Vaccination. Really? The Vaccine Reaction Sept. 15, 2017.
7 Xylocaine®. RxList.
8 Lidocaine and Prilocaine Description. Drugs.com.
9 Campbell KE. Taking the OUCH! out of vaccines. ChildrensMD.org.
10 Swanson WS. 6 Tips For Successful Shot Visits. Seattle Children’s Hospital Nov. 5, 2010.
11 Medications and Drugs. eMedicineHealth.
12 Meininger K. Dangers of Lidocaine Cream. Livestrong.com Oct. 3, 2017.
13 Huffman M. FDA Warns of Skin Numbing Product Dangers. Consumer Affairs Jan. 20, 2009.
14 Reuters Staff. Overuse of skin numbing creams can cause death: FDA. Reuters Feb. 6, 2007.
15 Skin Numbing Creams May Cause Death. NBC 4 Oct. 13, 2008.
16 Barat SA, Abdel-Rahman MS. Cocaine and lidocaine in combination are synergistic convulsants. Brain Res Dec. 2, 1996;742(1-2):157-62.
17 Lidocaine topical drug interactions. Drugs.com December 2017.