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Last Updated: Thursday, 31 January 2008, 12:18 GMT
How do needlephobics get vaccinated?
The Magazine answers...

A fear of needles can develop into one of hospitals and white coats
A team of researchers is developing a painless method of delivering the flu vaccine, which will help needlephobics. So how do people fearful of needles get vaccinated?

Nobody enjoys injections but they are an important part of staying fit and healthy, especially for children and the elderly.

Yet those scared of needles can find their phobia deters them getting vaccinated and from getting the protection they need.

Needlephobia, or belonephobia to give the condition its proper name, affects around 10% of the UK's population to some degree, often triggered by a childhood experience.

Coping strategies help them overcome their fear
Mucosal vaccinations are given through the mouth or nose
Diabetics can use an SQ-pen that pierces the skin without a needle
For some it means that once-in-a-lifetime exotic holidays or even having children is out of their reach.

So how do needlephobics get vaccinations?

Many just have to face their fear. And making sure the patient knows what they're being injected with and why is a way of calming them down.

"We try to persuade the patient of the need to be vaccinated," says Dr Graham Archard, a GP from Christchurch in Dorset.

"It may sound unkind, but you have to be fairly unsympathetic, cooing over them makes it even worse."

Cuddly toy

Local anaesthetics can help soften the prick of the needle, in the form of cream rubbed on to the skin.

Commonly caused by bad childhood experience
Or a friend telling a story about an experience
The fear can develop into one of blood, white coats and antiseptic
And a "coping strategy" can involve a child's favourite cuddly teddy or just having a chat. One particular study found that talking about the weather takes the patient's mind far enough away from the needle to ease the fear while the needle pierces the skin.

If these methods do little to ease the terror of the needle, then help is on its way.

Alternative vaccinations - without a needle - are being researched and slowly becoming available, such as inhalers or mucosal forms administered through the mouth or nose.

One in the pipeline is administered under the tongue, by so-called sublingual means. It has only been tested as a flu vaccine on mice but appeared to successfully protect the rodents from the virus.

If you have type 1 diabetes and you don't have insulin, after a few days this will seriously damage your health and eventually you will die
Libby Dowling
Diabetes UK

This could completely eliminate the need for an injection and raises the possibility of mass immunisation because it does not require a specialist.

It also avoids the potentially destructive stomach enzymes by passing through thin membranes under the tongue, directly into the bloodstream.

In the meantime, there is some comfort to needlephobics that they may grow out of it.

But for people with diabetes, who may need injections up to four times a day, avoiding the problem is not an option - it can simply be fatal.

A regular part of the BBC News Magazine, Who, What, Why? aims to answer some of the questions behind the headlines
Libby Dowling, a care advisor with Diabetes UK says: "If you have type 1 diabetes and you don't have insulin, after a few days this will seriously damage your health and eventually you will die.

"So if you have a needlephobia on top of that, it's very challenging to get around.

"In the short term, you'd have to work with the person with diabetes, to get a compromise to give them insulin."

Up until last year, there was an alternative for diabetics called exubera, an insulin inhaler used by 600 people until its withdrawal due to poor sales.

But there is still the SQ-pen, a small device that fires a high-pressure dose of insulin which penetrates the skin. This removes the need for a needle aspect, but can still be quite painful when used several times a day.

Add your comments on this story, using the form below.

My dad has a real fear of needles, and when I was diagnosed as having diabetes at five years old, we were sent home, and he had to deal with it, because if he didn't give me my injections, I would have died. It's one thing injecting yourself, but quite another injecting your own child! We coped quite well with him regularly saying 'this won't hurt... much!' as he did my injections. We made it all into a big joke which really helped both of us.
Philippa, London

I was belonephobic for years after a robust nurse threw me on my front and injected me when I was 5. It's only since training as a hypnotherapist have I overcome that phobia, along with a few other phobias, so it can be done. I was always the difficult patient with getting blood from my arm, but with self hypnosis I am able to imagine my arm as a lump of ice and get so chilled out the nurses have no problem at all. I now treat people with similar problems.
Penny Ling, Nailsea Somerset

As a needlephobic I can safely say that it is probably better that we don't pander to the phobia. It is very debilitating having this anxiety and I think therapy over alternative ways is more useful. After all, blood tests need needles!
Emma , Durham

When I was a small child, I just sat on my mother's lap without screaming the GP pratice down when I had my injections. Now, I am more squeamish. What changed it for me was when we were having our TB jabs done at school. Remember a girl fainting whilst having a long trail of blood down her arm. I have a fear of blood (even fake blood). I would rather have the jab than suffer the illnesses.
Helen, Leicester

WAAAAH!!! I HATE needles! I can't get them, be near them, or even watch somebody else get one! If I was diabetic I think I'd choose death!
Daniel, Ireland

Needles make me turn a whiter shade of green and perspire in a fire hyrant-like manner (especially above my top lip and forehead!). Having said that I recently had my first baby and spent nine months like a pin cushion having blood taken here and there and epidurals et al. I was quite proud of myself that I didn't pass out once (it was all for the good of my baby - born healthily. I even managed to take her for her 12-week injections and hold her while it was done... and I only nearly passed out. You've got to have a sense of humour about these things!
Helen O'Neill, Falkirk, Scotland

As a type 1 diabetic, once you've been injecting for a while you just don't feel it most of the time - I guess my nerve endings are used to it by now!
Ian, Herts

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