Let’s face it, just like people try to avoid getting stung by wasps, they also avoid getting shots. A large-scale study by the University of Oxford found that 26% of adults screened positive for injection phobia, with those in this group twice as likely to report hesitancy to get the Covid-19 vaccine. If all needle anxiety was eradicated, it’s possible that vaccination rates could increase by up to 16 percent. With Covid-19 vaccination rates worldwide stalling, this is a critical area to address to reach herd immunity and prevent further surges, reduce the spread of variants, and get on with our lives.

Skepticism, distrust, and politicization of the vaccine exist, certainly. But what is likely underreported is the wide prevalence of needle phobia and medical anxiety underlying vaccine hesitancy. It’s much less vulnerable to say, “I’m healthy, I don’t need a vaccine,” than “Truth is, I’m terrified of needles.”

Here’s the good news: unlike political distrust, needle phobia is treatable. The issue is not that we can’t treat it, it’s that there are so many barriers to treatment: affordability, stigma, lack of access, and lack of awareness (in both the medical field and public). Cognitive Behavioral Therapy (specifically, exposure therapy with applied tension) has been shown to be effective for the treatment of needle phobia. For example, in a 2018 study among highly needle fearful individuals, 70% completed a successful blood draw after just one group CBT session. Exposure-based CBT is a method of empowering you to confront your fears safely and gradually, always with you in control.

Importantly, needle anxiety is not just on the individual to figure out. We must figure out how to deliver healthcare in more equitable and empathic ways that take into account different people’s needs. We also must acknowledge our country’s history of medical mistreatment and apathy, which has disproportionately affected people of color and contributes to medical anxiety. While CBT is in no way a solution to these systemic root causes, it provides a practical, targeted treatment to empower access to healthcare for the millions with needle anxiety. The Covid-19 vaccine nasal spray, which is being developed for those with needle anxiety, will be available around 2023, but we don’t have the time to wait.

For millions of Americans, vaccinations are not “just a poke.” Don’t judge people who aren’t yet vaccinated; let’s work together to deliver inclusive care for all.

To the Public, here’s your call to action:

We need to bang some pots and pans to raise awareness about needle anxiety. An estimated 10-25% of adults have needle phobia, and these numbers are even higher in children and adolescents. Start talking about needle anxiety with others. Know that in as little as a few hours, you can get the tools you need to confront healthcare goals such as vaccination. Be a support person for someone with needle phobia by holding their hand and walking them through our top strategies for managing needle phobia. With up to 1 in 4 people suffering from needle phobia, someone you know is having a hard time getting vaccinated because of it. Let’s normalize it, team up, and get on with our lives. 

Over the course of a lifespan, needle phobia can lead to chronic avoidance of essential medical care and poor health outcomes. Because people with needle anxiety often avoid medical care, healthcare systems tend to ignore this sizable group of the population, and the cycle continues. Nearly all Covid-19 deaths in the U.S. are now among the unvaccinated. People with needle anxiety deserve access to life-saving healthcare just as much as everyone else.

Don’t like needles?

If your needle anxiety is relatively mild (and/or motivation very high), these self-help strategies may be sufficient to get you vaccinated. You can also explore our other resources here, including our nationwide referral list for blood-injection-injury phobia specialists.

A personal story: As a mom and a psychologist, I’ve seen how powerful needle anxiety can be. I have such a vivid image of my daughter, typically so fierce and confident, reacting with terror at the sight of a nurse with needle in hand. Acting on instinct, she leapt off the examination table, ran to the corner of the pediatrician’s office, and wedged herself into the corner of the room so the nurse could not access the part of her arm just cleaned with rubbing alcohol. My little girl suddenly had the strength of a rhinoceros as she rammed her body against the wall in defiance. By coming up with comfort strategies and walking her through basic CBT steps (in a nutshell, gradually exposing her to the different components involved in vaccination: the needle, the smell of rubbing alcohol, etc. in a way in which she felt in control and understood), she now handles her routine vaccinations like a champ.