Table 4.

Interventions to reduce the pain associated with vaccination

ProceduralFor all children, no aspiration during intramuscular vaccine injections; inject the most painful vaccine last
PhysicalFor children aged ≤ 2 y, breastfeed during vaccine injections. For children aged ≤ 1 mo, encourage skin-to-skin contact
PositioningFor children aged ≤ 3 y, encourage holding during injections, and if holding is not used, encourage patting or rocking after injections. Encourage children > 3 y to sit up during injections
PharmacologicFor children aged ≤ 12 y, consider topical anesthetics before injections. For those aged ≤ 2 y, consider sucrose or glucose solutions before injections
ProcessEducate parents of children of all ages about pain management for vaccine injection before or on the day of vaccination. For children aged ≤ 10 y, parents should be present during vaccine injections
  • Data from Taddio et al.65