Children need immunizations to prevent them from getting sick. Like adults, children deserve honest answers about their healthcare. Consider teaching your child — before their appointment — about why immunizations are important. This information can be difficult for a child to understand, but hearing it ahead of time, in a “safe” place, from someone they trust, is helpful. Here are some suggestions for helping prepare your child for their immunizations. This language can be adapted for any medical procedure.

Before your child’s vaccine

• If possible, try to schedule your appointment for a time that is best for your child. Some children will have a better experience first thing in the morning while others are more relaxed at the end of the day.
• If you have any information for the staff that would help make your child’s experience a more positive one, please call the office ahead of time and ask to speak with a nurse.
• Prepare your child for what will happen during their appointment. Typically, the older your child is, the farther in advance they should be prepared.
  • For example, a toddler should only be prepared one to two days in advance, where an 11-year-old may need up to a week to be prepared.
• Explain to your child that they will be getting a vaccine at their next doctor’s appointment, and that a vaccine is a fluid which goes into the body to keep their body as healthy as possible.
• Explain that getting vaccines sometimes feels like a poke or a pinch in the upper arm or thigh and that their job is to hold very still so they stay safe. Reassure them that the pinch will go away very quickly. It’s a typical reaction for children to cry or become mad or upset upon hearing this information. It is still important for most children to be prepared for this experience. Focus on things they have a choice in.
  • Try saying, “It’s OK to feel upset about this. Together, let’s figure out a way we can make it as easy as possible.”
• Think about pain management options for your child. Talk with your healthcare provider about your options.
• Ask what would help them hold still and have them bring that to the visit. Some children like to bring a special toy or blanket, electronic devices or anything that typically helps to calm them. This may help them feel more in control.
• Some children respond well to incentives such as stickers, healthy treats, or a special activity with their caregiver. It’s best to set this up ahead of time. If done in the moment, this becomes a bribe which is not as effective.
  • Example: “If you try your hardest to hold still and follow directions during your doctor’s visit, we will go to the park afterward.”
• Let them know you will be with them the whole time (give teens a choice) and it’s OK to not like getting vaccines, but their job is to hold very still.

During your child’s vaccine

• While you may be nervous about the immunizations, your child will take their cues from you. If you are relaxed and calm, it will help them feel the same way.
• If your child is highly anxious about their immunizations, ask your nurse or doctor if they can administer the vaccines at the beginning of the visit instead of waiting until the end. This may help your child better engage in their visit if they know that part is over.
• Get into a comfortable position with your child during their vaccine (see comfort positioning).
• While some children like to look away during immunizations, many will choose to watch. Either is appropriate and will depend on how the child copes. If your child prefers to watch, allow them to do so. This will build trust and increase their sense of control over the situation.
• Incorporate distraction for your child, such as singing a song, counting, playing “I spy” or holding a special toy.
• Distraction should never be used to trick your child. The purpose is to help them focus on a pleasant thing or sensation rather than uncomfortable or scary ones (see distraction tips).
• The fewer people in the room, the better. Sometimes an extra person may come in to help your child’s arm or leg remain as still as possible.
• It usually helps to have only one person talking to your child at a time so they do not get confused and overwhelmed.
• If your child becomes highly agitated or unsafe towards themself or others, we may ask that you reschedule your visit for another day. We can discuss some strategies and plan interventions that help other kids who become anxious in this setting.
• Some children think that they are getting an immunization because they were “bad.” Please help us to assure your child that immunizations are not a punishment.

After your child’s vaccine

• Praise your child for specific behaviors, such as holding still, taking big breaths or being brave. 
• Provide empathy for your child but focus more on the positives or what can be done next time to make it better. 
• Remember to never apologize for giving an immunization, but instead let them know how proud you are of them and reinforce the reason for the vaccine — to keep them healthy.
• Please refrain from referring to anyone on the medical team as “the bad guy” or that immunizations are bad. Instead, teach your child that we are all helping them to be healthy. This will help your child learn to build a trusting relationship with their healthcare team.