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Experts say the causes of trypanophobia aren’t known. JEAN-PHILIPPE KSIAZEK/AFP via Getty Images
  • Experts say a fear of needles may keep some people from getting a COVID-19 vaccination.
  • They say the causes of this fear, known as trypanophobia, aren’t known, but past experiences and brain chemistry may be factors.
  • Experts say there are therapies and medications that can help.

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The vaccines now available for COVID-19 have been shown to be highly effective and safe.

But that doesn’t mean everyone is excited to get the shot.

For some people, reluctance to get vaccinated is rooted in distrust of science or the government.

For others, however, there’s something far more primal at work: fear of needles.

Known as trypanophobia, the fear of needles is a common phobia.

A 2018 University of Michigan study published in the Journal of Advanced Nursing found that a majority of children, as well as 20 to 50 percent of adolescents and 20 to 30 percent of young adults, exhibited fear of needles.

“The fear of needles and injections tends to manifest differently among different age groups,” Sarah Johnson, RN, the health and wellness ambassador for online elder care provider Family Assets, told Healthline. “For children, the fear is an understandable response to the anticipation of pain and the foreign sensation of something metallic and sharp against the skin.”

“In adults, the fear is similar, but some evolutionary psychologists believe that a fear of needles may be, in part, a survival response rooted in a primal and very natural fear of puncture wounds, dating back to human prehistory when any small wound could have spelled infection and potentially death,” she added.

The University of Michigan researchers found that avoiding flu shots due to needle fear or phobias was cited by 16 percent of adult patients, 27 percent of hospital employees, 18 percent of workers at long-term care facilities, and 8 percent of healthcare workers at hospitals.

“While the whole world celebrates the discovery and distribution of COVID-19 vaccines, people with trypanophobia are left to face yet another challenge as they dwell on how they’ll wake up from this pandemic nightmare while carrying a common fear of needles,” Sam Nabil, CEO and lead therapist for Naya Clinics, a national chain of counseling centers, told Healthline.

The precise causes of trypanophobia are unknown.

One suspected culprit is past traumatic experiences, which could include a bad episode with needles at a young age.

Genetics, changes in brain chemistry, low pain tolerance, or other cognitive or temperamental factors could also be at play.

Dr. Dawn Richardson, an emergency room physician in New Hampshire, has vast experience both giving and taking shots. Yet she struggles with a lifelong fear of needles that had no apparent trigger.

“I have no idea [why], but it has always been there,” she told Healthline.

Trypanophobia symptoms can include dizziness, fainting, anxiety, insomnia, panic attacks, high blood pressure, elevated heart rate, or feeling emotionally or physically violent.

Avoiding or running away from medical care is common.

“I did have a patient last week who left after refusing blood tests,” Richardson recalled. “He really could not do it and it was a barrier to our figuring out what was wrong with him.”

“For me it’s a physiological response, vasovagal syndrome, in which my blood pressure drops abruptly after a shot,” she added. “I have low blood pressure to begin with, so that temporary drop right after is enough to make me pass out.”

“I can say that passing out is a real deterrent for me. I can’t stand it and avoid it,” she said.

Counseling can help people with trypanophobia overcome their fear of needles, experts say.

Cognitive behavioral therapy (CBT) sessions may explore the roots of needle fear and offer coping skills.

Exposure therapy is similar but involves a stepped-up process of exposing people to needles in order to overcome their fear.

Doctors can prescribe medication to manage anxiety when people are scheduled for a blood test or vaccination.

Health professionals can also play a role in reducing trypanophobia.

“People with trypanophobia can get their fears under control if they have someone they know in the room to encourage and support them through the experience,” Nabil said. “Desensitizing patients by gradually exposing the needle phobia patient in the doctor’s office is also an excellent opportunity to lessen and address fears.”

Health professionals can reduce a person’s anxiety by providing a comfortable space or seat, blanket, or music while administering the vaccine, Nabil added. They can also create a signal system to give people a sense of control during the procedure.

“Explaining the steps and giving patients a distraction throughout the process can also help ease their tension,” he said.

Richardson, who described her fear of needles as moderate, has developed her own coping methods for what is, for her, an occupational necessity.

“I get my fair share of shots, but I know I have to inform the person giving it of my tendency to pass out, so I get to lie down and stay down for a few minutes to prevent that,” she said.

The role of trypanophobia in vaccine acceptance is often overlooked, Nabil said, “posing great dangers to many people as the condition’s impact ultimately results in avoidance in getting adequate medical care when most needed.”

A Kaiser Family Foundation survey published in December, for example, found that 27 percent of U.S. adults said they probably or definitely would not get vaccinated against COVID-19.

The “vaccine hesitant” participants cited reasons such as fear of side effects (59 percent), lack of trust in the government to ensure the vaccines’ safety and effectiveness (55 percent), concerns that the vaccine is too new (53 percent), and concerns over the role of politics in the development process (51 percent).

Respondents weren’t asked about needle fear, however.

Despite the urgency attached to COVID-19 vaccinations, fear of needles is likely to remain a significant barrier for some people.

“I’ve already gotten the COVID-19 shot because I’m so high risk at work,” Richardson said. “I was more eager to get the COVID shot than I am to get a flu shot because of the higher mortality. I really don’t have the expectation of dying from the flu.”

Richardson added that she also gets a flu shot each year, motivated by a desire to protect her family and not miss work or lose income.

However, Nabil said, “Phobias, especially if accommodated for a long period of time, do not just magically go away when you want them to. People with trypanophobia will likely still feel the usual anxieties and other effects of the condition as they would if they were getting their regular flu shots.”

“It’s an internal emotional and mental struggle that’s involuntary. Having stronger motivations to be injected will help with their drive to face their fears, but it will have very little impact on their responses during the whole phobic experience,” he said.