Preparing Individuals with Special Needs for a COVID-19 Vaccination

Categories: ASD and DD, Adult-focused; COVID-19 Topics

[This column was published in the West Springfield Republican on April 29, 2021.]

Many people become anxious when they need to get a shot, and individuals with Intellectual Disabilities (ID) and other special needs are no different. Just like neurotypical individuals, some are more willing to get vaccinated and some are more afraid. Because each person with ID is different, preparing for the COVID-19 vaccination should be individualized.

At the May Center for Adult Services in Western Massachusetts, more than 90% of the men and women who live in our residences have been vaccinated. Below are some observations and suggestions gleaned from our experiences that I hope will be helpful to others who care for people with special needs.

First, plan ahead! You may encounter long lines and crowded clinics, and the individual in your care may have adverse side effects after the shot. These possible scenarios can result in challenging behaviors.

Additionally, “pre-teaching” is a way to explain what to expect ahead of time. Keep the explanation appropriate, matching the individual’s cognitive ability; don’t talk about the details of a vaccine that the person may not understand. You might have a conversation that goes something like this: “Chris, in a couple days we’re going to get medicine that will help keep you from getting sick. There might be a lot of people around, and we’ll be there about 20 minutes. You’ll be getting a quick shot in your arm. I’ll be with you the whole time, and on the way back we can stop and do something fun.” Pre-teaching works best if it is repeated a few times before the actual vaccination date.

For the adults in our care, we also used “social stories” to help us pre-teach. These are simple stories accompanied with pictures that explain what to expect. An internet search for “COVID-19 vaccine social story” should result in several different options.

Also, it may help to do a practice visit to the clinic ahead of time if the child or adult has never been to that location. Check to see if you can visit, sit in the waiting and observation areas a few minutes, and say hi to someone working at the clinic. Pharmacies are more likely to allow this than other clinics. After the practice visit, do something the individual enjoys so the experience at the clinic is paired with something fun.

Some people take a mild sedative before medical procedures. If the individual in your care has a script for this, ask the prescriber if it is appropriate for him or her to take this medication before getting the vaccine. 

It may be important to keep as normal a routine as possible on the day of the appointment. Individuals with ID are perceptive and may become anxious if you appear anxious or if their routine is altered significantly. If appropriate, inform a clinic staff member of your situation, and ask him or her to have everything ready before you enter the room for the vaccination. To help keep the individual’s attention on you instead of the shot, you can use conversation, pictures on your phone, or a snack. 

Remember to do something enjoyable after the shot! It doesn’t always have to be food. Stopping at a favorite store, doing a special activity, or repeating what you did after the practice visit are also options.

Be prepared for possible side effects to the shot. If the person is receiving the Pfizer or Moderna vaccine, the first shot often results in a sore arm. (Consult with the individual’s physician before administering a pain killer such as acetaminophen or ibuprofen after the vaccination.) If the individual doesn’t express pain, watch for indications of discomfort. This is especially the case after the second shot, which may result in cold or flu-like symptoms 24-30 hours later. 

For those of us who care for and about individuals with ID and other special needs, helping them obtain a COVID-19 vaccination is another way we can help them live the healthiest and happiest lives possible.

By Glenn Little, MSW, BCBA

About May Institute
May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis and evidence-based interventions, serving autistic individuals and individuals with other developmental disabilities, brain injury, neurobehavioral disorders, and other special needs. Founded nearly 70 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. For more information, call 800.778.7601 or visit