Preparing Students with Special Needs for Vaccinations

By Justine Butler, B.S.N, R.N., NCSN

[This column was published in The Stoughton Journal on December 7, 2021, in The West Springfield Republican on December 16, 2021, and in more than 200 papers across the country.]

“No shots!” is something I occasionally hear from my students when they find out they need to see the doctor. The prospect of getting a shot or vaccine can be intimidating for anyone, including children with autism and other special needs. With the COVID-19 vaccine becoming more accessible to wider populations, more and more children and their caregivers might be facing the “vaccination challenge” in the coming months. 

There are many great techniques families can use to help make vaccination appointments successful. Let’s break these techniques down into the three C’s – check, collaborate, and commit. 

Check:
Check in with yourself as the parent or guardian—are you anxious, nervous, or fearful? Children are very adept at recognizing emotional shifts and may feed off the energy you emit. Try to remain calm during the appointment. This can help your child remain calm as well.

Check in with your child’s provider and see if they recommend pre-medicating with an over-the-counter pain reliever or using a topical numbing cream/spray. Your child’s provider might have other suggestions to help minimize pain or discomfort. 

One great non-pharmacological suggestion is using a Buzzy. This is a small hand-held device that creates a cooling vibration, or buzzing, when placed on the skin. The buzzing confuses the nerves to prevent the pain of a sharp needle stick. It works the same way as rubbing a bumped elbow or putting cool water on a burn. The device is placed near the injection site from slightly before to right after the shot is administered. 

Collaborate and Plan: 
Before the appointment, call the office and see if your child’s provider can help you create a schedule of tasks or list of steps that will occur during the appointment. Try to include times for breaks and opportunities for reinforcement for your child. If needed, use visuals to review with your child so s/he can know what to expect. Collaborate with the provider and share what is challenging for your child. Ask what accommodations they can provide. Accommodations may include beginning or end-of-day appointments, extra support staff, or practice visits. 

Be honest with your child and explain to them what will be happening. For some children, it might be appropriate to prepare a couple days in advance; for others it might be the day of. You may find it helpful to use visual supports such videos or social stories that depict children having a positive experience with receiving a shot. 

Bring your child’s favorite toys, snacks, or items to the appointment. These small distractions can help make a scary and difficult experience easier and more pleasurable. 

Commit:
Commit to your plan and goal of helping your child have a successful vaccination experience. During the appointment, try to remain calm and reassuring. Talk your child through each step and task of the appointment. Utilize visuals and a schedule if necessary. Remember that it is okay to ask the provider to take breaks and to go slowly. Allow your child to move and find a comfortable position to receive the vaccination. Some children may want to stand, be held, sit, or lie down for the vaccination. 

If appropriate, encourage your child to take some deep breaths, or shake the sillies out. I love having my students shake the “sillies” or nerves out when they are nervous. I have them do this by making a game out of shaking each arm, hand, and leg in a silly way before sitting down and committing to the task at hand. 

Lastly, reward your child after the appointment. Some children may need frequent reinforcement during the appointment. For example, you might want to give your child a small treat or sticker after each stage of the experience. 

Remember to talk with your child’s healthcare provider regarding any comments, questions, or concerns you may have regarding vaccinations. If you have concerns regarding your child being able to participate in medical appointments, reach out to his/her educational and behavioral team members. These clinicians may have other strategies or ideas to help target these concerns. 

Justine Butler is a Registered Nurse at the May Center School for Autism and Developmental Disabilities in West Springfield. She can be contacted at jbutler1@mayinstitute.org.

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. May Institute operates five schools for children and adolescents with autism spectrum disorder (ASD) and other developmental disabilities. For more information, call 800.778.7601 or visit www.mayinstitute.org.