The Covid-19 vaccine is likely to be authorized for children 5 to 11 years old within days, which means parents who have been eagerly awaiting the chance to vaccinate their kids will soon get the opportunity.
But those kids may not be as excited about the shots as their parents.
A fear of needles, or trypanophobia, is common in children - a majority have it, one statistical analysis found.
If the phobia is so acute that going to the doctor is traumatizing, parents can consider therapy for their children. But in most cases, they can take measures on their own to make even the most needle-nervous child more comfortable. Here's what psychologists and pediatricians recommend:
Step 1: Prepare your child.
Before taking your child to receive their Covid vaccination, gently inform them that they will be getting a shot, said Mary Alvord, a psychologist who specializes in anxiety and self-regulation techniques for children and teenagers.
While this might seem like it would produce more anxiety, it ultimately helps build trust, she said.
"You need to say, 'We're going to be brave and we're going to practice facing your fears,'" Alvord said. "Say, 'You're going to meet with a very kind person. I know it's going to be hard. I'm nearby or next to you, and we're going to practice your breathing together, or I'm going to tell you silly stories.'"
Reading children's books about going to the doctor in the days before can help familiarize youngsters with what they will experience. So can having them play doctor, Alvord said. Children can use pens that look like syringes to give their dolls and stuffed animals pretend immunizations.
Most kids are afraid shots will hurt, and parents should not tell them that they won't, Alvord advised, because if the shot does, kids will wonder why their parents lied to them.
"It needs to be said to kids that no one likes to get shots," she said. "There is a little bit of discomfort with it, but there is so much benefit."
In extreme cases, parents might consider exposure therapy ahead of their child's doctor visit. Treatment is typically short-term and involves gradual exposure to the aspects of a shot that prompt fear in a child, such as the smell of the alcohol swab used before the injection, while working to bring down the child's anxiety around each step.
Step 2: Plan with your pediatrician.
If parents are concerned that their child will panic when they feel pain, they can contact their children's pediatrician ahead of time to ask about numbing creams, which will dull the sensation of the needle on their skin, but must be applied about a half hour before, said Dr. David Becker, a pediatrician, psychotherapist and clinical professor of pediatrics at the University of California, San Francisco.
Becker recommended that families check out the game plan for getting injections that is available through the Meg Foundation, a nonprofit that empowers children to prevent and reduce pain. The printable form gives children options such as where they want a parent to sit while they receive their shot.
"The most important thing is that children should not be held down for any medical procedure against their will," Becker, who is on the board of the Meg Foundation, said, explaining that pinning kids down for vaccinations can traumatize them and make them afraid of future interactions with doctors. "They can be held in a parent's arms, in their lap, and sometimes hugging them will be enough for them to feel comfortable."
How parents and practitioners talk about an impending shot to an anxious child is also crucial, he said.
"You can shift the word 'pain' or 'shot' to 'poke' or 'bother,'" he said, as in: "I don't know if it's going to bother you when you get your vaccine or immunization. Let's come up with a plan so you can feel more in control."
Step 3: Relax and distract.
The minutes leading up to the injection as a doctor or nurse is preparing the vaccine may be the most anxiety-producing for little ones - or anyone else with a fear of needles.
As a result, muscles tense up, which will make a shot more painful. So Alvord has parents tell kids to "keep the body loose."
This might be achieved by doing calming exercises together that focus on breathing - parents can use kid-friendly mindfulness apps - or parents can guide children to tense and then relax muscle groups one at a time, a technique known as progressive muscle relaxation.
This is also a time when it's OK to take out the phone and put on a child's favorite video or audio book, Alvord said.
In addition to distracting kids, reinforce their bravery in those final moments, Alvord said.
"The message is, 'I know it's hard, but you're going to be brave,'" she said.
Step 4: Celebrate. Even if it was a little bumpy.
The ideal time to take your child for a vaccination is when they are at their most upbeat - that is, when they are unlikely to be tired or hungry - and when you have time afterward to do something fun, Alvord said. Get an ice cream cone to celebrate their bravery, she suggested. The celebration should happen even if the doctor's appointment included some tears.
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Ice cream or a family trip to the zoo is what Shaun Harris, a father of two in Reedsburg, Wisconsin, is planning to do after he takes his needle-phobic 7-year-old, Ginny, to get vaccinated. Ginny has always been terrified of shots, even crying when she's not the one being injected: Seeing her 10-year-old brother, Teddy, get shots upsets her, too.
To prepare Ginny, Harris has been talking to her about the importance of Covid vaccines: how getting one will not only keep her protected, but will keep others safe, too, and how it will hopefully enable the family to go on a trip to Disney World in the spring. Ginny has vowed to "be a brave girl to stop the virus," Harris, a writer and high school English teacher, said.
"It probably won't go great when it happens, because she'll still be scared," he said. "But she's going to know that she's doing the right thing, and that means a lot to her."
In the end, all children who overcome their fear of needles to get their Covid vaccinations will gain skills that will help them beyond just getting a shot at a doctor's visit, Alvord said.
"Being resilient is not having no stress in your life," she said. "It's dealing with all the challenges that come your way. And if we can start with the little challenges, then we build on it."