Children's Pain and Distress at a Public Influenza Vaccination Clinic: A Parent Survey and Public Observation Study

Influence of the Olfatín Project on the reduction of pain related to intranasal influenza vaccination, as part of a school influenza vaccination program

PURPOSE

To evaluate the influence of viewing the Olfatín Project video on the assessment of school LAIV-associated pain in three and four-year-old children through the Wong Baker Faces® pain classification scale.

DESIGN AND METHODS

A three-arm randomized multicenter clinical trial with a placebo control group was carried out. The main variable measured was pain, assessed through the score on the Wong Baker Faces® Pain Rating Scale. There were a total population of 4591 children three and four-year-olds (born in 2019 and 2020) and who attended the 1st and 2nd year of early childhood education. Before the school vaccination, researchers randomly assigned participant schools corresponding to each of the basic health areas to each of the three study groups: Olfatín's video viewing, a control video viewing not related to influenza and no video viewing.

RESULTS

No significant differences according to sex, age or the minor's grade according to the assigned intervention were detected. 72.3% of those vaccinated assigned a 0 from the Wong Baker Faces® scale: 75.4% of those who watched Olfatín's video, 68.3% for those in Drilo's group and 72.8% for those who didn't watch any video, but without significant differences (p = 0.08). There were no significant differences either stratifying by sex.

CONCLUSION

LAIV is a painless vaccine for children, which has to be taken into account by the health authorities when planning the pediatric influenza vaccination campaign.

PRACTICE IMPLICATIONS

Olfatín's cartoon video can be used by professionals to create a greater experience for children and therefore a better acceptance.

Implementing a clinical protocol using breastfeeding to mitigate vaccination pain in infants

BACKGROUND

Although an effective public health intervention and a routine pediatric practice, vaccines are a common source of iatrogenic pain in childhood. Techniques, such as exam table restraint may cause infants to struggle and heighten distress, but studies demonstrate that breastfeeding and lap holding are effective strategies to reduce injection pain during vaccination.

LOCAL PROBLEM

Adoption of pain-relieving techniques into clinical practice is often underutilized. In a pediatric clinical practice in southern Connecticut, there were no guidelines for providing pain mitigation strategies, including breastfeeding, during infant vaccination.

METHODS AND INTERVENTIONS

The Plan-Do-Study-Act (PDSA) cycle was used for the improvement process. A clinical protocol introduced breastfeeding as a pain-relieving strategy during vaccination; lap holding was a second option. All clinical staff were educated on the infant pain experience, and nurses were further trained on vaccine administration techniques during breastfeeding.

RESULTS

A total number of 354 infants were seen for vaccination during the 12-week project: 168 were breastfed infants, of which 53% were breastfed during vaccination; 234 were placed on the parent/caregiver's lap during vaccination; and only 13 infants were restrained on the exam table. There was no documentation of position for 18 infants.

CONCLUSIONS

A clinical protocol was an effective tool to guide nurses on pain-relieving options, such as breastfeeding and lap holding, during vaccine administration. Positive experiences during vaccination administration have the potential for short-term and long-term benefits including, compliance with routine care and adherence to vaccination schedules.