Parent-led interventions in reducing infant vaccination pain after participation in a longitudinal randomized control trial

Evidence is accumulating on the negative short- and long-term ramifications associated with poorly mitigated vaccine injection pain in infants including high levels of infant and parental distress, dissatisfaction with the vaccination experience, development of needle fears, and future noncompliance with immunization and other health care interventions involving needles (1). The use of pain mitigation interventions is therefore clinically important and considered by the World Health Organization to be part of good immunization practice (2). At present, utilization of pain mitigation strategies during vaccination is suboptimal (3). We sought to examine parental patterns of pain mitigation strategy utilization during vaccination in infants after participation in a vaccination analgesic trial whereby parents learned about and had experience using a variety of different analgesic strategies (4). The primary research question was: What is the rate of uptake of analgesic strategies by parents during childhood vaccinations after participation in the trial? We conducted a prospective, observational study including parent–infant dyads who participated in a longitudinal randomized controlled trial of analgesia for infant vaccination injections. The details of the methodology for the randomized controlled trial are reported elsewhere (4). Briefly, infants were randomized to four different analgesic regimens of increasing intensity for 2-, 4-, 6- and 12-month vaccinations: 1) standard care (placebo control), 2) parent-directed educational video (video) with information about acting calm, cuddling and distracting infants, 3) video and oral sucrose solution (sucrose), and 4) video and sucrose and liposomal lidocaine cream (lidocaine). In all groups, procedural techniques to minimize pain were used including injecting without aspiration, and injecting the most painful vaccine last (4). Treatments were given in the clinics of seven participating paediatricians in a blinded manner. Randomization was performed offsite by the research pharmacy at The Hospital for Sick Children using a computer randomization table and allocation was concealed using a matched placebo for all interventions (i.e., double-dummy design) (4). At the 15-month vaccination, all infants received all the active interventions in an open manner. Parents were then informed about how to make sucrose solution and where to purchase topical anesthetics for future vaccinations as they were not available at the clinics after the 15-month vaccination.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.