Immunizing Against Pain and Fear: Rethinking the Vaccination Experience

Managing a patient’s pain and fear during vaccination is not a courtesy but an expected part of care, argues Anna Taddio, PhD, a professor at the University of Toronto and lead author of the 2026 Canadian clinical practice guideline update on reducing distress during vaccine injections, published in CMAJ.

In an interview with Patient Care Online, Taddio explains that more than a decade had passed since the 2015 guideline, leaving time for new research and for changes in guideline methodology. The COVID-19 pandemic added urgency. With confidence in vaccination slipping and a growing number of injectable treatments in routine care, she notes that one negative needle encounter can become a barrier, not only to future vaccines but to any care involving needles.

She compares overlooking distress to skipping a step as basic as keeping vaccines refrigerated, and describes her group's aim as immunizing against pain and fear as well as disease. Taddio also stresses the safety stakes: fear can escalate to dizziness and fainting, which can lead to injury.

Taddio also reflects on the main shortcoming of the earlier guideline. It offered a long list of do’s and don'ts, with little direction on how clinicians should actually put them into practice. That gap shaped how the panel packaged the update, which now presents 16 recommendations organized across 5 domains of distress management.

Watch the full episode to hear Taddio explain why primary care clinicians should rethink how they approach the vaccination experience.

Relevant disclosures for Anna Taddio, PhD, include GSK Chair in Vaccine Education and Practice-Oriented Tools.

References:

1. Taddio A, Shah V, McMurtry CM, et al. Reducing distress during vaccine injections: 2026 clinical practice guideline update. CMAJ. 2026;198(32):E1243-E1263. doi:10.1503/cmaj.260123

2. Taddio A, McMurtry CM, Shah V, et al; HELPinKids&Adults. Reducing pain during vaccine injections: clinical practice guideline. CMAJ. 2015;187:975-982. doi:10.1503/cmaj.150391