title: From the mouth of babes: Getting vaccinated doesn't have to hurt.
abstract: BACKGROUND
  Analgesic interventions are not commonly administered during childhood vaccination, despite the fact that two-thirds of children are afraid of needles and one-tenth are noncompliant with immunization.
  
  
  OBJECTIVE
  To explore children's experiences of vaccination and preferences for analgesia.
  
  
  METHODS
  A total of 17 children (four to 14 years of age) at an independent school in Toronto (Ontario) participated in three focus-group interviews. The majority had previous experience with pain management interventions during vaccination. Thematic content analysis was used to analyze interview transcripts.
  
  
  RESULTS
  THE FINDINGS WERE CATEGORIZED INTO THREE MAIN THEMES: experience of vaccination; roles and responsibilities regarding pain management; and impact of pain management. Children easily recalled previous vaccinations and discussed fear and distress experienced by themselves and others. Children believed that parents and immunizers should prepare them ahead of time and use interventions to manage and monitor pain. They also wanted adults to support their efforts to lead pain management. Children discussed benefits of managing pain, including reduced unnecessary suffering, improved vaccination experience, reduced risk of developing needle fears and reduced noncompliant behaviours. They were knowledgeable about strategies for reducing pain including distraction, topical anesthetics and injection techniques. They contrasted vaccination with and without pain management, and indicated a preference for pain management.
  
  
  CONCLUSIONS
  Children reported that managing vaccination pain is important and that analgesic interventions should routinely be used. Incorporating pain management in the process of vaccination has the potential to improve children's experiences with vaccination and promote more positive attitudes and behaviours.
authors.affiliation: Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, and Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Anna
authors.initials: A
authors.lastname: Taddio
authors.affiliation: Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, and Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Ilersich
authors.affiliation: Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, and Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Ilersich
authors.affiliation: AboutKidsHealth, The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Jenny
authors.initials: J
authors.lastname: Wells
keywords: Children; Pain management; School-based immunization clinics; Vaccination