Needle Phobia in the Time of COVID-19 Vaccines

Suraji Wagage, PhD, JD

Many of us have a fear of hypodermic needles (trypanophobia). But before the COVID-19 pandemic, if you have trypanophobia, it may not have interfered with your life very much or affected your behavior beyond avoiding getting your yearly flu shot. The COVID-19 pandemic has changed the stakes of having a fear of needles: now, COVID-19 vaccines are touted as a way of saving many lives and proof of vaccination may be required to travel, attend events, or enter businesses. This may pose a serious issue for people with trypanophobia, who may also feel shame admitting that their reason for not getting a vaccine is a fear of needles.

The good news is that this phobia is highly treatable through exposure therapy. When required to get an injection, people with trypanophobia may experience rapid heart rate, nausea, dizziness, sweating, chills, shaking, tightness of the chest, and more. They may also sometimes lose consciousness. You can do many things on your own to manage fear of needles, but if you tend to lose consciousness, you should visit a cognitive behavioral therapist who does exposure therapy who can help with this. When addressing your fear of needles, think of someone who has a fear of public speaking and what you might recommend to them to overcome this fear. You would likely suggest that they start with something manageable and work up to more difficult tasks, like practicing a speech in front of a mirror, and then in front of two friends, and then in front of ten people, and so on until speaking in front of an auditorium full of people no longer feels so daunting. 

Similarly, with a needle phobia, you can start with steps such as smelling rubbing alcohol, wiping your arm with an alcohol pad, looking at pictures of hypodermic needles online, and repeatedly watching videos of people receiving injections or medical personnel handling needles (or medical shows or movies involving such content). You can also imagine yourself getting an injection in great detail. The key is repetition and sticking with your practice for long enough (20-30 minutes at a time, several times a week). You may wish to contact a therapist to perform further steps involving handling actual hypodermic needles. 

You can also practice habituating to the physical sensations (rapid heart rate, dizziness, sweating, etc.) by running in place or breathing quickly and shallowly for short periods of time and then observing everything you feel physically. The more you do this, the more you can separate your physical sensations from your panic and interpretations (e.g., “this situation is dangerous!”) when you’re in a situation where you have physical sensations due to your phobia. Then, instead of a cascading fear effect — I feel fear, so my heart pounds, and noticing my heart pounding makes me feel more afraid, which intensifies my physical sensations — you can short-circuit the cascade: I feel fear, so my heart pounds, and I notice that my heart is pounding and recognize this as nothing more or less than an uncomfortable physical sensation.

A therapist will work with you on all these exposures and more. Together, you will create an exposure hierarchy planning out exposures to needle-related materials in graduated manner so you can start with manageable experiences and work your way up to more challenging situations. You will do exposures to physical sensations and discuss thoughts, emotions, and behaviors that are related to your phobia. Your therapist can guide you through and assist with exposures in-session and give you exposures to practice on your own. Many people experience success with this type of therapy in only a few sessions (6+).