The number of injected same-day preschool vaccines relates to preadolescent needle fear and HPV uptake.
PURPOSE
Fear of needles develops at approximately five years of age, and decreases compliance with healthcare. We sought to examine the relationship of preschool vaccine history, parent and preadolescent needle fear, and subsequent compliance with optional vaccines.


METHODS
As part of a private practice randomized controlled trial, parents and 10-12year olds rated needle anxiety on a 100mm visual analog scale. This follow-up cohort study compared their needle anxiety to previous vaccination records, including number of vaccinations between ages four and six years (total and same-day maximum), and subsequent initiation of the HPV vaccine through age 13.


RESULTS
Of the 120 preadolescents enrolled between 4.28.09 and 1.19.2010, 117 received preschool vaccinations between ages four and six years. The likelihood of being in the upper quartile of fear (VAS≥83) five years later increased with each additional same-day injection (OR=3.108, p=0.0100 95%CI=1.311, 7.367), but was not related to total lifetime or total four-to-six year injections. Only 12.5% (15) of parents reported anxiety about their preadolescents' vaccines (VAS>50). Parent and child anxiety was weakly correlated (r=0.15). Eight children in the upper fear quartile began their HPV series (26.67%) compared to 14 in the lower quartile (48.28% VAS<32) (OR 2.57, p=0.0889, 95%CI 0.864-7.621); there was no difference in HPV uptake between upper and lower quartile of parent anxiety.


CONCLUSIONS
The more same-day preschool injections between 4 and 6years of age, the more likely a child was to fear needles five years later. Preadolescent needle fear was a stronger predictor than parent vaccine anxiety of subsequent HPV vaccine uptake.
['Baxter|Amy L|AL|', 'Cohen|Lindsey L|LL|', 'Burton|Mark|M|', 'Mohammed|Anaam|A|', 'Lawson|M Louise|ML|']
D000328:Adult D002648:Child D015331:Cohort Studies D005239:Fear D005260:Female D005500:Follow-Up Studies D006801:Humans D007267:Injections D008297:Male D055118:Medication Adherence D008875:Middle Aged D009339:Needles D010146:Pain D027383:Papillomaviridae D014612:Vaccines
Needle fear HPV Adherence Pain Vaccine Hesitancy phobia