You walk into the doctor's office after giving yourself a pep-talk in the car. Medical crepe paper crunches as you shift on the exam bench. The nurse arrives uncaps a 16 mm needle attached to a syringe filled with a vaccine, and you begin to feel like you're in the intro to Eminem's song "Lose It", "...palms are sweaty, knees weak, arms are heavy. There's vomit on his sweater already." Blood drains from your face and you feel faint.
If this sounds like your experience when you see a needle, you might have trypanophobia. And you're not alone. The Centers for Disease Control and Prevention (CDC) estimates 25 percent of adults have a fear of needles that can have effects on their health care, including skipping much-needed vaccines.
What Is Trypanophobia?
Trypanophobia comes from the Greek root "trypano," which means puncturing or piercing, and "phobia," which is fear. That doesn't sound pleasant and for the individuals who have it, it's not.
"Trypanophobia is a fancy way of saying 'needle phobia,' which is anxiety that is out of proportion to the threat in the environment and event," says Dr. Ashley Love, DrPH, DHSc. Love is a public health professional and associate professor at the University of the Incarnate Word in San Antonio, Texas, who co-published "Considering Needle Phobia among Adult Patients During Mass COVID-19 Vaccinations," in the Journal of Primary Care & Community Health.
People with trypanophobia experience severe emotional and physical responses when they think of or are around needles. Even if they know that a vaccine or routine blood test is important, they find it extremely difficult to cope with their fear. Common symptoms of trypanophobia include:
- panic attacks or anxiety
- increased heart rate or palpitations
- insomnia before getting a shot
When Needle Phobia Affects Quality of Life
It's hard to know exactly how many people might have trypanophobia because they tend to avoid medical institutions or medical care in general. But Love estimates that number could be anywhere between 11.5 and 66 million Americans. That's no small number, especially when the mitigation of a global health pandemic rests on vaccinations to develop herd immunity.
This couldn't be truer in the case of needle phobia amid the COVID-19 pandemic. "Not getting the COVID-19 vaccination puts people at significant risk of hospitalization and death compared to those who have received the COVID-19 vaccinations," Love says.
But these phobic vaccine avoiders aren't just putting themselves at risk, they're also putting others at risk of illness, like those who can't (yet) receive the COVID-19 vaccine, including children younger than age 11, because it undermines herd immunity. While the number of people not getting the COVID-19 vaccine because of trypanophobia is hard to know, a 2019 study stated that one in six adults don't get the flu vaccinations because of their fear of needles.
But having trypanophobia doesn't just stop people from getting vaccinations for things like influenza and COVID-19. "People suffering from needle phobia avoid going to the doctor; therefore, any early detection of diseases will be missed," Love says.
That means people with trypanophobia can miss detection of diseases like cancer or struggle to receive routine blood samples for diabetes. "Life-threatening conditions are ignored among people with needle phobia and the quality of life decreases since they avoid getting shots at all costs," Love says.
Causes of Trypanophobia
Why is this phobia so common? Researchers can't say for sure, but they suspect family life and heredity play a big role. According to Love's study, four out of five adults with needle phobia have a first-degree relative with the same fear.
It could be genetic, or it could be from childhood trauma, says Indianapolis-based child and family therapist, Charity Rose, MSW, LSW.
"Trypanophobia is the 10th most common phobia that people have, and it is the most common phobia I treat here in Indianapolis," Rose says. "Some people can't pinpoint when their phobia started, but it can be caused by trauma experienced with needles. Most of the time this is when babies and small children receive their first vaccines."
A 2017 study published in the journal Vaccine showed that childhood vaccines, especially those given between the ages of 4 and 6, strongly impact vaccine anxiety as kids get older. Researchers suggest that future studies look at ways to make preschool-age vaccines less traumatic. Ideas include:
- dimming harsh lights during shots
- having children looking away while getting a shot
- letting kids watch trusted adults get shots to see that it doesn't have to be scary
- using relaxation techniques when children start to feel afraid
While there's not a one-size-fits-all approach to treating trypanophobia, there are professionals who specialize in helping people with phobia overcome their fears.
Face the Fear With Exposure Therapy
There is no cure for trypanophobia, but treatments like exposure therapy or distraction techniques can help people cope. Rose says that exposure therapy — the intentional exposure of patients to their fear in a safe environment— is the most effective treatment for phobias like needle fear. Rose is trained in exposure therapy and uses it in her practice to help patients.
"[Exposure therapy] treats the whole fear, not just one instance," she says. "Other distraction tools can be used, but it doesn't treat the fear. It's more like putting a Band-Aid over the fear at the moment."
If you can't find a therapist who specializes in exposure therapy, there are other ways to cope with the effects of trypanophobia when you have to have a shot.
- Ask a friend or family member to go with you.
- Tell the nurse or doctor that you have a fear of needles so they can take it easy on you.
- Practice relaxation before you get the prick.
- Don't watch!
- Sit or lie down to avoid falling when you feel faint.
- Ask for a numbing spray on the injection site.
- Use distraction techniques like vibrating devices or cold.
Someone with trypanophobia can't just "buck up," and they shouldn't be expected to. However, it is difficult for people with needle fear to face injections like the COVID-19 vaccination, knowing it could bring them stress and physical anguish. Increasing research on trypanophobia and treatments like exposure therapy can shed a light on this debilitating phobia and offer people help so they can get the medical care they need.