Getting a shot can be a frightening prospect for any kid. And the noise, the crowds or the pain of COVID shots can keep some children with developmental disabilities from getting vaccinated at all.
A team from the UMass Chan Medical School say they've broken through with a calmer, more personalized experience for people whose sensory support needs might keep them away from mass vaccination sites or busy pharmacies. They hope the approach has lessons to share with the broader national vaccination campaign.
The “VaxAbilities” program may help to resolve part of one particular vaccination dilemma: people with autism spectrum disorder appear to face potentially more severe health risks from COVID-19, regardless of their age — and also tend to be vaccinated at lower rates.
Beyond roadblocks related to access and information, program lead Emily Lauer says that sensory experience also can be a disincentive; patients may be especially “sensitive to certain sounds or bright fluorescent lights, or other types of distractions,” she said.
But the clinics hope to be welcoming. “We tend to take any child, or adult, who feels that they could benefit from the support," including those who share the widespread fear of needles, Lauer said.
In the past two months, the program has set up shop alongside larger vaccination sites in Boston, Worcester, Brockton and Lowell — and carved out spaces with lower light and room for privacy.
They also offer some positive draws. Kids get their choice of toys that can occupy their hands, “everything from fidget spinners to squeeze balls, things that light up,” said Lauer, who also directs UMass’ Center for Developmental Disabilities Evaluation and Research. Recent clinics at the Museum of Science in Boston and the Ecotarium in Worcester came with free admission for anyone vaccinated.
The team gave particular thought to softening — or almost eliminating — the sensation of the shot itself. For instance, staff sometimes use a vibration device called the "buzzy bee" on a patient’s body between the site of the shot and the head.
“It confuses the signals that are relaying from the nerves in your arm to your brain,” Lauer said. “It really serves to mitigate quite a lot of the sensation of the injection going in.”
Vaccine administrators also often try to hide the injection from the patient's view, and sometimes solicit help from a caretaker or relative to keep kids distracted.
Given the wide array of people they hope to serve, program staff are trained to adapt. Lauer said a recent patient shared an anxiety about a loss of control around the shot — so staff let them handle a vaccine vial and look at the equipment that would be used.
By the numbers, “VaxAbilities” is a small part of the ongoing campaign to vaccinate kids against COVID-19. During nine clinics since November, staffers have administered shots to over 850 people. (A 10th is planned for Jan. 7, also at the Museum of Science, and others remain to be scheduled.)
But for the community they hope to serve, the approach has worked impressively well: “I would say we have over a 99% success rate, even with kids who have some pretty substantial needs,” Lauer said.
Based on that sort of result serving a hard-to-reach population, sensory-minded clinics are scaling up. Similar efforts to center the focus on kids with developmental disabilities are underway in Pennsylvania and Illinois.
But Lauer hopes the approach will also help drain some of the dread — and the potential trauma — out of the experience of inoculation for the broader population.
“Wherever people go," she said, "we want an understanding that there are ways to make this a more pleasant and comfortable experience.”