Topical Anesthetic Creams Work Best To Reduce Pain From Childhood Vaccination Interview with:

Dr. Anna Taddio PhD Professor in the Leslie Dan Faculty of Pharmacy University of Toronto Adjunct senior scientist and clinical pharmacist at SickKids

Dr. Anna Taddio

Dr. Anna Taddio PhD
Professor in the Leslie Dan Faculty of Pharmacy
University of Toronto
Adjunct senior scientist and clinical pharmacist at SickKids What is the background for this study?
Response: We do not know enough about how well different pain interventions work over time and when combined together. In this study, we compared the effectiveness of interventions when layered together, starting from simplest to most complicated in terms of implementation, in the first year of life in infants undergoing routine vaccinations.

We compared 4 different treatments:
1. placebo (sham),
2. Educational video for parents about how to soothe their infants,
3) video and sucrose (sugar water),
4) video and sucrose and liposomal lidocaine cream. What are the main findings?

Response: The main findings are that only the topical anesthetic combined with sucrose and a parent educational video provided consistent analgesia over time when compared to all other groups (i.e., sucrose and video, video alone, and placebo control).

This suggests that only the topical anesthetic was beneficial. What should readers take away from your report?

Response: Topical anesthetics such as liposomal lidocaine are effective to reduce vaccination pain and should be used more. At present, they are rarely used to mitigate vaccination pain. What recommendations do you have for future research as a result of this study?

Response: We need less painful vaccines as even with the use of the topical anesthetic, there was still pain in infants. That is, pain was reduced but not eliminated.

Ideally we should be preventing the pain that is caused by the procedure. Is there anything else you would like to add?

Response: We need to do a better job teaching parents and health care providers about the importance of mitigating pain in children and how to do so as contrary to common belief, “it doesn’t just last a minute” – negative experiences with pain can increase sensitivity to future pain, and contribute to negative attitudes about immunization and noncompliance with immunization and other medical interventions that involve needles.

This negatively impacts the health of individuals themselves and society at large. Thank you for your contribution to the community.


Anna Taddio, Rebecca Pillai Riddell, Moshe Ipp, Steven Moss, Stephen Baker,Jonathan Tolkin, Dave Malini, Sharmeen Feerasta, Preeya Govan,Emma Fletcher, Horace Wong, Caitlin McNair, Priyanjali Mithal,and Derek Stephens

Relative effectiveness of additive pain interventions during vaccination in infants
CMAJ cmaj.160542; published ahead of print December 12, 2016,doi:10.1503/cmaj.160542

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on December 13, 2016 by Marie Benz MD FAAD