KUALA LUMPUR, July 26 — While it is heartening that Malaysia has ramped up its Covid-19 vaccination drive in its endeavour to attain herd immunity soon, people who have an aversion to needles are having a hard time overcoming their fear and getting themselves inoculated.

For those who have a strong fear of needles, getting the vaccination is a big deal and can be anxiety-inducing. 

According to Universiti Malaysia Sarawak psychiatrist Dr Amanda Albert, fear of needles is not uncommon, with some experts postulating that avoidance of pain caused when the needle pierces the skin is actually an evolutionary instinct. 

“The human race survived by avoiding pain and injury with their fear instinct, creating a human predisposition to this fear of needles. 

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“However, problems arise when this fear reaches the extreme level of a phobia as this will affect one’s ability to obtain the vaccine or undergo any other medical procedure involving needles,” she told Bernama recently. 

The specific phobia about medical procedures involving needles is called trypanophobia which, said Dr Amanda, is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as a blood-injection-injury type phobia. 

In Malaysia, there are no statistics pertaining to the number of people with this phobia but globally it is estimated that up to one in 10 people may suffer from some form of trypanophobia, she said.

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“Studies also show that four out of five people with trypanophobia report having a first-degree family member with the same phobia. However, experts believe this may be due to learned behaviour more than actual genetic inheritance,” she added.  

 Symptoms of medical needle phobia

 Dr Amanda said trypanophobia is diagnosed when a person has an immediate and marked fear response to medical needles. 

Symptoms include fainting, dizziness, light-headedness, nausea, vomiting, sweating and palpitation. 

“This fear can go on for at least six months and cause the person to avoid the trigger with intense fear and anxiety, usually out of proportion to the actual danger posed by the needle.

“It is also out of proportion to the person’s sociocultural context, meaning their fear responses are different from the fear responses of those in their social circles and cultural background,” she explained. 

She said in certain cases, persons with this phobia have been known to completely avoid going to a clinic or hospital despite having an illness that requires treatment, or even refusing to get the Covid-19 vaccine. 

“They will avoid medical needles at all costs, be it needles for vaccines or blood transfusion or medications that are given through the vein,” she said, adding that those with extreme trypanophobia may not only avoid the Covid-19 vaccine but also resist having their blood sample taken or any medication given via needles should they develop Covid-19. 

Unlike anti-vaccination groups that have no trust in science or vaccine safety, individuals with trypanophobia generally do not object to vaccinations — they avoid it purely due to their fear of medical needles. 

“People with trypanophobia would probably have no problem with taking vaccines that are given orally, like the polio vaccine,” she said, adding that people with this phobia can seek the help of a professional therapist, such as a clinical psychologist or psychiatrist, to overcome their fear.

Dealing with the fear of needles

Dr Amanda said those who are avoiding the Covid-19 vaccine due to their fear of needles must teach themselves to relax and do deep breathing exercises “to slow down the bodily responses of fear such as fast heartbeat and fast breathing” as it can help one to feel more at ease. 

“(While at the Covid-19 vaccination centre) after you have checked that you are being given the right vaccine dosage, find things that would take your attention away from the procedure at hand. Bring a trusted friend or family member with you, or talk to them on the phone.

“You can also hold an ice pack in your hand as (the sensation of) pain and temperature run along the same nerve pathways to the brain, so this is a form of ‘distraction’ to your nerve pathway. If the room you are in has a piece of art or a cartoon drawing that you appreciate, pay more attention to it than the needle,” she said.

She also said that people with trypanophobia could prepare themselves for the vaccination through exposure therapy, which involves exposing themselves to medical needles step by step.

“Read about it and watch videos, then accompany someone to a vaccination centre,” she added. 

Meanwhile, Dr Ammar Rashidi Abdullah, a medical officer at Hospital Kepala Batas in Penang, said individuals who have a phobia about needles should consult a psychiatrist or counsellor to overcome their fear.

The fear of needles can be detrimental to one’s state of health as it discourages a person from getting the Covid-19 vaccine, as well as any medical treatment involving the use of needles, he said.

He also reminded that the Covid-19 vaccines offered by the Ministry of Health are safe and approved by the ministry’s National Pharmaceutical Regulatory Authority Malaysia, as well the World Health Organisation. — Bernama