HEALTH

It’s the jab, not the vaccine, some fear

A MASS vaccination programme against Covid-19 is began in the UK on this week. While the government is working to ease the fears of those who are worried about safety, some people have a more primal fear – needles.
“My heart would be racing. My mind saying, ‘calm down, it’s going to be fine’ but also, ‘it’s terrifying, it’s going to really hurt you’. Then ‘you don’t know this person, so you can’t trust them’. I would be thinking of ways to get away from it.”
Raelene Goody, 31, who has cystic fibrosis, an inherited condition that causes lung infections and problems digesting food, regularly requires injections, including an annual flu jab.
But from the age of four to her late teens, she suffered from severe needle phobia that would leave her “shaking” and often meant she had to be sedated.
“It’s like when you are really scared of something like spiders and snakes and you want to run away. It’s a similar feeling, except it is a needle,” she says. “Apparently I punched my dad in the face once, but I was so petrified I can’t remember it.”
Raelene’s severe phobia of injections, known as trypanophobia, in her younger years is not uncommon. Some others have a more general fear of needles, known as belonephobia. Studies show such a fear is highest in children and decreases with age. Nevertheless, it affects up to 10 per cent of the overall population, according to charity Anxiety UK.
Despite her phobia, Raelene, from West Sussex, was still able to go through with her flu vaccination each year, although it could sometimes take hours to administer the jab.
“I had to have it. If you don’t have the flu jab and you get the flu it would be worse than getting a chest infection [which reduces lung function in people with cystic fibrosis],” she says. “You could actually die.”
She has been prioritised for the Covid-19 vaccination, as a clinically extremely vulnerable person, for similar reasons.
And she says there were ways she was able to get through her flu jabs at the height of her phobia. A friendly nurse would visit her at home and her parents would be present for reassurance.
Immunisations with the Pfizer-BioNTech vaccine, approved by the British medicines regulator, the MHRA, are due to start this week in the UK for people in some high-priority groups. People will be vaccinated via injection twice – 21 days apart – and full immunity starts seven days after the second dose.
As it stands, there is no alternative to the needle. All Covid-19 vaccines have to be given via injection. Could it mean some people might choose to opt out of the vaccine because of their fear of needles?
The Department of Health has not released any specific guidance around needle phobia and the coronavirus vaccine.
People with concerns around vaccinations should contact their local healthcare provider, according to NHS England, which is expected to release vaccine guidance in the coming days.
Prof Heidi Larson, who runs the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, says needle anxiety and phobia are an issue for some people around vaccination “in general”, and “may be the case for the Covid-19” vaccine as well.
But it’s not expected to be “the dominant cause of hesitancy”. Surveys and social media monitoring suggest there are a mix of reasons for people’s concern, she adds, such as worries about the speed it was developed.
So what can you do if you have a needle phobia?
Methods of coping with needle phobia can vary from person to person, with treatments including cognitive behavioural therapy, and clinical hypnotherapy.
There are also self-help methods. Anxiety UK advises self-administered behavioural exposure – a technique where individuals expose themselves to the situation they are phobic about in a gradual manner.
There are three steps in the process:

• Relaxation – which could be by practising progressive muscle relaxation, breathing exercises or meditation
• Developing an anxiety hierarchy or “fear ladder” – write down a list of all of the situations related to needles that you fear, arranged in order of difficulty
• Pairing relaxation with the situations detailed in your hierarchy – by climbing the ladder (thinking about or acting out each step) from bottom to top, exposing yourself to the fear for a tolerable amount of time before taking time to relax

Guy’s and St Thomas’ Hospital in London also recommends trying applied tension, a technique to increase blood pressure levels back to normal to avoid fainting.
Raelene has overcome her needle phobia, although she still has some lingering anxiety about having IV lines after a traumatic experience having one inserted. It’s problematic, she says, because people with cystic fibrosis “deal with having needles all the time for blood tests, IVs, CT scans”.
“It’s something that happens to you a lot, so people will think you just deal with it but it’s not as simple as that,” she says. “People have had traumatic experiences, and there’s trauma there that will freak them out.”
Reflecting on her fears, she says there will likely be people with needle phobia who are too scared to get the coronavirus vaccine.
But she says “there will also be some that will feel the same way, but are also terrified of getting coronavirus.
“Knowing that can kill you, people will be terrified – but able to fight through it.” – BBC

Positive outlook, less memory decline

WE may wish some memories could last a lifetime, but many physical and emotional factors can negatively impact our ability to retain information throughout life.
A new study published in the journal Psychological Science found that people who feel enthusiastic and cheerful — what psychologists call “positive affect” — are less likely to experience memory decline as they age. This result adds to a growing body of research on positive affect’s role in healthy aging.
A team of researchers analyzed data from 991 middle-aged and older US adults who participated in a national study conducted at three time periods: between 1995 and 1996, 2004 and 2006, and 2013 and 2014.
In each assessment, participants reported on a range of positive emotions they had experienced during the past 30 days. In the final two assessments, participants also completed tests of memory performance. These tests consisted of recalling words immediately after their presentation and again 15 minutes later.
The researchers examined the association between positive affect and memory decline, accounting for age, gender, education, depression, negative affect, and extraversion.
“Our findings showed that memory declined with age,” said Claudia Haase, an associate professor at Northwestern University and senior author on the paper.
“However, individuals with higher levels of positive affect had a less steep memory decline over the course of almost a decade,” added Emily Hittner, a PhD graduate of Northwestern University and the paper’s lead author.
Areas of future research might address the pathways that could connect positive affect and memory, such as physical health or social relationships. – Science Daily

Lung damage ‘identified’ in study

COVID-19 could be causing lung abnormalities still detectable more than three months after patients are infected, researchers suggest.
A study of 10 patients at Oxford University used a novel scanning technique to identify damage not picked up by conventional scans.
It uses a gas called xenon during MRI scans to create images of lung damage.
Lung experts said a test that could spot long-term damage would make a huge difference to Covid patients.
The xenon technique sees patients inhale the gas during a magnetic resonance imaging (MRI) scan.
Prof Fergus Gleeson, who is leading the work, tried out his scanning technique on 10 patients aged between 19 and 69.
Eight of them had persistent shortness of breath and tiredness three months after being ill with coronavirus, even though none of them had been admitted to intensive care or required ventilation, and conventional scans had found no problems in their lungs.
The scans showed signs of lung damage – by highlighting areas where air is not flowing easily into the blood – in the eight who reported breathlessness.
The results have prompted Prof Gleeson to plan a trial of up to 100 people to see if the same is true of people who had not been admitted to hospital and had not suffered from such serious symptoms. He is planning to work with GPs to scan people who have tested positive for Covid-19 across a range of age groups.
Moving the goalposts
The aim is to discover whether lung damage occurs and if so whether it is permanent, or resolves over time.
He said: “I was expecting some form of lung damage, but not to the degree that we have seen.”
The risk of severe illness and death increases markedly for the over 60s. But if the trial discovers that the lung damage occurs across a wider age group and even in those not requiring admission to hospital “it would move the goalposts,” according to Prof Gleeson.
He believes the lung damage identified by the xenon scans may be one of the factors behind long Covid, where people feel unwell for several months after infection.
The scanning technique was developed by a research group at the University of Sheffield led by Prof James Wild who said it offered a “unique” way of showing lung damage caused by Covid-19 infection and its after-effects.
“In other fibrotic lung diseases we have shown the methods to be very sensitive to this impairment and we hope the work can help understand Covid-19 lung disease.” – BBC