As someone with a needle fear, it’s unsettling to see photos of people getting shots. Of course, needle-in-arm visuals have been hard to avoid since the COVID-19 vaccine rollout began in December. On one hand, I’ve been happy to see a nationwide vaccination effort unfold in real time on my feeds. Vaccine selfies, aka “vaxxies,” have helped normalize and humanize vaccination for people on the fence about rolling up their sleeves. That’s undoubtedly a good thing. Still, when it came time for my own shot, photos of metal piercing skin flooded my mind and ratcheted up my anxiety. Panting and sweating in CVS after my first Pfizer dose wasn’t my proudest moment.
But I suspect I’m not the only vaccine recipient who’s gotten the sweats. Needle fear is common at every age. Most kids are scared of shots, and anywhere from 20 to 50 percent of adolescents and 20 to 30 percent of young adults say they’re apprehensive about needles, according to a 2018 review of studies published on the issue. This aversion to pricks resulted in 16 percent of adults (including me) skipping their annual flu shots.
For the US to achieve herd immunity against COVID — which some experts predict may not be possible — medical professionals need to win over the vaccine hesitant. This has shown to be a formidable challenge. While patients might be wary of the COVID-19 vaccine for a number of reasons, needle fear can play a role. “It’s a common issue and it has a worrisome potential outcome that people are not going to seek healthcare because they do not want to interact with the needle,” says Patricia A. Stinchfield, a pediatric nurse practitioner and president-elect of the National Foundation for Infectious Diseases.
Immunization images aren’t likely to help matters for the needle-phobic. Research shows that pictures can influence whether patients adhere to certain healthcare guidelines, like getting recommended vaccines. A strong emotional reaction to those images, positive or negative, influences whether someone actually does what medical professionals urge them to. Additionally, a 2018 study found that 1 in 8 photos associated with vaccination news coverage were negative, such as an image of a nurse holding a needle next to a crying baby, raising concerns about these photos undermining vaccination efforts. For someone who’s been consistently scared or anxious when viewing vaccine photos, the decision to forego vaccination altogether might not be surprising.
Early in the COVID vaccine rollout, Stinchfield advised journalists on appropriate images to pair with vaccine-related stories, urging the media to avoid photos of large needles and syringes or hyperbolic cartoons that negatively exaggerate the shot experience. Even so, she says, “we sure have seen a lot of large needles, close ups of needles and cartoons of needles.”
Michael Pitt, an associate professor at the University of Minnesota and one of the co-authors of the 2018 vaccine imagery study, agrees that fear-inducing images of vaccines have become more prevalent over the last year. News outlets are notorious for publishing the types of attention-grabbing images that can reinforce needle fear, Pitt says, such as photos of injections or celebrities mid-jab.
It can be enticing to publish an article with positive vaccine news alongside a vaxxie of an uber-famous cultural icon like Dolly Parton. But experts point to less anxiety-inducing photo options that can still leverage a star’s status. “Dolly getting vaccinated is a great thing because there are a lot of people who follow Dolly and will do what Dolly does,” says Marla Dalton, CEO of the National Foundation for Infectious Diseases. “But they can show Dolly back singing on stage or with a bandaid on her arm or her vaccine card. I think that would go just as far.”
Non-media folks also unknowingly contribute to a barrage of evocative needle imagery. From the early days of COVID-19 vaccination, medical workers and political leaders posted shots of their shots as a trust-building exercise to reinforce the vaccine’s safety. The trend continued as vaccine eligibility expanded to the general public: Social media is still rife with photos of nurses, needle in hand, sticking patients’ biceps. (Even pre-COVID, vaccine images on Twitter were mainly of people and syringes, according to a 2018 study.) With 12 to 15 year olds now authorized to receive the Pfizer vaccine, Dalton predicts more shot-related selfies dominating our digital space.
Lay social media users probably don’t consider the potential harm in sharing vaccine selfies. Still, experts agree there are more effective ways to encourage vaccination than showing the actual moment of inoculation. Any image that displays a positive outcome of the shot, Dalton says, is less fear-inducing. A selfie with a vaccine card (just make sure personal information isn’t visible) or a group photo of vaccinated friends spending time together or on vacation are aspirational depictions of post-vax life that could compel a hesitant or fearful friend to get their jab. “At the end of the day, a picture of somebody hanging out with friends will probably be far more impactful than a picture of somebody with a needle in their arm,” Dalton says.
Pitt suggests getting vulnerable in captions for these images, especially if you overcame needle fear yourself. Appealing to others through storytelling is more productive than sharing statistics or data about how safe and effective the vaccines are, Pitt says: “I think vulnerability goes a long way — stories as opposed to vaccine selfies.”
As for the media, experts recommend the American Academy of Pediatrics and SELF Magazine’s Immunization Image Gallery, which provides free images that positively depict vaccination, showing kids of all ages and races getting shots, nary a tear in sight. A photo of a person with a bandaid on their arm or one where the needle isn’t the central focus are also safe options, Pitt says.
In a moment in history where images and stories help influence public health, you should be mindful of the narratives you’re sharing. You just might inspire a needle-phobic person to get their shot.
“If we can avoid any building hesitancy by showing needles, let’s stop that now,” Dalton says. “That’s immediately in our control.”