, which was led by U of T President Emeritus David Naylor, and calls for a $1.3-billion increase in federal research funding over four years, as well as sweeping changes to how it is administered.
Why? If CIHR's public funding didn't exist, Taddio may never have had the opportunity to conduct research into a problem many in the medical community previously believed was a non-issue – to the extent they thought about it at all.
A child is vaccinated in North Darfur in 2012. Recommendations by Taddio's team were adopted by the WHO three years later (photo by UNAMID via Flickr)
Statistics show that roughly one out of every four people is scared of needles, albeit to differing degrees. And Taddio estimates that as many as 10 per cent of people avoid getting vaccinations because of a fear of needles or concern about injection pain, a situation that poses an obvious personal and community health risk.
What's more, those same fears can prevent people from going to doctors for other routine procedures and tests until it's too late.
Taddio explains that we have a medical culture that has historically viewed needles and vaccinations, and the pain associated with them, as a necessary evil – something that patients must simply grin and bear.
“Most needle fears develop between the ages of four and eight, and it’s usually in the context of a bad procedure where somebody held you down and you were struggling,” she says, noting that about half of all people who are scared of needles and vaccinations had a negative childhood experience.
The rest is due to simple apprehension. “Somebody scares you – or you see somebody else, say you see your brother get a needle – and it’s very traumatic,” says Taddio. “Then you become very afraid.”
Taddio speaks from both professional and personal experience. She recalls taking her eldest son to a Toronto clinic for a blood test when he was four. The nurse jabbed his arm, missed the vein, and jabbed again as he struggled and screamed.
He understandably left the clinic with a fear of needles, Taddio says.
But it doesn't have to be this way.
Taddio's work has shown a number of relatively simple measures that can be taken to reduce the pain and fear associated with vaccinations. They include: injecting the most painful vaccine last during a series of injections; ensuring older children and adults are sitting upright; breastfeeding infants before or after the injection; and using topical anesthetics.
Taking steps to acknowledge children's pain and distracting them during injections can also be effective.
“Many people are afraid of needles and so avoid getting vaccinated, which is such an important preventative intervention,” says Professor Heather Boon, the dean of the Leslie Dan Faculty of Pharmacy.
“Dr. Taddio’s work helps us understand why that fear develops so we can take simple steps to prevent it.”
Taddio began looking at childhood and infant pain back in the 1990s and was immediately struck at how little research existed on the subject. “People laughed at me,” she recalls. “They thought it was much ado about nothing.”
When it came to infants, she recounts the prevailing thinking at the time as follows: It’s too difficult to assess pain in babies because they’re incapable of communicating; even if their nervous systems are developed enough to feel pain, they’re too small to be administered drugs without side-effects; and, regardless of how much pain they feel, it doesn’t really matter because there are no long-term consequences.
Needless to say, Taddio found such justifications wanting, particularly when it came to “invasive” procedures like circumcision.
“If you were doing something like that in an adult, there’s just no way you would just strap someone down and proceed,” she says. “So I would watch these procedures and these babies were just crying – they had so much pain they would actually stop breathing.
“I thought, ‘This is ridiculous.'’’
So Taddio, who did her PhD in pain management at U of T, began researching ways to reduce the suffering of babies undergoing circumcision and the safety of assoc