It was in the neonatal intensive care unit at Toronto’s SickKids Hospital in the late 1990s that Anna Taddio witnessed the consequences of infant pain first-hand.
The University of Toronto childhood pain researcher says newborns would frequently start crying as soon as nurses approached their incubators – particularly those who had been in the unit for an extended period.
“It’s almost like they anticipated something bad was going to happen,” says Taddio, a senior associate scientist at SickKids and a professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy.
“And that’s probably because you were about to do something unpleasant – you didn’t go in there just to cuddle them.”
The observation was later affirmed by a 2002 paper, one of nearly 200 Taddio has authored over two decades, that showed babies pricked with multiple needles within the first several hours of being born reacted much more strongly to a standard screening test that involved drawing blood. Other research showed that negative health care experiences early in a child's life – involving needles or other painful procedures – could haunt them as they grew older.
Making needles and vaccinations more tolerable became a focus of Taddio’s ground-breaking pain research, the vast majority of which was funded by the Canadian Institutes of Health Research, or CIHR. Both are critical preventative medicine tools and represent most people’s first interaction with the health-care system, helping to shape long-term attitudes about it in the process.
Taddio's work is already having a big impact. In 2015, vaccine-administering recommendations developed by her team were written into Canadian clinical practice guidelines. Several were also adopted the same year by the World Health Organization.
It's yet another example how investing in fundamental research can dramatically improve the lives of Canadians and others around the world. Moreover, Taddio's research underscores the importance of adopting the recommendations of Canada’s Fundamental Science Review, 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, Taddi