iated drugs. Then something unexpected happened while she was working on a study that looked at topical anesthetics and children receiving vaccines. She found, to her surprise, boys often had a higher pain score than girls, which, initially, made little sense.
“We later had this a-ha moment which was: Their experience with pain is different because boys are more likely to have been circumcised than girls,” she says.
The finding was bolstered by looking at the differences in pain scores between circumcised and uncircumcised boys in the same study, and another longer-term study that tracked boys who had been given an anesthetic during circumcision and those who hadn’t.
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Taddio continued her research in a similar vein until 2007, when she decided to do a survey on vaccinations in Greater Toronto to see how her work and that of fellow pain researchers had influenced clinical practice.
That’s when Taddio decided to add translational research to her fundamental research. She assembled an interdisciplinary team of clinicians, scientists and policy-makers from across Canada to promote better pain care during vaccine injections. They called the initiative Help ELiminate Pain in Kids, or HELPinKids for short. “I thought it would be a good gateway to talking about pain,” she says.
The HELPinKids team published its first clinical practice guideline on reducing vaccine injection pain in 2010 in the Canadian Medical Association Journal. In 2015, they published an updated and expanded guideline in the same journal. Taddio was also invited to Geneva the same year to present at the WHO, which later adopted about half of the recommendations (some, like the use of topical anesthetics, aren’t applicable in developing countries because of the high costs).
Taddio stresses that her research, and the global vaccine guidelines that ultimately sprung from it, were heavily reliant on public funding. “I primarily depended on CIHR because I couldn’t have the work associated with any conflicts of interest,” she says. “That was really important for the guideline panel, who are all working with governments.”
Even so, she says it remains difficult to get funding as a pain researcher, a field that she describes as relatively un-sexy.
“What I achieved with the money I received is actually amazing,” she says, adding that the full adoption of the Naylor report’s 35 recommendations would likely make it easier to attain funding.
The problem of pain and vaccinations is hardly fixed. Despite her research, Taddio says health-care delivery has been slow to change and pain management is still not optimally incorporated into medical procedures – a point that was hammered home when staff at a local hospital politely refused to give her needle-wary son a topical anesthetic before administering an injection.
“People were telling me not to use it because it didn’t work and I was like, ‘Uh, no. I will show you the paper.’”
Anna Taddio is creating tools that can be used to help children deal more effectively with pain during vaccination campaigns in schools (photo by Chris Sorensen)
With the guidelines now in place, Taddio intends to continue with her pain research and find ways to generate further awareness. She’s now focusing on vaccination programs in schools, which represent many children’s first interaction with the health-care system without the assistance of their parents.
One strategy involves creating an easy-to-remember acronym to remind children their options when it comes to vaccination. For example, they might request being vaccinated in private rather than in front of peers, or they might bring a video game or smartphone into the vaccination room to serve as a distraction.
“In the past, we’ve burdened the health-care provider with everything,” says Taddio. “But I think it’s better to show the kids and then they can choose how to best cope.”
In the end, Taddio says it’s all about medical community acknowledging the existence of pain and working with pa