Pain management strategies used during early childhood immunisation in Victoria


  • Conflict of interest: The authors declare no conflicts of interests associated with the conduct of this study or the paper.
  • Work carried out from: Royal Children's Hospital, Victoria, Australia.
  • NB. First author (Corresponding author) resided in Victoria, Australia where project was designed, planned and carried out. She now resides in Ontario, Canada, where the analysis was conducted.

Correspondence: Dr Denise Harrison, Children's Hospital of Eastern Ontario and University of Ottawa, 3rd Floor, RGN Building, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada. Fax: +1 613 737 6504; email:



The study aims to identify pain management practices used during scheduled childhood immunisation.


A survey of members of the Australian Nurses Federation (Victorian Branch) Immunisation Nurses Special Interest Group. Questions included frequency of use of pain reduction strategies during immunisations for infants, toddlers and children, injection techniques and existence of an articulated pain management policy.


The survey was emailed to 274 Immunisation Nurses Special Interest Group members with registered email addresses, and 125 (46%) completed the survey. Nineteen respondents (15.2%) stated their main place of employment had a pain management policy during immunisations and 20 (16.0%) respondents were not sure. Distraction strategies were frequently used during immunisation for all age groups, with 95 (76.0%) replying that distraction was used often or always. Breastfeeding during immunisation for infants younger than 6 months was used occasionally (n = 54, 44.6%), often (n = 11, 9.1%) or never (n = 55, 45.5%) and was used even less frequently for infants aged 6–12 months. Sucrose or other sweet solutions were almost never used for infants prior to, or during, immunisation. As a reward, lollies were frequently given to children after immunisations. Topical anaesthetics were almost never used in any age groups. Over half the respondents used a rapid injection technique; 55 (44.7%) used a slow technique and four respondents aspirated the needle before injections.


Many distraction strategies were used during and following immunisation but sweet solutions, breastfeeding or topical anaesthetics were rarely used. Use of these strategies where feasible, should be facilitated in diverse settings where immunisations take place.