Like hearing fingernails on a chalkboard. Feeling lightheaded if you stand up too fast. Having "lizard brain" take over, triggering almost overwhelming fight-or-flight instincts. That's how Eryn O'Neil of St. Paul describes the acute discomfort that has accompanied her lifelong fear of needles. Nevertheless, the 36-year-old software engineer and mother of a toddler isn't backing away from the COVID-19 vaccine. The greater good of ending the pandemic is far more important, she said, than the temporary but very real distress that comes with the shot.

"I'm getting it. There's no question whatsoever," O'Neil said, even as she recounted past coping strategies — among them, bringing an understanding friend willing to endure a crushing handhold during an injection.

As the campaign to vaccinate the nation continues, its success hinges in part on overcoming a fear that O'Neil shares with many others — needle phobia. The official term for extreme fear is "trypanophobia." The feelings it triggers can range from procrastination to panic over everyday medical procedures such as immunizations or getting an IV.

This is a public health problem even when there's not a pandemic. "Avoidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities, and 8% of healthcare workers at hospitals," concluded a 2018 article in the Journal of Advanced Nursing.

Overcoming this common reason for vaccine hesitancy is especially critical in the battle to control COVID-19. Vaccinating virtually everyone as quickly as possible is the key to stopping the virus from circulating and mutating into more dangerous strains. Needlephobes can't sit this out, which is why the Star Tribune Editorial Board has chosen to address this issue in its ongoing "Our Best Shot" series.

Talking about our fears and knowing that others are battling them, too, can be helpful. To those who find shots scary, you have a lot of company. Twin Cities teacher Mark Westpfahl recently shared his needle fears in a video posted on Twitter. Accompanying Westpfahl to his appointment: Walnut, a stuffed toy bear brought for moral support.

Shannon Watson of St. Paul has an intense, lifelong fear of finger pricks and vaccinations. She delayed getting a booster shot required to attend graduate school until the last possible moment. But when a COVID vaccine appointment recently became available in Brainerd, she drove there, bravely stood in line even as she worried she might faint, then marveled at how quickly the appointment was over. She got a little "woozy" when she took off the small bandage later but was glad to do her part to conquer COVID.

As a veteran medical provider and president of the Minnesota Academy of Family Physicians, Dr. Andrew Slattengren has cared for many patients with needle phobia. He advises those with concerns to share their fear with their doctors or whoever is administering the shot. Fearful patients will get help, not comments to toughen up. "This shouldn't be something people feel embarrassed about," said Slattengren, who also shared his expertise in video accompanying this editorial (also available at

Sometimes acknowledging fear or addressing other concerns, such as potential vaccine side effects, are all that a patient needs. But others need additional strategies. Among the measures that can help:

• Distraction. Bring a smartphone and earbuds and play a favorite song or TikTok video during the vaccination. A slightly different approach involves the Buzzy bee, an award-winning medical device that yes, looks like a bee, and uses ice and vibration to help block injection pain. Clinics may have them on hand for kids, but the device can help adults, too.

• Deep breathing. Inhaling and exhaling in a measured manner (which can be guided by smartphone and watch apps) can keep fear at bay.

• Enlist a buddy. Medical providers understand that hand-holding is helpful and that a familiar voice is soothing.

• Medication and therapy. For those still struggling with fear, a doctor may be willing to prescribe a low-dose anti-anxiety drug to help. Or, use a topical anesthetic at the injection site. Working with a therapist is another option for those who have struggled with this over a lifetime.

"If you have a needle fear, or any other reason to be vaccine-hesitant, talk to your primary care provider," Slattengren said, "and work through it so you can do what you need to do to stay healthy."


The faster we vaccinate, the faster the COVID-19 pandemic ends. But the speed with which the shots were developed has led to understandable questions. The Editorial Board's #OurBestShot series enlists Minnesota health and community leaders to deliver timely, trustworthy answers.

Here's a collection of articles, videos and other resources presented so far:

Editorial: The big risk is in not getting vaccinated (March 28).

Video: Dr. Greg Poland of the Mayo Clinic discusses the potential side effects of the vaccines, and explains why the risks and impacts are low.

Editorial: Communities of color face unique vaccination fears (April 4).

Video: M Health Fairview, in a conversation with leaders of Black, Indigenous, and People of Color (BIPOC) communities in the Twin Cities, addresses questions and concerns about the vaccines.

Frequently asked questions: A report from the Sahan Journal, a trusted St. Paul-based source of news and information for migrant and immigrant communities, provides and wealth of vaccine information while also dispelling rumors that the shots contain pork or other products not considered halal.

The Star Tribune Editorial Board operates independently of the newsroom and is not involved in setting newsroom policies or in reporting or editing articles in other sections of the newspaper or