Evidence map›Paper›PMID 26201016›Full record

SynthesisThe Clinical journal of pain2015

Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults: Systematic Review and Meta-Analysis.

Vibhuti Shah, Anna Taddio, C Meghan McMurtry, Scott A Halperin, Melanie Noel, Rebecca Pillai Riddell, Christine T Chambers, HELPinKIDS Team

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Clinical journal of pain, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06312228 (The Effect of the Helper Skin Tap Technique and Buzzy® Application on the Level of Pain and Anxiety Experienced by Children During Vaccination), which is not on this map. Cited by 46 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 12 pooled it
16.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06312228 nacompletednot on this mapstarted 2023, after this paper: background citation

The Effect of the Helper Skin Tap Technique and Buzzy® Application on the Level of Pain and Anxiety Experienced by Children During Vaccination

TypeinterventionalSponsorTarsus UniversityRan2023 to 2023Enrolled96ConditionsChild, OnlyArmsHelfer Skin Tap, Buzzy
3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 12 syntheses or guidelines pooled it, 102 citations in OpenAlex.

  1. Reducing distress during vaccine injections: 2026 clinical practice guideline update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Breastfeeding for procedural pain in infants beyond the neonatal period.The Cochrane database of systematic reviews · 2016
    Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Reducing pain during vaccine injections: clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015
    Guideline
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Relative effectiveness of additive pain interventions during vaccination in infants.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017
    Trial
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Vibhuti Shah*Mount Sinai Hospital †Faculty of Medicine ‡Leslie Dan Faculty of Pharmacy, University of Toronto §The Hospital for Sick Children ‡‡Department of Psychology, York University, Toronto ∥Department of Psychology, University of Guelph, Guelph ¶Children's Health Research Institute, London #Department of Paediatrics, Western University, London, ON **Departments of Pediatrics and Microbiology and Immunology, IWK Health Centre, Dalhousie University §§Department of Pediatrics and Psychology, Faculty of Science, IWK Health Centre, Dalhousie University, Halifax, NS, Canada ††Department of Psychology, University of Calgary, AB, Canada.
Anna Taddio
C Meghan McMurtry
Scott A Halperin
Melanie Noel
Rebecca Pillai Riddell
Christine T Chambers
HELPinKIDS Team
Faculty (United Kingdom) · GB3M (United States) · USChildren’s Health Research Institute · CAHospital for Sick Children · CAUniversity of Toronto · CA

Funding

Canadian Institutes of Health Research KRS 132031
6 · The paper itself

Abstract

backgroundThis systematic review assessed the effectiveness and safety of pharmacotherapy and combined interventions for reducing vaccine injection pain in individuals across the lifespan. DESIGN/

methodsElectronic databases were searched for relevant randomized and quasi-randomized controlled trials. Self-reported pain and fear as well as observer-rated distress were critically important outcomes. Data were combined using standardized mean difference (SMD) or relative risk with 95% confidence intervals (CI).

resultsFifty-five studies that examined breastfeeding (which combines sweet-tasting solution, holding, and sucking), topical anesthetics, sweet-tasting solutions (sucrose, glucose), vapocoolants, oral analgesics, and combination of 2 versus 1 intervention were included. The following results report findings of analyses of critical outcomes with the largest number of participants. Compared with control, acute distress was lower for infants breastfed: (1) during vaccination (n=792): SMD -1.78 (CI, -2.35, -1.22) and (2) before vaccination (n=100): SMD -1.43 (CI, -2.14, -0.72). Compared with control/placebo, topical anesthetics showed benefit on acute distress in children (n=1424): SMD -0.91 (CI, -1.36, -0.47) and self-reported pain in adults (n=60): SMD -0.85 (CI, -1.38, -0.32). Acute and recovery distress was lower for children who received sucrose (n=2071): SMD -0.76 (CI, -1.19, -0.34) or glucose (n=818): SMD -0.69 (CI, -1.03, -0.35) compared with placebo/no treatment. Vapocoolants reduced acute pain in adults [(n=185), SMD -0.78 (CI, -1.08, -0.48)] but not children. Evidence from other needle procedures showed no benefit of acetaminophen or ibuprofen. The administration of topical anesthetics before and breastfeeding during vaccine injections showed mixed results when compared with topical anesthetics alone. There were no additive benefits of combining glucose and non-nutritive sucking (pacifier) compared with glucose or non-nutritive sucking (pacifier) alone or breastfeeding and sucrose compared with breastfeeding or sucrose alone.

conclusionsBreastfeeding, topical anesthetics, sweet-tasting solutions, and combination of topical anesthetics and breastfeeding demonstrated evidence of benefit for reducing vaccine injection pain in infants and children. In adults, limited data demonstrate some benefit of topical anesthetics and vapocoolants.

Indexed as

PainAdultAnalgesicsChildHumansInjectionsNeedlesPain ManagementVaccinationAnalgesics

Identifiers

PMID26201016
PMCPMC4900424
OpenAlexW1020151862

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.