Guideline sources The following summarized guidelines for the management of pain during vaccine injections are prepared by our editorial team based on guidelines from the Help ELiminate Pain in Kids and Adults (HELPinKIDS 2015). 1 Guidelines 1. Patient education General education: educate clinicians administering vaccine injections about pain management. B 2. Preventative measures Body position: advise breastfeeding during vaccine injections in children 2 years of age. B Topical anesthetics: apply topical anesthetics before vaccine injections in patients 12 years of age. B Oral sucrose solution: provide sucrose solution before vaccine injections in patients 2 years of age. B Injection techniques: Avoid using aspiration during intramuscular vaccine injections in individuals of all ages. D Inject the most painful vaccine last (rather than first) during vaccine injections in individuals of all ages. B https://web.pathway.md/diseases/receDiJXZGz4iN5E7 1/2 6/29/23, 10:51 PM Pain during vaccine injections Pathway Clinical findings Symptoms Integument exam Fatigue Skin tenderness Fever Headache Itching Nausea Pain References 1. Taddio A, McMurtry CM, Shah V et al. Reducing pain during vaccine injections: clinical practice guideline. CMAJ. 2015 Sep 22;187 13 975 82. Open https://web.pathway.md/diseases/receDiJXZGz4iN5E7 2/2