TORONTO -- While many Canadians have been able to breathe a sigh of relief over the COVID-19 vaccine, there are some people who look at the shot with a sense of impending doom.

Those with needle phobias, one of the more common phobias people tend to have, are being exposed to images and depictions of needles more than ever. And while it may be a comfort to know you’re not alone, being faced with having to get the COVID-19 vaccine may still cause deep anxiety for some.

“One of the most common forms of anxiety disorder is called simple phobia, which would include things like fear of heights, fear of mice, fear of needles,” Mark Berber, assistant professor in psychiatry at the University of Toronto, told in a phone interview.

There are different ways of treating fears and phobias, through cognitive behavioural therapy, and most often, exposure therapy. That might involve looking at pictures of needles, and eventually handling the syringe in your hand, for example.

With vaccine selfies all over social media, most people have had more than enough of their share of exposure therapy, but it’s missing one important piece of the puzzle.

“Good exposure therapy is voluntary,” Melanie Badali, registered psychologist and board director with Anxiety Canada, told in a phone interview on Friday.

The sort of exposure therapy we are faced with by the onslaught of vaccine selfies on social media isn’t voluntary, but experts say it’s important to learn to deal with these fears to help stop the global pandemic.

“Anxiety and needle fear can keep people from getting vaccinations,” she said.

“One of the big things that we see with specific phobias like needle or injection phobias, and in anxiety disorders in general, is avoidance... And so people are afraid of something, they avoid it, and then they don't get the opportunity to learn that it wasn't as dangerous or threatening as they thought, or they don't get the chance to learn.”

She said that for those who are finding themselves looking away or cringing at the sight of vaccine selfies, this might be a good opportunity to explore what is behind the feeling and ways to handle it.


These fears can stem from different areas. Some people are afraid of the pain, others are concerned about side effects, some are worried that they will faint when they get a needle.

“When it comes to the development of phobias. We must think about two things, nature and nurture,” said Berber. “Nurture would be the experience that you've had, a bad experience, the can predispose to later having a phobia. The other thing is, nature, which some people are just more genetically predisposed to being anxious. That has a biological explanation.”

When trying to overcome your phobia, a good place to start is with Anxiety Canada’s MindShift CBT app, said Badali. People with any fears or phobias can use the app to build what’s called a fear ladder, where you rank different situations on a scale from one to 10 from least scariest, to scariest.

They also have an applied tension technique to help people who are worried about fainting.

People with needle phobia can overcome their fears, or at least learn how to handle them in a way that makes injections feel less terrifying.

Judith Law’s daughter developed a fear of needles when she was 7-years-old. Now, at 17, they may not be her favourite activity, but the sense of doom and sleepless nights before a needle are gone. She uses a few different techniques to get through it.

“She likes listening to music on her phone, if they let her or she plays with her phone,” Law told in a phone interview on Friday.

Distraction helps keep her mind off of what is about to happen. Even talking with someone as they prepare the injection helps ease her anxiety. She also likes to reward herself for getting the injection.

“It can be something really small like, go to Starbucks,” said Law. “And when she was little, I used to, as a mom, bribe her, so I would say ‘okay after this we can go get an ice cream.’”

Law, who is the CEO of Anxiety Canada, said that CBT and fear ladders helped get her daughter through her phobias when bribes of ice cream stopped working.

“She had cognitive behavioral therapy, and the therapist worked on a fear ladder with her. And so it started with a picture of a needle, just a picture,” she said.

And up the ladder the needle related situations got scarier and scarier and she worked her way through each one.

“And then eventually, she had pencils, and she was asked to, as homework, to pretend the pencil was a needle, and to tap the spots where she would be injected,” said Law. “It's really quite an amazing process.”

Now, her daughter registered online for the vaccine herself without having to be prompted and without the anxiety response she once would’ve had.

“She said, ‘I'm just going to do it and get it over with, and I'm going to use the strategies.’”

Using social media as exposure therapy might seem like a good rung on your fear ladder, but Berber said it depends on the picture.

“If the needle is in the arm and the person having the shot is smiling a big smile and the emoji is a smiley face, and the comment is that it didn’t hurt at all, that that would send a very positive message,” he said.

But photos of people wincing as they get the needle can cause more anxiety by making the shot seem painful.

“Seeing negative images plant the seed whereby a person thinks it is going to be a much more unpleasant experience,” he added.

Take it from him, he said, the needle is painless: “Less than a scratch.”

But even as vaccination efforts across the country ramp up, all of the waiting can also make people more anxious.

“There is a concept called awfulizing, or another person has used the term catastrophizing, if time is prolonged before the injection occurs, some people have more time to exaggerate the negative things that can happen,” Berber said.

While the waiting isn’t ideal, it can give you more time to work through your fears and try new techniques. But the best thing you can do for your fear, is to get the vaccine.

“Taking action and not avoiding it is really the crux of overcoming it,” said Law.

And if it all feels like it’s just too much to handle, that’s probably your anxiety speaking.

“Sometimes our anxiety convinces us that we can't handle things, and the reality is, we often can,” said Badali.