Pfizer-BioNTech COVID-19 vaccine vials sit on a table at a vaccination clinic at the Shepherd Union Atrium at Weber State University in Ogden. Studies show up to 30% of adults have a fear of needles and that fear is one reason for COVID-19 vaccine hesitancy in many people. (Scott G Winterton, Deseret News)

PROVO — Britta Adams can't remember a time when she wasn't afraid of needles. Her earliest memories of going to the doctor involve running from nurses and hiding under chairs and tables.

So when she heard that a COVID-19 vaccine was being developed, she immediately started preparing. Over a year later, she got her shot and almost fainted.

When the time came for the Provo resident to get her vaccine, she chose the Johnson & Johnson vaccine so she would only have to get one shot. She and her husband, Sam, entered the old Provo High building that was serving as a vaccination site, trying to avoid looking at the other people getting their shots. Her knees and legs shook, and she could feel her heart rate increasing.

This reaction isn't entirely uncommon, as Adams has generalized anxiety disorder, but it's particularly bad with needles.

After filling out the paperwork, she was called back to get the vaccine. The nurse told a joke as she stuck Adams's arm.

"I remember the needle going in. That didn't hurt. I did feel it, but it didn't hurt. The needle went in and out, and I was fine," she said.

But for her, the fear and anxiety really hits after the shot. As her husband was being vaccinated, she felt light-headed and her vision became cloudy. She asked the nurse if she could go lie down, and the nurse quickly agreed when she saw how pale Adams was.

Adams went over to a staircase and laid flat so she wouldn't pass out, removing her mask, even though she was and is so vigilant about masking, so she could breathe until the anxiety would pass. Eventually she felt better and better and was able to leave.

According to a study by the University of Michigan, 20% to 30% of adults have a fear of needles, from mild anxiety to a strong phobia, also known as trypanophobia. Symptoms for this condition can include shaking, dizziness, fainting, panic attacks, insomnia, high blood pressure, anxiety, elevated heart rate and quickened breath.

In severe cases, people have even refused life-changing surgeries or procedures because of their phobia of needles.

Although the problem is fairly common, trypanophobia is not always included in COVID-19 resources. There are no official state or federal online resources relating to trypanophobia and vaccination. Immunize.utah.gov only has training for how to comfort children who are afraid of needles during vaccinations, not adults. Coronavirus.utah.gov tells patients to talk to their health care provider to be directed to resources for needle fear.

During a Poynter webinar in December about COVID-19 journalism coverage, a nurse said that the constant media coverage with images of needles and shots might actually discourage people from getting the vaccination. And, now that COVID-19 vaccinations are available to everyone, Adams says people like her are presented with a difficult choice — face their fear that literally paralyzes them, or risk being unvaccinated and spreading COVID-19 to their vulnerable family members.

People, especially doctors and nurses, don't always understand how terrifying needles can be. Adams compared her fear to the amount of fear the average person might feel if they were to have to cross a street with incoming traffic and said the fear can put your brain in crisis mode, freezing your ability to make a decision.

It took her five or six years to decide to get a Gardasil vaccination — when she realized that she didn't want important choices about her health to be dictated by fear.

Adams knows that with generalized anxiety disorder, the fear will always be there. Instead, she has to make a choice she can live with. And, in this case, that was being vaccinated.

"This is important to me and even though the needle part is hard and scary, it's worth it," she said. And she tries to convey to doctors and nurses, up front, that she might faint or have an anxious reaction, so they are prepared.

"This pandemic, to me, it was a big enough deal. Not only to protect myself, but also to protect people around me. I wanted to do my part protecting my community. It was absolutely terrifying for me in ways I can't describe. I don't think I can over-exaggerate the amount of fear I feel. But the pandemic is serious enough for me to make a brave decision."

Adams also explained that there is shame and stigma surrounding the fear of needles, especially when it comes to the COVID-19 vaccine and that it tends to be oversimplified. She doesn't want to say "if I can do it, you can do it," because there are people who probably want to get the vaccine and don't dismiss the science, but have a more severe fear of needles than even she does.

"I can understand why the judgment is happening. The pandemic has really been made into a moral issues, and to a certain extent that is understandable, but in this instance maybe it's been taken too far. It's very black and white when there needs to be more gray," she said.

"At the same time, I do think there's a difference between staying frozen and sitting with the fear, giving it a chance to speak, talking back to it and working with the fear to make a decision rather than just avoiding the decision."

According to Edward-Elmhurst Health, people with trypanophobia, who want to receive the COVID-19 vaccination, can seek professional help from therapists, ask about medication that can help with anxiety, practice deep breathing exercises and focus on the positive outcome and potential benefits of the vaccine to get through it.

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