Regarding the ID Snapshot column in the April AAP News “How to reduce pain at the time of vaccination” I was taken aback by the space allotted to use the eutectic mixture of local anesthetics (EMLA) or 4% lidocaine topical application to reduce pain from immunizations. The time needed for such application to be effective, as well as office space and staff availability, makes such suggestion impractical in the typical primary care pediatric office.
In our office, we use a “shot blocker,” a low-tech plastic device that “prickles” the skin and dulls pain. With older children, the time-honored technique of “blowing out the candles” works like a charm.
We have not had a single after-hours call regarding fever or pain in years. There really is no credible evidence that immunogenicity of vaccines is reduced.
Stuart Trust, D.O., FAAP