A new clinical practice guideline provides evidence-based tools to help clinicians and patients manage fear and pain during vaccine injections.
Key facts
- •The guideline updates the 2015 HELPinKids&Adults Collaborative recommendations.
- •Interventions are organized into five categories: process, procedural, physical, pharmacologic, and psychological.
- •The CARD system stands for Comfort, Ask, Relax, and Distract.
- •The updated guidance was published in the Canadian Medical Association Journal in 2026.
- •The authors intend for the tools to help health system leaders and providers improve vaccination experiences.
Researchers have released an updated clinical practice guideline aimed at reducing distress, including fear and pain, associated with vaccine injections. The guidance, published in the Canadian Medical Association Journal, updates the 2015 HELPinKids&Adults recommendations. It is intended for clinicians, vaccination service providers, and patients to help improve the vaccination experience.
The 5P Framework and CARD System
The guideline suggests interventions categorized under a 5P framework: process, procedural, physical, pharmacologic, and psychological. Authors emphasize that patients and caregivers should select the options that best suit their needs. To implement these strategies, the guideline recommends the CARD system—Comfort, Ask, Relax, and Distract—as an evidence-based tool for managing distress before and during the vaccination process.
Addressing Vaccination Confidence
Dr. Anna Taddio, of the University of Toronto and The Hospital for Sick Children, notes that the update is particularly timely given declining vaccine confidence and low vaccination rates among adults and children since the COVID-19 pandemic. The authors aim to reduce the stigma surrounding needles and encourage higher vaccination uptake by making the process more positive and comfortable.
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This article was independently rewritten by ManyPress editorial AI from reporting originally published by Medical Xpress.
