Needle phobia influences allergy treatment choices: SLIT tablets preferred over shots!

In a recent cross-sectional survey, researchers have found that most caregivers prefer sublingual immunotherapy (SLIT) tablets over allergy shots for children with needle fear. The aim was to explore how needle phobia impacts the decision between subcutaneous immunotherapy (allergy shots) and SLIT tablets for kids suffering from hay fever with or without conjunctivitis. In the online survey, caregivers of children aged 5–17 with allergic rhinitis/conjunctivitis were recruited.

The survey, exempt from institutional review board review, described SLIT tablets as “under-the-tongue tablets”.  Approximately 34% of caregivers who participated in the survey (n = 437) mentioned that their kid had a severe fear of needles, while 47% revealed moderate fear. Among guardians, 53% had talked about allergy shots and 43% had considered SLIT tablets with their kid's physician. SLIT tablets were chosen by 84% of caretakers. On the other hand, 6% preferred injections, and 10% stated no preference.

Caregivers of kids with severe needle fear exhibited the highest preference for SLIT tablets (95%) over injections (2%). Among caretakers of kids having moderate and low fear, 85% and 60%, respectively, opted for SLIT tablets. Additionally, 93% of caregivers of kids with severe fear believed their child would prefer SLIT tablets, compared to 43% who thought their kid would accept ongoing allergy shots. A child’s needle fear was linked to their caregiver’s fear level, with the most fearful caregivers having the highest percentage of children with severe fear, as shown in Figure 1:

Caregiver responses to allergy immunotherapy (AIT) preferences based on their perception of their child's needle fear level are illustrated in Figure 2:

Most caregivers favored SLIT tablets over allergy shots, especially when their child has a strong fear of needles. Thus, incorporating a child’s needle fear into allergy treatment discussions is crucial for effective shared decision-making.