Peds Pfizer vaccine

[phamlife]

I wanted to get other health care professionals opinion on this.

Our pharmacy has received peds pfizer vaccine and began giving them last week.

Yesterday, a child and her mom came to the pharmacy to get the vaccine. She was 7. For nearly 15 minutes, the child was fighting with her mom refusing to get the shot. Kicking, screaming and throwing her arms around. Clearly, it was not safe for me to give the vaccine so I explained to the mom that it would be better if she goes to her pediatrician or someone/somewhere whos more fit to handle the situation better. Mom got furious and refused to leave until her child got vaccinated. Long story short, the mom ended up forcefully bear hugging the child long enough for me to inject.

Here is my problem. I think this is child abuse.

I specifically states that it is unsafe for the child and myself for me to attempt to vaccinate her yet the mom just didnt listen. She got upset and asked for the manager and i told her i am the manager. She was speechless and kept on trying to physically restrain the child. We are located in a large clinic and the entire clinic heard this debacle.

Has anyone experienced this type of craziness at your pharmacy? How was it handled?

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[WorthlessOxygen]

Not doing peds Pfizer at my pharmacy but we've been doing flu shots for 3+ for years now. Most are reasonably cooperative but I've had a few where I needed to get the parent to hold them. I've also found a few in the 5-8 range that do significantly better when they're allowed to sit by themselves. I usually distract them by having them try to read something out loud to me and/or just ask them random questions about how school is going or whatever.

CDC does have some tips for holdingkids here.

How to Hold Your Child During Vaccinations

Steps to support your child and make the vaccination process less stressful.

www.cdc.gov

I get why you'd want to refer to the pediatrician but I'm not sure what they would do differently.

I can obviously see your safety cconcerns but child abuse seems pretty hyperbolic to me.

 

[phamlife]

Not doing peds Pfizer at my pharmacy but we've been doing flu shots for 3+ for years now. Most are reasonably cooperative but I've had a few where I needed to get the parent to hold them. I've also found a few in the 5-8 range that do significantly better when they're allowed to sit by themselves. I usually distract them by having them try to read something out loud to me and/or just ask them random questions about how school is going or whatever.

CDC does have some tips for holdingkids here.

How to Hold Your Child During Vaccinations

Steps to support your child and make the vaccination process less stressful.

www.cdc.gov

I get why you'd want to refer to the pediatrician but I'm not sure what they would do differently.

I can obviously see your safety cconcerns but child abuse seems pretty hyperbolic to me.

Holding the kid with reasonable amount of force is understandable. Children are obviously afraid of getting shots so they’ll react accordingly. This was not that. The kid was beyond being reasonably scared. She was using all of her strength to resist. It was very painful to watch her mom physically restraining the kid. I know this may sound too extreme but it was almost like a movie scene where a girl was resisting rape. It was that extreme. And the mom just did not care and was determined to get her the shot.

Safety was my primary concern but I genuinely felt sick to my stomach watching this unfold before my eyes. It was very uncomfortable.

 

[WVUPharm2007]

Sounds like a fantastic parent to me. You're getting that vaccine whether you like it or not, brat. Eliminate another infection vector from society before it's too late.

 

[owlegrad]

FWIW, I think you did the right thing giving the vaccine. Sounds like a tough situation.

 

[Seriously Serious]

Yes, has been happening a lot lately. Can actually be pretty traumatizing to some, not gonna lie. As a manager, I would think you have the right to turn them away if they are making too much of a scene. Customers definitely do not want to be around that, plus you risk causing harm to the child if they keep flailing their arms.

Just more fun for us to look forward to as pharmacists, aka not publicly accepted frontline workers/healthcare professionals.

 

[VA Hopeful Dr]

Welcome to giving vaccines to kids. Not uncommon to take 2 people to hold them down. I bear-hugged both my kids earlier today to get them vaccinated. It's OK.

It's not child abuse. You get used to it.

Great job getting that kid vaccinated, seriously you pharmacists have absolutely kicked ass getting people their COVID vaccines. Keep up the good work!

 

[phamlife]

Welcome to giving vaccines to kids. Not uncommon to take 2 people to hold them down. I bear-hugged both my kids earlier today to get them vaccinated. It's OK.

It's not child abuse. You get used to it.

Great job getting that kid vaccinated, seriously you pharmacists have absolutely kicked ass getting people their COVID vaccines. Keep up the good work!

Were your kids actively resisting while you bearhugged them?

I know some kids could calm down or stay still while theyre being hugged by parents which would be fine but once that arm starts swinging, wouldnt you be worried that there could be accidental needle stick?

Ive heard horror stories about sticking needle in the neck and face. ☹️

Not sure what the exact definition of child abuse is but if the parent is forcefully placing the child in a high risk situation, i would think it is considered child abuse. I.e. accidental needle stick.

 

[pencilandpen]

and what do you think happens at the pediatrician office? someone bear hugs the child and give them the vaccine, except now it happens at the pharmacy

 

[BC_89]

If it helps - I've been doing the immunizations and scheduling for all patients at my current site. When the approval for the peds pfizer vaccine went through I reached out to see how the pharmacy wanted to handle it. They simply told me to turn anyone away asking for their kids getting vaccinated. They did admit it'd been a hot minute since they had attempted to try and give any vaccines to kids.

Of course, Bi-Mart got bought out and this particular pharmacy took on all of their customers over a span of 2 days so I'm sure delegation and being short staffed played a huge role in the decision as well.

 

[RxPreceptor]

Never had something so extreme with vaccinating a child. Use the parents strategically to hold, stabilize, distract, and restrain child if necessary. I respect your decision if you still feel uncomfortable/it is too dangerous to vaccinate said child (needle sticks are all too real); I think the parent needs to be understanding of your concerns as well rather than force things without control.

My gripe still being, yeah, try doing this in a timely manner while your techs hunt your down for DURs, counseling, verifying, etc. out in an open environment during rush hour with phones ringing off the hook.

If you are lucky enough to have a separate room for vaccine/clinic room; reserve use for children (temper tantrums). Just more reason RPh are quitting left and right....no salary increases for the never ending slew of services and responsibilities thrown onto us without additional resources.

I don't like vaccinating 4 year olds regularly, nonetheless, I feel strangely satisfied after the fact simply because of the degree of difficulty and skill required.

 

[phamlife]

and what do you think happens at the pediatrician office? someone bear hugs the child and give them the vaccine, except now it happens at the pharmacy

I would think pediatricians are trained to handle this type of situation better? I mean im sure they spent way more time during their residency years learning about child psychology/behavior? Have a private room and nursing staff to help? Know the child and the parents better which would help in communicating with them? I know some places have toys to distract them.

 

[VA Hopeful Dr]

Were your kids actively resisting while you bearhugged them?

I know some kids could calm down or stay still while theyre being hugged by parents which would be fine but once that arm starts swinging, wouldnt you be worried that there could be accidental needle stick?

Ive heard horror stories about sticking needle in the neck and face. ☹️

Not sure what the exact definition of child abuse is but if the parent is forcefully placing the child in a high risk situation, i would think it is considered child abuse. I.e. accidental needle stick.

One was, one wasn't. I will say that often times parents aren't willing to restrain their kids sufficiently. I'm a family doctor and so deal with similar problems from time to time. So when I retrain my kids I make sure its good enough so whatever is being done to them can be done safely.

Seriously, drop the child abuse thing. Getting your kids vaccinated, even if they resist, is not anything approaching child abuse.

I would think pediatricians are trained to handle this type of situation better? I mean im sure they spent way more time during their residency years learning about child psychology/behavior? Have a private room and nursing staff to help? Know the child and the parents better which would help in communicating with them? I know some places have toys to distract them.

Very few doctors personally vaccinate their peds patients. We don't want them to associate us with shots so our nurses do it. Those nurses do have some techniques they use to settle the kids out while they get everything ready but its mainly different ways of distracting the kids so they're reasonably calm right before the injection. But it doesn't always worse. Then, to quote Downton Abbey "When reason fails, try force".

Kids need vaccines, you do what you have to.

 

[phamlife]

One was, one wasn't. I will say that often times parents aren't willing to restrain their kids sufficiently. I'm a family doctor and so deal with similar problems from time to time. So when I retrain my kids I make sure its good enough so whatever is being done to them can be done safely.

Seriously, drop the child abuse thing. Getting your kids vaccinated, even if they resist, is not anything approaching child abuse.


Very few doctors personally vaccinate their peds patients. We don't want them to associate us with shots so our nurses do it. Those nurses do have some techniques they use to settle the kids out while they get everything ready but its mainly different ways of distracting the kids so they're reasonably calm right before the injection. But it doesn't always worse. Then, to quote Downton Abbey "When reason fails, try force".

Kids need vaccines, you do what you have to.

Again, i am not saying vaccinating a resisting child is child abuse. How we go about doing it and risking the child’s safety may be. If I, as the immunizer, do not feel safe for the child then I should have every right to refuse to vaccinate for the child’s sake. If the parent further pursues fully knowing the unsafe situation and the potential harm it can cause, I would have a serious problem with that.

Also, it wasnt just the physical restraint and chaos that ensued that bothered me, it was the way her mom was acting. When I told her it would be better for us to either wait and come back later or potentially seek out other health care professionals or facilities, she became furious and demanded that I vaccinate her child. She became a karen and asked for the manager. This type of behavior shows how terrible of a parent she is.

 

[VA Hopeful Dr]

Again, i am not saying vaccinating a resisting child is child abuse. How we go about doing it and risking the child’s safety may be. If I, as the immunizer, do not feel safe for the child then I should have every right to refuse to vaccinate for the child’s sake. If the parent further pursues fully knowing the unsafe situation and the potential harm it can cause, I would have a serious problem with that.

Also, it wasnt just the physical restraint and chaos that ensued that bothered me, it was the way her mom was acting. When I told her it would be better for us to either wait and come back later or potentially seek out other health care professionals or facilities, she became furious and demanded that I vaccinate her child. She became a karen and asked for the manager. This type of behavior shows how terrible of a parent she is.

You absolutely can refuse to do something you don't feel comfortable with. No argument there.

Wanting to get her child vaccinated, even in the face of behavior like that, does not make her a terrible parent. You can make the argument that she's not a very nice person, but barring extreme behavior a single incident does not give you enough insight to make judgment on someone's parenting abilities.

You getting way too into this. You did not feel safe vaccinating the kid, you refused. The mom threw a tantrum. That should have been the end of it. It's not child abuse, she's not necessarily a bad parent.

 

[Seriously Serious]

Welcome to giving vaccines to kids. Not uncommon to take 2 people to hold them down. I bear-hugged both my kids earlier today to get them vaccinated. It's OK.

It's not child abuse. You get used to it.

Great job getting that kid vaccinated, seriously you pharmacists have absolutely kicked ass getting people their COVID vaccines. Keep up the good work!

It's definitely something that's new to our profession (for the most part - we've been giving seasonal pediatric flu shots). But something providers fail to realize is this is assembly line-type work. We are looking at doing easily 20-60 doses PER DAY, EVERYDAY. This is on top of SIMULTANEOUSLY dealing with angry Karen's bc they have to wait 10 min for their medicines to be filled on top of providers/patients waiting on the phone with orders/questions. This is not a controlled environment where a patient is allotted 30 min for an office visit.

This is a stressful situation building on an already fast-paced stressful environment. It would be manageable stress if we were staffed appropriately.

 

[VA Hopeful Dr]

It's definitely something that's new to our profession (for the most part - we've been giving seasonal pediatric flu shots). But something providers fail to realize is this is assembly line-type work. We are looking at doing easily 20-60 doses PER DAY, EVERYDAY. This is on top of SIMULTANEOUSLY dealing with angry Karen's bc they have to wait 10 min for their medicines to be filled on top of providers/patients waiting on the phone with orders/questions. This is not a controlled environment where a patient is allotted 30 min for an office visit.

This is a stressful situation building on an already fast-paced stressful environment. It would be manageable stress if we were staffed appropriately.

Absolutely, and if you don't want to deal with kids fighting I will support that 100%.

 

[owlegrad]

If I, as the immunizer, do not feel safe for the child then I should have every right to refuse to vaccinate for the child’s sake.

Is anyone saying you don’t have the right to refuse? The mother can’t make you do anything. Sounds to me like what you really want is the mother to be understanding, which of course would be nice but it’s hardly rare to deal with an unreasonable person.

 

[phamlife]

Is anyone saying you don’t have the right to refuse? The mother can’t make you do anything. Sounds to me like what you really want is the mother to be understanding, which of course would be nice but it’s hardly rare to deal with an unreasonable person.

Not necessarily. Like I said, the mom sounded like a terrible person to be around. I just felt bad for the kids which is why I ended up injecting so I can get the mom out of the pharmacy. Didnt really care for the mom. The entire time I was feeling very uncomfortable with how she was screaming and complaining at me, the child and my staff. I knew she was one of those that just didnt care about others and wants to get what she wants because she feels she’s entitled to it. I was done as soon as she said, “i am a nurse”. In my mind i was like, “b**** so what?”

My primary concern was for the kid and how I felt like this whole situation was just wrong. Hence child abuse. Apparently, according to above posts, aggressively controlling a child is normal? My parents never did that with me nor have I ever witnessed any parent in real life do what she did so maybe I just didnt know this part of life. Maybe it was one if those things where you had to be there to understand what exactly i am talking about.

 

[owlegrad]

I mean if you REALLY think it was child abuse why did you choose to participate? You contributed to child abuse just to get rid of the mother? If I saw child abuse I like to think I would call 911 or at least child protective services.

 

[phamlife]

I mean if you REALLY think it was child abuse why did you choose to participate? You contributed to child abuse just to get rid of the mother? If I saw child abuse I like to think I would call 911 or at least child protective services.

I gave the injection when there was a couple seconds of calmness. I think the kid just got physical tired from all the kicking and screaming while the mom was bearhugging the crap out of her for what felt like an eternity.

I never said vaccinating the child is child abuse. I felt that her mom was wrong to physically handle the child so aggressively to a point where me and my staff felt uncomfortable and kept on insisting that we inject her even after i had informed her that it would be unsafe for the child and myself if she keeps on moving.

Maybe I shouldve called 911 or child protective services. But then again there will be some people saying i am overreacting and that moms manhandling her child to get vaccinated is normal. Haha.

I am going to put up a sign that says if the child requires physical restraint, we will not vaccinate.

 

[confettiflyer]

Holding kids down for any injection or lab draw procedure is pretty par for the course. I’ve seen 3-4 phlebotomists hold down a kid before and struggle, same for XYZ vaccine. At least all you need is a split second clear shot for the IM shot.

This is why lots of providers come in from behind the peds patient so the kid doesn’t have time to react while you fiddle with the syringe out of view.

But OP - I wasn’t there. If you had other abuse concerns that weren’t directly attributed to the injection process, that’s something else.

 

[FutureDocTree9]

I wanted to get other health care professionals opinion on this.

Our pharmacy has received peds pfizer vaccine and began giving them last week.

Yesterday, a child and her mom came to the pharmacy to get the vaccine. She was 7. For nearly 15 minutes, the child was fighting with her mom refusing to get the shot. Kicking, screaming and throwing her arms around. Clearly, it was not safe for me to give the vaccine so I explained to the mom that it would be better if she goes to her pediatrician or someone/somewhere whos more fit to handle the situation better. Mom got furious and refused to leave until her child got vaccinated. Long story short, the mom ended up forcefully bear hugging the child long enough for me to inject.

Here is my problem. I think this is child abuse.

I specifically states that it is unsafe for the child and myself for me to attempt to vaccinate her yet the mom just didnt listen. She got upset and asked for the manager and i told her i am the manager. She was speechless and kept on trying to physically restrain the child. We are located in a large clinic and the entire clinic heard this debacle.

Has anyone experienced this type of craziness at your pharmacy? How was it handled?

This is not child abuse. As a mom who has a teen who is afraid of needles, I’ve had to undergo this each time my child got vaccinated. Her pediatrician’s office, in fact, had to have me bear hug her to get vaccinated and at one point they restrained her with straps. I would rather go through this for a few minutes with my child and have her protected with her vaccines than to forgo vaccines altogether. My child even thanked me for getting her vaccines in spite of her fear. Yes, this is uncomfortable, but not child abuse.

 

[thecoolpharmboi]

I gave the injection when there was a couple seconds of calmness. I think the kid just got physical tired from all the kicking and screaming while the mom was bearhugging the crap out of her for what felt like an eternity.

I never said vaccinating the child is child abuse. I felt that her mom was wrong to physically handle the child so aggressively to a point where me and my staff felt uncomfortable and kept on insisting that we inject her even after i had informed her that it would be unsafe for the child and myself if she keeps on moving.

Maybe I shouldve called 911 or child protective services. But then again there will be some people saying i am overreacting and that moms manhandling her child to get vaccinated is normal. Haha.

I am going to put up a sign that says if the child requires physical restraint, we will not vaccinate.

Sometimes kids need to be restrained. They will have fear of needles but it is something they have to do. If you give in and let them have their way then you are just as responsible as teaching them it’s ok to cry and whine in the world so they will get their way.

Instead of putting a sign, perhaps get some training on how to safely give injection to a child. Someone has to. If you deny, then doctor office has to do it. You think it won’t be the same situation at the doctors?

 

[Leon'sMom]

OP-What you described sounds like a real s***show. I'm sorry you had to go through that. Just remember, as a pharmacist you always have the right to refuse filling a prescription if you don't feel comfortable with it (for multiple reasons). Same applies to giving vaccinations.

Refusing service is awkward, uncomfortable, and can lead to an escalation with the customer, but it is always your professional right. The blowback from management (for I'm sure this mother would have submitted a prompt complaint), is something that is also unpleasant, but if your feet are firmly planted on the basis of doing the right thing for the patient in that moment, practicing within your scope/skill level, maintaining a professional/safe work environment for all, and providing guidance to the mother as to how to more efficiently/safely get her child vaccinated, then you fulfilled your role. Same thing occurs in dentistry, when a general dentist recommends a difficult child be seen by a pediatric dentist for more tailored care and in a great many other areas of medicine.

There is no argument that pharmacists giving vaccinations is a great public service. Pharmacists in my area were at the epicenter of procuring, distributing, and administering the Covid vaccines in the early months of vaccine availability--moreso than any other profession. Today, there is no shortage of vaccines. Any outpatient clinic or doctors office can order them. Any parent can make their Covid vaccination appointments with their child's pediatrician. Your primary function as a pharmacist--to safely dispense RX medications, counsel patients on their OTC and RX medications, and perform insurance/regulatory compliance duties within your pharmacy-- is your ultimate responsibility. Those things can not be referred elsewhere. Giving a vaccination to an uncooperative child in a situation of questionable safety and comfort can be.

I would put up that sign--stating that if a child cannot be reasonably calm enough to safely receive vaccination, you will need to refer them to another provider--(and if your management overlords object to a sign, I would verbally state this each and every time a child sits in that vaccination chair) and if they don't cooperate within X amount of minutes, make your referral and move on to your primary pharmacist duties. There is no shame in that. In fact, it is in the better interest of society as a whole for you not to personally vaccinate one child (who can go elsewhere) at the expense of a multitude of patients who rely on you for their pharmacy services.

 

[grumpyRph]

when did giving yearly flu shots to kids even become a thing? i was born in 1986, and i have no memory of yearly flu shots and verified with my parents. that being said, if the kid is acting dangerously and hysterical, just let them go. It's not worth needle stick injury to anyone. What if I jab them, and THEN they make a sudden move while i'm pushing in the vaccine? and only half the dose goes in or something crazy? then what? I'd say let the brat have their way , we don't have time for this at the pharmacy. I bet in a lot of cases, if a different parent or family members brings them in another day, they'll act more calm.

 

[BidingMyTime]

What a nightmare situation. I have no experience with this, but in this situation I think I would tell the mom I had to attend to other customers and to come and get me after her child calmed down. And then don't give the vaccine until you feel the child is calm enough to do it safely. Was the child special needs? I don't understand why parents wouldn't take their children to the pediatrician if they knew their child was going to throw a fit. At least at the doctor's office it is private and quiet, that alone could calm the child down more than being in a pharmacy.

 

[JustFillIt]

Surprised no one has mentioned - of course there is a difference the pediatrician can offer. I have seen providers snow them with Valium in the most extreme cases.

Makes it much easier…. Kinda like the gas at a dentist office. And let’s be honest - nurses at the pediatrician office have quite a bit more experience with this than we do. I know this is hard to admit for some but it’s true.

If it’s literally on this level of “extreme” we should offer treatments that remove this reaction. One clever pediatrician I worked with gave a 6 year old boy 50 mg of Hydroxyzine and put them in the office with the lights off with a movie on. They fell to sleep about 1 hour later and they came In tip toeing and shot them up with all sorts of stuff. It was perfect.

Although it sounds like the ops situation worked out - I would have been fine saying, “I just can not offer what this patient needs, at this time”. Offer the mother a comment card and give them a reasonable alternative. Get on with the day.

As to if the child is a, “brat” or not - I would say that we should really keep our opinions to ourselves. Like always - I would be willing to bet that those that consider the child described as a “brat” likely do not have kids themselves (I’m sure they would say that they have dogs and this is the same as having kids).

 

[VA Hopeful Dr]

when did giving yearly flu shots to kids even become a thing? i was born in 1986, and i have no memory of yearly flu shots and verified with my parents. that being said, if the kid is acting dangerously and hysterical, just let them go. It's not worth needle stick injury to anyone. What if I jab them, and THEN they make a sudden move while i'm pushing in the vaccine? and only half the dose goes in or something crazy? then what? I'd say let the brat have their way , we don't have time for this at the pharmacy. I bet in a lot of cases, if a different parent or family members brings them in another day, they'll act more calm.

I was born in 1983 and have been getting yearly flu shots since age 9

 

[owlegrad]

(I’m sure they would say that they have dogs and this is the same as having kids).

I have never heard anyone say that.

 

[JustFillIt]

I have never heard anyone say that.

Oh I have - often

 

[RxPreceptor]

Ok drama Mommas & disgruntled Dads, this is NOT turning into breeders vs. non-breeders....we all need like a dedicated separate thread for this epic, battle royal smack down to go down

 

[mustang sally]

It definitely sounds unpleasant, but I would disagree that it is child abuse.

No different than what would go on in a pediatrician's office with a kid who really doesn't want to be vaccinated.

 

[Sparda29]

I had to give a covid vaccine to a developmentally challenged 20 something year old. Physically, he was strong as a bull and could have easily kicked my ass but his parents insisted that he get the vaccine. When I approached with the needle he would keep pulling away and his mom would push him back towards, I was afraid that I would inject the wrong site or get injected myself so I would pull back if I noticed any hesitation from him.

Eventually, I told the mom to grab an ice cream from the freezer and give it to him. While he was focused on unwrapping the ice cream and not paying attention, I gave the vaccine successfully and without any visible discomfort from the guy.

Lately, they've been sending us a good batch of needles that seem to be going in and out of the patient without any pain. When I got my booster, I had no idea that the pharmacist had already injected me.