A meta-analysis of digital interventions to reduce vaccination-related pain in children

Despite the effectiveness of vaccination in decreasing the mortality rate, pain related to needle procedures contribute to the children's incompliance vaccination uptake. Digital technology, as a widely used distracting tool, requires investigation for its efficacy and consistency. This study aims to see and compare the effectiveness of each digital intervention in reducing pain in children's vaccination. A systematic review and meta-analysis were conducted from five databases: Cochrane Library, APAPsychNet, Embase, EBSCO, and PubMed from June to September 2024. Two group trials using any digital intervention to reduce children's vaccination pain were included. A classical meta-analysis using random effects was applied to measure the effect size of pain level between intervention and control for overall and per category of digital interventions. 11 of 1665 records were analysed. Digital intervention showed an overall pain education during vaccination (SMD = −0.54, 95 % CI: −1.06, −0.02, I 2 = 92.2 %, P = 0.04). All groups, including robots and mobile/computer technologies, showed more pain reduction than the control group. However, only virtual reality studies showed a statistically significant difference (SMD = −0.74, 95 % CI: −1.41, −0.08, I 2 = 88.4 %, P = 0.03). Digital interventions have enormous potential in reducing needle-related pain. While virtual reality has a prominent effect due to its immersive nature, robots have viable efficacy by considering the interaction and realistic presentation. Mobile technologies' flexibility enables customization to children's needs and synergy with combined interventions. • 11 from 1665 studies examined digital interventions for children's vaccination pain. • 620 children across 8 countries from 2013 to 2023 were analysed. • From 6 RCTs and 5 non-RCTs, The risk of bias mainly stems from deviation of intended interventions. • Digital intervention and virtual reality showed sigificant pain reduction compared to controls.