TOPLINE

Infants who received the ShotBlocker, a C-shaped plastic device that applies pressure around the injection site, immediately before vaccination had lower pain scores than those who received vaccination based on standard practice.

METHODOLOGY

• Researchers conducted a systematic review and meta-analysis of randomized controlled trials to assess whether the ShotBlocker device could reduce pain in infants during vaccination.
• They included five trials published from 2017 through 2026 involving 378 infants (aged 12 months or younger) who were undergoing routine vaccinations; one trial was conducted in Iran and the other four in Turkey.
• The trials assessed the use of ShotBlocker, a C-shaped plastic device with blunt projections surrounding a central opening positioned over the injection site; it was applied immediately before administration of the measles-mumps-rubella, pneumococcal conjugate, or hepatitis B vaccine. Infants who underwent vaccination without ShotBlocker served as the comparator group.
• Pain intensity during vaccination was the primary outcome. It was assessed using the Neonatal Infant Pain Scale (three trials) or the Face, Legs, Activity, Cry, and Consolability scale (two trials), with higher scores indicating greater pain.
• Pulse rate (beats/min) after vaccination was the secondary outcome.

TAKEAWAY

• Infants who received vaccination with the use of ShotBlocker had lower pain scores during vaccination than those who received vaccination without the device (standardized mean difference [SMD], -1.49; P = .018; five trials); however, substantial heterogeneity across trials was noted (I² = 91.6%).
• In a sensitivity analysis that excluded one trial, a stronger pooled effect was observed (SMD, -1.86; P < .001; I² = 0%).
• The use of ShotBlocker was associated with a lower pulse rate after vaccination (MD, -5.90 beats/min; P = .024; two trials; n = 160).
• Both findings were rated as low-certainty evidence.

IN PRACTICE

"[The study] findings indicate that ShotBlocker may offer analgesic benefit during routine infant immunization, but the current evidence base remains insufficient to support definitive clinical recommendations," the authors wrote.

SOURCE

The study was led by Shaimaa Madkour, MD, of the Department of Pediatrics in the Faculty of Medicine at Fayoum University in Fayoum, Egypt. It was published online on October 24, 2026, in the Journal of Pediatric Health Care.

LIMITATIONS

Blinding was difficult as the device was visible to the people scoring pain. The trials also differed in how old the infants were, which vaccine they received, which scale was used to rate pain, and when it was scored; these differences may have contributed to heterogeneity.

DISCLOSURES

The study received no specific funding. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.