Immersive virtual reality during pediatric vaccination: a quasi-experimental study of pain, fear, and care experience.

Authors

Laura Costa, Tânia Lourenço, Maria Fátima Pina, Małgorzata Szkup, Márcia Maria Carneiro Oliveira, Márcia Helena Machado Nascimento, Luís Batalha, Rita Fernandes

Published in

Journal of pediatric nursing. Sep 21, 2026. Epub Sep 21, 2026.

Abstract

Vaccination is a common source of childhood pain and fear and may negatively affect future immunization experiences. Although virtual reality (VR) has shown promise in pediatric needle-related procedures, evidence from routine vaccination in primary care remains limited.
To assess preliminary between-group differences in children's self-reported pain and fear during pediatric vaccination, comparing immersive VR with usual care, and to describe acceptability and safety indicators.
This quasi-experimental, non-randomized controlled study included 100 child-caregiver dyads from three Portuguese primary care centers: 50 in the VR group and 50 in the usual-care group. The main clinical outcomes, pain and fear, were assessed before and after vaccination using age-appropriate measures. Post-vaccination outcomes were analyzed using baseline-adjusted analyses of covariance. In the VR group, children, caregivers, and nurses rated ease of use and willingness to recommend; nurses recorded VR-related adverse effects.
Adjusted post-vaccination pain was lower in the VR group than in the usual-care group (mean difference = -1.94, 95% CI [-2.99, -0.88], p < 0.001), as was fear (mean difference = -0.78, 95% CI [-1.29, -0.27], p = 0.003). Ease-of-use and recommendation ratings were favorable. VR-related adverse effects occurred in 6% of children, were mild and transient, and required no intervention.
Immersive VR was associated with lower post-vaccination pain and fear during routine pediatric vaccination in primary care. Favorable VR experience and safety indicators support further evaluation of VR as a complementary nonpharmacological strategy aligned with atraumatic, child- and family-centered nursing care.

PMID:
42767907
Bibliographic data and abstract were imported from PubMed on 22 Sep 2026.

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