We recommend topical anesthetics be applied before vaccine injections in children 12 years and younger (strong recommendation; very low confidence in estimates of effect).

Topical anesthetics are local anesthetic-containing creams, gels and patches that block transmission of pain signals from the skin.17 Topical anesthetics are a well-established therapy for the mitigation of needle-related pain in individuals of all ages. In a meta-analysis including 1424 children undergoing vaccination, there was a substantial benefit of topical anesthetics on acute distress (SMD −0.91, 95% CI −1.36 to −0.47).9 There is no evidence of an adverse effect of topical anesthetics on the vaccine immune response.9 The provision of topical anesthetics should be a standard preventive measure for children, who cannot advocate for themselves and are at risk of long-term harm from unmitigated pain due to the development of needle fears. The majority of children are afraid of needles and report a preference for analgesics to be used.2,18 Because topical anesthetics incur additional time and costs, their use requires some planning. In many cases, they can be accommodated in usual clinic waiting times.19 Otherwise, they can be applied before clinic arrival.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001531/

‍