Bakgrund Barn som genomgår vaccination enligt allmänt vaccinationsprogram upplever smärta under injektioner. Smärtlindrande metoder som bedövningskräm och sötningsmedel finns, men används inte rutinmässigt. Detta utgör ett onödigt lidande för dessa barn. Syfte Syftet är att undersöka om bedövningskräm alternativt sötningsmedel, ensamt eller i kombination med andra interventioner, kan minska smärtresponsen hos barn mellan 0–6 år i samband med vaccination enligt allmänt vaccinationsprogram. Metod För att besvara studiens syfte gjordes en deskriptiv litteraturöversikt med kvantitativ ansats. Artiklar med RCT som metod kvalitetsgranskades, analyserades och syntetiserades till ett resultat. Resultat Resultatet visar att bedövningskräm respektive sötningsmedel minskar smärtresponsen hos barn som vaccineras enligt allmänt vaccinationsprogram. Bedövningskräm i kombination med amning var ännu mer effektivt än att använda antingen bara bedövningskräm eller bara amning. Vid jämförelse av sötningsmedel och amning pekar forskningen i olika riktningar. Slutsats Resultatet från denna litteraturöversikt visade att bedövningskräm och sötningsmedel kunde minska smärtresponsen hos barn vid rutinmässiga vaccinationer. Även amning kunde minska smärtan, och en kombination av bedövningskräm och amning minskade smärtan ytterligare. Andra interventioner som kunde minska smärtan var fysiskt tröstande metoder, kylspray ochatt suga på napp eller finger. Resultatet skulle kunna leda till ett ökat användande av dessasmärtlindrande metoder på BVC. / Background Children undergoing vaccination according to general immunization programs experience pain during injections. Analgesic methods such as anesthetic cream and sweetening agents are available but are not used routinely. This is an unnecessary suffering for these children. Aim The aim is to investigate whether anesthetic cream or sweetening agents, alone or in combination with other interventions, can reduce pain response in children between 0-6 years of age, during vaccination according to general immunization programs. Method To answer the purpose of the study, a descriptive literature review was done with a quantitative approach. Articles with RCT as a method were quality reviewed, analyzed and synthesized to a result. Results The results show that anesthetic cream and sweetener respectively reduce the pain response in children during vaccination according to general immunization programs. Anesthetic cream in combination with breastfeeding was even more effective than using either just anesthetic cream or just breastfeeding. When comparing sweeteners and breastfeeding, research points in different directions. Conclusion The results from this literature review showed that anesthetic cream and sweeteners could reduce the pain response in children during routine vaccinations. Breastfeeding could also reduce the pain, and a combination of anesthetic cream and breastfeeding could further reduce the pain. Other interventions that could reduce the pain were physically comforting methods, cooling spray and sucking on a pacifier or finger. The result could lead to an increased use of these painrelief methods at childcare centers.

Background: On 1 January 2020, the UNCRC was incorporated into the Swedish national law. The Convention argues that all children have the right to health, life, survival and development. The Articles of the UNCRC require higher authorities, health facilities and parents to act in the best interest of children, and to do everything to secure children’s rights. Interpreting the Convention, it is possible to conclude that all children have the right to safe and effective vaccines. Even though vaccines are accessible and free of charge to all children in Sweden, vaccination coverage for multiple vaccine-preventable diseases in Sweden has dropped. As one of the reasons for this drop in vaccination coverage is proposed vaccination hesitancy. To fulfil children’s rights as proposed in the UNCRC, vaccination hesitancy needs to be understood and addressed.  Aim: The objective of the study is to understand causes of vaccination hesitancy among parents living in Stockholm, Sweden and to examine how healthcare professionals in Stockholm County are working to eliminate vaccination hesitancy, in goal to promote children’s rights to health, life, survival and development after the UNCRC became a Swedish law on 1 January 2020. Additionally, to analyze if strategies applied by Stockholm County are truly addressing identified causes of vaccination hesitancy among parents living in Stockholm, Sweden and in that way increasing vaccination rates this year. Method: This study used a qualitative research strategy. Vaccination hesitancy in Sweden was studied using 20 semi-structured interviews with parents living in Stockholm, while effect of the UNCRC incorporation into Swedish law on vaccination hesitancy was studied using a semi-structured interview with one health professional working in Stockholm County. The gathered data was summarized, categorized and analyzed according to the proposed themes of two theories. The theoretical framework consisted of the Health Belief Model and Social-Ecological Model. Conclusion: It was possible to conclude that the choice of immunization among parents is shaped by; 1) sources and type of the received information on vaccines, vaccination and vaccine-preventable diseases included in the general Swedish child vaccination program, 2) their views on vaccine quality, safety, effectiveness and necessity for satisfying children’s rights to health, life, survival and development, 3) the level of knowledge of epidemiological concepts, mechanisms, infectious diseases and vaccines included in the vaccination program, and 4) the level of trust in the Swedish Government and healthcare, and belief if they are acting in the best interest of children. After the UNCRC incorporation into Swedish law, there have not been observed any changes in the strategic work of Stockholm County against vaccination hesitancy. For the past ten years, they are applying methods at the individual- and interpersonal level, which are not quite reaching vaccine hesitant parents living in Stockholm. Other methods at the community- and public policy level are needed. Due to unclear implications of the UNCRC entrance as a national law and COVID-19 pandemic, it is not possible to estimate if there are any changes in the vaccination rates this year.