Non-Cochrane · intervention · PM41395305
Music intervention alleviates pain and distress in children undergoing vaccination: a systematic review and meta-analysis.
Wang Dan, Lei Jiao, Wu Shanshan, et al. · Frontiers in pediatrics · 2025 · PubMed · doi:10.3389/fped.2025.1699437
Findings
Population Children aged 0-12 years undergoing routine vaccination or immunization
6 findings
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Pain intensity (WBFRS, NIPS, FPS, FPS-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Sensitivity: excluding studies with data extracted from figures (Bekar 2022, Yinger 2016) | SMD -0.34 [-1.02, 0.34] GRADE not reported 2 studies · 108 participants |
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Pain intensity (WBFRS, NIPS, FPS, FPS-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Random-effects model with HKSJ adjustment (as stated in Abstract) | SMD -0.58 [-0.92, -0.24] GRADE not reported 4 studies · 207 participants |
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Distress (OSBD, OSBD-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Sensitivity: excluding study with data extracted from a figure (Yinger 2016) | SMD -0.76 [-1.44, -0.09] GRADE not reported 2 studies · 140 participants |
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Distress (OSBD, OSBD-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Sensitivity: leave-one-out excluding Noguchi 2006 | SMD -0.84 [-1.18, -0.50] GRADE not reported 2 studies · 138 participants |
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Pain intensity (WBFRS, NIPS, FPS, FPS-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Fixed-effect model (primary, Results) | SMD -0.55 [-0.81, -0.28] GRADE not reported 4 studies · 207 participants |
| Music intervention (lullabies, children's songs, recorded music) during or within 15 min of vaccination | Standard or routine care without music | Distress (OSBD, OSBD-R) During vaccination procedure · Vaccination or immunization procedures (Turkey, USA, Italy, Iran, Canada) · Fixed-effect model (primary, Results) | SMD -0.83 [-1.12, -0.54] GRADE not reported 3 studies · 179 participants |
Included primary studies 5
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bekar 2022 Effects of mother-sung lullabies on vaccination-induced infant pain and maternal anxiety: A randomized controlled trial. PMID:35341657 | 2022 | this review only | Pain intensity (WBFRS, NIPS, FPS, FPS-R) | not extracted yet |
| Megel 1998 Children's responses to immunizations: lullabies as a distraction. PMID:10531890 | 1998 | this review only | Distress (OSBD, OSBD-R) | not extracted yet |
| Monaci 2024 Maternal singing reduced pain indexes in 2-month-old infants and increased proximity during vaccinations. PMID:38264948 | 2024 | this review only | Pain intensity (WBFRS, NIPS, FPS, FPS-R) | not extracted yet |
| Noguchi 2006 The effect of music versus nonmusic on behavioral signs of distress and self-report of pain in pediatric injection patients. PMID:16671836 | 2006 | this review only | Pain intensity (WBFRS, NIPS, FPS, FPS-R); Distress (OSBD, OSBD-R) | not extracted yet |
| Yinger 2016 Music Therapy as Procedural Support for Young Children Undergoing Immunizations: A Randomized Controlled Study. PMID:27535171 | 2016 | this review only | Pain intensity (WBFRS, NIPS, FPS, FPS-R); Distress (OSBD, OSBD-R) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children aged 0 to 12 years undergoing routine vaccination; children with underlying medical conditions excluded | Children 2 months to 6 years from Turkey, USA, Italy, Iran, Canada (n=306) |
| Intervention | Any music intervention during or within 15 min of vaccination; combined interventions excluded | Lullabies, children's songs, recorded music or musical/spoken story recordings (n=5 RCTs) |
| Comparison | Standard, routine or normal care without music | Routine care (n=5 RCTs) |
| Outcomes | Pain (WBFRS, NIPS, FPS, FPS-R); distress (OSBD, OSBD-R) | Pain intensity (n=4 RCTs, 207 children); distress (n=3 RCTs, 179 children) |
| Study designs | RCTs; full-text English articles | RCTs (n=5) |
| Timing | Not specified | During vaccination procedure |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |