{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T21:05:52Z","timestamp":1779483952184,"version":"3.53.1"},"reference-count":21,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jpeds.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pediatrics"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.jpeds.2026.115035","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:12:23Z","timestamp":1771027943000},"page":"115035","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Preventing Postvaccination Presyncope and Syncope in Adolescents: A Randomized Controlled Trial of a Clinic-Based Intervention"],"prefix":"10.1016","volume":"293","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6947-099X","authenticated-orcid":false,"given":"Michael J.","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa A.","family":"Harrington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wes","family":"Rountree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek S.","family":"Poniewierski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L.","family":"Spreng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Broder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Kroger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"McNeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Marquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel B.","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jpeds.2026.115035_bib1","first-page":"2","article-title":"Syncope among U.S. Air Force Basic Military trainees, August 2012-July 2013","volume":"20","author":"Webber","year":"2013","journal-title":"MSMR"},{"key":"10.1016\/j.jpeds.2026.115035_bib2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.pcad.2012.11.004","article-title":"Medical therapy and physical maneuvers in the treatment of the vasovagal syncope and orthostatic hypotension","volume":"55","author":"Raj","year":"2013","journal-title":"Prog Cardiovasc Dis"},{"key":"10.1016\/j.jpeds.2026.115035_bib3","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-0508","article-title":"Drinking water to prevent postvaccination presyncope in adolescents: a randomized trial","volume":"140","author":"Kemper","year":"2017","journal-title":"Pediatrics"},{"key":"10.1016\/j.jpeds.2026.115035_bib4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1177\/1367493515587062","article-title":"The effects of three different distraction methods on pain and anxiety in children","volume":"20","author":"Sahiner","year":"2016","journal-title":"J Child Health Care"},{"key":"10.1016\/j.jpeds.2026.115035_bib5","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1097\/AJP.0000000000000281","article-title":"Pharmacological and combined interventions to reduce vaccine injection pain in children and adults: systematic review and meta-analysis","volume":"31","author":"Shah","year":"2015","journal-title":"Clin J Pain"},{"key":"10.1016\/j.jpeds.2026.115035_bib7","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1177\/1073191111411667","article-title":"Item banks for measuring emotional distress from the patient-reported outcomes measurement information system (PROMIS): depression, anxiety, and anger","volume":"18","author":"Pilkonis","year":"2011","journal-title":"Assessment"},{"key":"10.1016\/j.jpeds.2026.115035_bib8","series-title":"Anxiety: current trends in theory and research","author":"Spielberger","year":"2013"},{"key":"10.1016\/j.jpeds.2026.115035_bib9","series-title":"Manual for the state-trait anxiety inventory","author":"Spielberger","year":"1970"},{"key":"10.1016\/j.jpeds.2026.115035_bib10","doi-asserted-by":"crossref","first-page":"S72","DOI":"10.1097\/AJP.0000000000000265","article-title":"Psychological interventions for vaccine injections in children and adolescents: systematic review of randomized and quasi-randomized controlled trials","volume":"31","author":"Birnie","year":"2015","journal-title":"Clin J Pain"},{"key":"10.1016\/j.jpeds.2026.115035_bib11","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/0009922814548672","article-title":"Using iPads for distraction to reduce pain during immunizations","volume":"54","author":"Shahid","year":"2015","journal-title":"Clin Pediatr (Phila)"},{"key":"10.1016\/j.jpeds.2026.115035_bib12","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.janxdis.2006.01.004","article-title":"Fear of needles and vasovagal reactions among phlebotomy patients","volume":"20","author":"Deacon","year":"2006","journal-title":"J Anxiety Disord"},{"key":"10.1016\/j.jpeds.2026.115035_bib13","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/0022-3999(95)00639-7","article-title":"Predicting vasovagal reactions in volunteer blood donors","volume":"40","author":"Meade","year":"1996","journal-title":"J Psychosom Res"},{"key":"10.1016\/j.jpeds.2026.115035_bib14","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0304-3959(01)00314-1","article-title":"The faces pain scale\u2013revised: toward a common metric in pediatric pain measurement","volume":"93","author":"Hicks","year":"2001","journal-title":"Pain"},{"key":"10.1016\/j.jpeds.2026.115035_bib16","author":"Kroger"},{"key":"10.1016\/j.jpeds.2026.115035_bib17","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jadohealth.2023.11.005","article-title":"Incidence of adolescent syncope and related injuries following vaccination and routine venipuncture","volume":"74","author":"Groom","year":"2024","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.jpeds.2026.115035_bib18","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/archpedi.1997.02170400041007","article-title":"Syncope after immunization","volume":"151","author":"Braun","year":"1997","journal-title":"Arch Pediatr Adolesc Med"},{"key":"10.1016\/j.jpeds.2026.115035_bib19","first-page":"457","article-title":"Prevention. Syncope after vaccination--United States, January 2005-July 2007","volume":"57","year":"2008","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.jpeds.2026.115035_bib20","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jopan.2014.05.011","article-title":"The effect of combined stimulation of external cold and vibration during immunization on pain and anxiety levels in children","volume":"30","author":"Canbulat","year":"2015","journal-title":"J Perianesth Nurs"},{"key":"10.1016\/j.jpeds.2026.115035_bib21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pedn.2017.09.009","article-title":"Effects of thermomechanical stimulation during vaccination on anxiety, pain, and satisfaction in pediatric patients: a randomized controlled trial","volume":"38","author":"Redfern","year":"2018","journal-title":"J Pediatr Nurs"},{"key":"10.1016\/j.jpeds.2026.115035_bib22","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.pmn.2018.07.001","article-title":"Influencing vaccinations: a buzzy approach to ease the discomfort of a needle Stick-a prospective, randomized controlled trial","volume":"20","author":"Redfern","year":"2018","journal-title":"Pain Manag Nurs"},{"key":"10.1016\/j.jpeds.2026.115035_bib23","doi-asserted-by":"crossref","first-page":"7526","DOI":"10.1016\/j.vaccine.2022.10.026","article-title":"Prevalence of pain and fear as barriers to vaccination in children - systematic review and meta-analysis","volume":"40","author":"Taddio","year":"2022","journal-title":"Vaccine"}],"container-title":["The Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022347626000636?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022347626000636?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T20:23:58Z","timestamp":1779481438000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022347626000636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":21,"alternative-id":["S0022347626000636"],"URL":"https:\/\/doi.org\/10.1016\/j.jpeds.2026.115035","relation":{},"ISSN":["0022-3476"],"issn-type":[{"value":"0022-3476","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Preventing Postvaccination Presyncope and Syncope in Adolescents: A Randomized Controlled Trial of a Clinic-Based Intervention","name":"articletitle","label":"Article Title"},{"value":"The Journal of Pediatrics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpeds.2026.115035","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"115035"}}