Swedish clinics use virtual reality to reduce the sting of shots

“Hello, I am here to help you calm down. Here you are completely safe. Nothing bad can or will happen to you.” The voice emanates from nowhere in particular.

Birds chirp and butterflies flitter at the lakeside campsite. As night falls, a neon green sign buzzes alive, bearing the name of the pharmacy chain that is promoting this virtual reality experience across Sweden.

The app, called “Happy Place,” is a virtual reality program for the Oculus Rift headset commissioned by Apotek Hjärtat, Sweden’s largest private pharmacy chain. The pharmacy already provides headsets with the software to nurses at six of its medical clinics. The app is designed to alleviate pain — such as the pain of receiving a vaccination — by distracting patients with a peaceful, interactive environment.

Lotta Haller, a nurse at one of these clinics in Stockholm, recalls a recent teenage patient receiving a vaccination for tick-borne encephalitis. She finished administering the shot and told the boy he could take off the virtual reality helmet.

“Can I sit a bit more?” he asked.

Haller says that when she tested the virtual reality simulation, she too was reluctant to reenter the real world. Haller’s clinic started using the virtual reality simulation earlier this month, and so far, she’s used it on about 20 patients while giving them shots. Users can also download it at home for personal use.

The app takes users to a lakeside campsite replete with objects with which the patient can interact by staring at them. They can light a fire, read a book, play music, or summon a sea monster. Meanwhile, an omnipotent narrator utters serene phrases and gives physiological advice: “Acknowledge any thoughts without trying to get rid of them. Keep taking several slow deep abdominal breaths.”

Researchers have been studying virtual reality for pain relief over the past 20 years. The technology was made famous by SnowWorld, developed by University of Washington Medical Center researchers, which immerses burn victims in a frigid environment. Scientists have also tested virtual reality experiences to help chemotherapy patients alleviate pain.

Josh Sackman, president and cofounder of AppliedVR, which develops virtual reality experiences and connects software and hardware companies with medical centers, said that hospitals from Boston to Los Angeles are looking for ways to use virtual reality technology to help their patients. This is the first pharmacy he’s seen jumping into the game.

Apotek Hjärtat’s head of communications, Jonas Mjöbäck, said they are motivated by reasons medical and marketing. Research shows that virtual reality is effective at distracting people from temporary pain, he said. And promoting a virtual reality app might set Apotek Hjärtat apart from competitors in terms of pain management — the over-the-counter painkillers in Sweden are the same between pharmacies, so marketing virtual reality might be a way to stand out. The idea of putting helmets in clinics came later.

The pharmacy chain also said that the virtual reality experience can relieve pain from menstrual cramps or from getting tattoos.

Stockholm resident Albin Ring recently spent 10 minutes in the virtual world while getting a tattoo.

Ring, 32, tested the app at the request of his cousin, who works for a public relations firm promoting it. As far as he knows, he’s the first person to be tattooed in real life while exploring in virtual reality.

“I still felt the pain,” Ring said. But, “I was so distracted, so I didn’t really think about it most of the time. And that’s quite amazing actually.”

More rigorous evidence may be forthcoming. Sackman said AppliedVR is involved in ongoing clinical trials of the technology, including one at Children’s Hospital Los Angeles that uses virtual reality for children getting their blood drawn. They are also selling virtual reality technology to some medical centers at a discounted price in exchange for data on how effective the software is for the patients.

Apotek Hjärtat knows this app is still in the very early stages. Mjöbäck didn’t even know how many times it had been downloaded so far. They still need to see what consumers think of it before they make concrete plans.

“Should we start selling the virtual reality helmet through our [website]?” Mjöbäck mused. “That could be an option. We just have to wait and see how it turns out.”

Sackman agreed. He praised the virtual environment of “Happy Place,” but noted that it may be more effective for the narration to correspond better to the patient’s actions. More testing, and more data, he said, is the way to move forward.