My policy, when going to the doctor's office, is that "I never know" whether there's going to be a shot. That's up to the doctor. Truth is, I sometimes know there is, but I never know there isn't - the way things are, there are sometimes surprises. So I just tell them it's there annual check up (or whatever), and if they ask if there's going to be a shot, I say I don't know, that's up to the doctor. As my kids got older, they did start to understand the risk-benefit issue, so the negative of the shot was tolerated better because they understood the serious ramifications possible in not getting it. Also, when they get shots, they always get a treat afterwards - ice cream or candy or something. When they get more than one shot, the treat can be a bigger one. Sometimes bribery is warranted! I consider it a reward/consolation for dealing with a tough experience. It really helped!