As more teenagers seek Covid-19 vaccinations—with or without parental approval—states are reexamining their medical consent laws for children under 18, Jan Hoffman writes for the New York Times.

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Parents push back against vaccination

Hoffman reports that although CDC has authorized Covid-19 vaccines for children as young as 12, many parents don’t approve of their children getting vaccinated, citing worries about potential side effects and the novelty of the vaccines.

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For instance, a Kaiser Family Foundation poll from April found that only 30% of parents of children between 12 and 15 would allow their children to be vaccinated right away. Other parents said they would wait for long-term safety studies or school requirements before having their children vaccinated.

But many teenagers are at odds with their parents over these concerns, Hoffman write. They’re eager to get vaccinated to "unloc[k] freedoms denied during the pandemic."

For example, Isabella, a 17-year-old from Florida, wants to be vaccinated so she can spend time with family members and friends. But her mother, Charisse, will not let her because she’s concerned the vaccine could affect her daughter's reproductive system—a misunderstanding that, according to Hoffman, experts have "repeatedly refuted."

States and vaccination consent

In 40 states, children under 18 need parental consent before being vaccinated, Hoffman reports. But because of the pandemic, some states and cities are reexamining their medical consent regulations, Hoffman writes.

The District of Columbia city council, for example, voted to allow children 11 and over to get vaccinated against Covid-19 without parental consent. In New Jersey and New York, new bills would allow children 14 and up to be vaccinated on their own. And in Minnesota, a new bill would allow some children as young as 12 to receive Covid-19 vaccines.

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However, some areas are making it harder for minors to be vaccinated without parental consent, Hoffman reports. For instance, although teenagers in South Carolina can consent to certain medical procedures at 16, a new bill would bar providers from giving minors a Covid-19 vaccine without parental consent. Similarly, although the age of medical consent in Oregon is 15, the state's Linn County enacted a measure requiring its county-run clinics to receive parental consent before giving a Covid-19 vaccine to anyone under 18.

As debates around Covid-19 vaccinations continue, providers need to decide what to do when a minor asks to receive a vaccination without parent consent. "We may be in a legal gray zone with this vaccine," Sterling Ransone, a family physician in Virginia, said.

Teens seek their own paths for vaccination

Some teens are looking for help in getting vaccinated when their parents disagree.

Many have turned to VaxTeen.org, Hoffman reports. The website outlines consent laws in different states, provides links to clinics, and shares resources on Covid-19, as well as advice on how teenagers can talk to their parents about vaccination. Kelly Danielpour, a teenager from Los Angeles, created the site two years ago, after she realized that many teenagers do not know their vaccination rights. In addition to working with experts to help her understand the different vaccination and consent laws, Danielpour also recruits other teenagers as "VaxTeen ambassadors."

Some teenagers have also chosen to get vaccinated without telling their parents, Hoffman writes.

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For example, in Oregon, where the age of medical consent is 15, a 16-year-old whose parents oppose the vaccine was able to get a Covid-19 vaccine at a clinic at her school without parental consent. "She was extremely relieved," said Elise Yarnell, a senior clinic operations manager for Providence health system, who met the girl.

Elizabeth, a 17-year-old whose parents are divorced, got the vaccine on her own at her school's pop-up clinic. Her mother had agreed but her father was against it. Elizabeth said that while the school technically requires consent from both her parents, she got the shot by presenting only her mother's note of approval. However, fearing repercussions from her parents or the school, Elizabeth has not yet told her parents.

Who does the decision really belong to?

The issue of consent around vaccinations raises questions about when minors should be allowed to make their own health decisions and who should decide when parents disagree, Hoffman writes.

Gregory Zimet, a psychologist and professor of pediatrics at Indiana University School of Medicine, said that from a developmental standpoint, children 14 years old or even younger are "at least as good as adults" at determining the risks of vaccination. He also noted that many states already allow teenagers to make decisions about contraceptives and sexually transmitted infections, which can be "more complex and fraught" than vaccines.

And other doctors are simply working to reassure parents of the vaccines' safety and efficacy, Hoffman writes. "I will validate their concerns," Jay Lee, a family physician and CMO of Share Our Selves, said of parents concerned about getting their children vaccinated. "[B]ut I point out that waiting to see if your child gets sick is not a good strategy. And that no, Covid is not just like the flu."

Ultimately, providers have little power in situations where parents steadfastly object, Hoffman writes. And this can mean teenagers interested in getting vaccinated simply have to wait until they are old enough to act independently.

Mobeen Rathore, a pediatrics professor at the University of Florida medical college, spoke about a patient who was vaccinated on her 18th birthday, after her mother originally refused permission three weeks earlier. "She sent me a message saying that was her birthday gift to herself," Rathore said. (Hoffman, New York Times, 6/27)