Teenagers should be able to get coronavirus vaccines without their parents’ permission – especially if physicians back the decision, a team of health policy specialists argued Monday.
They said older teens, especially, may understand the benefits of vaccination at least as well – and sometimes better than – as their parents do and argued that vaccinating children protects both the children and the population at large.
“Children and adolescents have the capacity to understand and reason about low-risk and high-benefit health care interventions. State laws should therefore authorize minors to consent to COVID-19 vaccination without parental permission,” Larissa Morgan of the University of Pennsylvania Carey Law School, Jason Schwartz of Yale University and Dominic Sist of the Department of Medical Ethics and Health Policy at the University of Pennsylvania wrote in the journal JAMA Pediatrics.
“In the context of vaccination, some older minors may possess a more accurate understanding of the risks and benefits of a vaccine than their hesitant guardians,” they wrote.
While coronavirus has not been hitting children and teens especially hard, more than 300 US children have died in the pandemic, the experts argued. Plus, they can be a reservoir for continued spread.
“Approximately one-third of confirmed COVID-19 cases in minors have been asymptomatic, creating an opportunity for minors to spread the virus unknowingly,” they wrote, adding, “The reduction of asymptomatic transmission is essential to slowing the spread of the virus, and growing evidence suggests that vaccination provides substantial public health benefits by decreasing transmission in addition to its direct, individual benefits.”
They suggested that healthy children under the age of 12 should still only be vaccinated with the permission of parents or guardians. “Children older than 9 years with underlying medical conditions for whom the vaccine could offer increased benefits, however, would be exempt from this general prohibition and, after an affirmative evaluation of their competency, may consent,” they wrote.
“Minors aged 12 to 14 years could consent to vaccination without parental approval with support and facilitation from their clinicians and other trusted adult figures. In such cases, clinicians should notify minors’ parents of their immunization unless notification might pose a risk to the minor,” they added.
“In such cases, weighing the risk of parental retribution or the loss of the therapeutic relationship against the risk of minors contracting the virus would require a careful case-by-case determination.”
Teens over the age of 15 should be able to give consent for vaccination with no approval needed, they said.
Few states currently authorize vaccination without parental consent, they noted. “In four states, minors can consent to immunizations for sexually transmitted infections, such as human papillomavirus and hepatitis B, without parental permission. In five states, minors are allowed to consent to any medical intervention, including vaccines.”