- While coronavirus vaccines are being developed, children with anti-vaxxer parents are at particular risk
- Only seven US states allow minors to make decisions regarding their health care, including immunisation
Long before Americans began clamouring for a novel coronavirus vaccine, a collection of teenagers across the nation was embarking on a quest for vaccination – by posing questions on Reddit. Teenagers with “anti-vax” parents were, and still are, desperately trying to figure out how to get vaccinated, but outdated laws in many states deny them agency.
As doctors, public health officials and regular citizens push for increased immunisation, teenagers can and should have a role to play.
They want autonomy – not simply to protect their personal well-being, but to help end preventable diseases for everyone.
All 50 states need to give teenagers the right to be vaccinated without parental permission.
When I was 16, I stumbled upon my peers’ Reddit posts. I was stunned by the fact they were asking these questions and by how difficult it was to find clear answers.
After a year of research, I launched VaxTeen, an organisation that helps teenagers make informed decisions about vaccines and provides simplified state-by-state guides on vaccine consent laws.
In the US, the ability of minors to consent to vaccinations depends on the state they live in. The patchwork of overlapping judicial decisions, state codes, federal laws and accepted practices that govern the age at which children can consent – and what vaccinations they can consent to, if any – is convoluted, inconsistent and at times deliberately obtuse.
Since vaccines often aren’t even explicitly mentioned, deciphering whether a minor is allowed to self-consent is extraordinarily complex, especially for teenagers trying to do so without their parents’ support.
Only seven states allow minors above varying minimum ages to make all of their own health care decisions, including those concerning vaccines. Delaware and Montana allow them to self-consent to all recommended vaccinations, although in Montana this doesn’t extend to the HPV vaccine. HPV is the most common sexually transmitted infection.
Kelly Danielpour launched VaxTeen to help fellow adolescents make informed decisions.
Six states, including California, permit them to consent to HPV and/or hepatitis B vaccinations, and six states apply a subjective “mature minor” exception that allows minors to self-consent to vaccination if a health care professional determines they are sufficiently mature.
In response to measles outbreaks among under-vaccinated communities in 31 states last year, the Illinois and New York legislatures are considering bills that would broaden a minor’s ability to self-consent to vaccinations from only those preventing sexually transmitted diseases to all vaccines that are recommended by the Centres for Disease Control and Prevention. Similar bills are being deliberated in Georgia and Washington, DC, where minor vaccine-consent is not allowed.
Parents who are increasingly opting not to vaccinate their children have endangered everyone as immunisation rates have fallen too low to keep diseases like measles and whooping cough at bay.
In the school year preceding the Covid-19 pandemic, the rate of childhood vaccine exemptions claimed by parents rose in 40 of 49 states with recorded data.
Requiring parental consent also poses a barrier to immunisation for older teens whose parents are pro-vaccination, since many of them attend routine check-ups alone.
Dr Arthur Caplan, founding director of the Division of Medical Ethics at New York University Langone Medical Centre, told me “a mature minor” ought to be able to obtain – without parental consent – a “proven, safe intervention” that can prevent death or disability.
“Parents should not have the authority to subject their children to serious preventable harm,” he said.
The American Medical Association and the Society for Adolescent Health and Medicine, among other medical organisations, strongly support laws permitting older minors to self-consent to vaccinations.
Granting teenagers this right is essential to stemming the spread of diseases, whether they are newly emerging like Covid-19 or have faded from the news. For example, although measles was declared eliminated from the US in 2000, last year the country had the highest number of cases since 1992.
Overall, more than 42,000 Americans die each year from diseases preventable by vaccination. Over the course of the pandemic, the US has experienced a dramatic drop in already falling childhood vaccination rates, driven by fears of being exposed to the virus in doctors’ offices and stoked by the growing prevalence of vaccine misinformation online. Minors must be allowed to self-consent to existing vaccinations – and to an adolescent Covid-19 vaccine once it is available.
Young people across the country are advocating for their medical rights to protect themselves and their communities. I am fortunate enough to have pro-vaccine parents, so I can only imagine the courage it takes to question your parents’ misguided beliefs. States should empower teenagers to act.
Covid-19 has served as a startling public health lesson: we each have a responsibility to prevent the transmission of disease – whether through vaccination or social distancing – to ensure our collective health. Encouraging our state legislatures to enact straightforward vaccine consent legislation for minors would help accomplish that.
Kelly Danielpour is a final-year student at Crossroads School in Santa Monica, California, and founder of the organisation VaxTeen