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Kelly Danielbur, founder of VaxTeen.org, in Los Angeles, June 16, 2021 (Jessica Pons/The New York Times)
Teens keep all kinds of secrets from their parents. drinking. sex. poor grades
But the secret that Elizabeth, a 17-year-old rookie high school student from New York City, is hiding is a new one on the teenage crime group. She does not want her parents to know that she is vaccinated against COVID-19.
Her divorced parents are of the same opinion about her health care. Although her mother strongly favors the vaccine, her father angrily opposes it and threatens to sue her mother if Elizabeth gets the vaccine. Elizabeth keeps a secret not only from her father, but also from her mother, so her mother can reasonably deny it. (Elizabeth asked that only her middle name be mentioned.)
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Vaccinating children is essential to achieve broad immunity against COVID-19 and to return to a regular school and work routine. But despite the approval of COVID vaccines for children under the age of 12, many parents, concerned about side effects and fearful about the novelty of vaccines, have refrained from letting their children have them.
A recent survey by the Kaiser Family Foundation found that only 3 in 10 parents of 12-17-year-olds plan to be vaccinated right away. Many say they will wait for long-term safety data or outputs from the school’s mandate. But with many teens wanting the shots they see as unleashing freedoms denied during the pandemic, tensions are rising in homes where parents vehemently refuse.
Forty states require parental consent to vaccinate minors under 18, and Nebraska sets an age of 19 (some states impose exemptions for homeless or emancipated teens). Now, due to the COVID crisis, some states and cities are seeking to relax medical consent rules, mimicking laws that allow minors to get the HPV vaccine, which prevents some cancers caused by a sexually transmitted virus.
Last fall, the District of Columbia Council voted to allow children younger than 11 to get recommended vaccinations without parental consent. New Jersey and New York legislatures have pending bills that would allow children under the age of 14 to approve vaccines; Minnesota has one that would allow some children as young as 12 to consent to COVID shots.
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But other countries are going in the opposite direction. Although teens in South Carolina can consent as early as 16, and doctors may perform some medically necessary procedures without parental permission even for younger children, a bill in the legislature expressly prohibits providers from giving COVID without parental consent to minors. In Oregon, where the age of medical consent is 15, Lane County has ordered county-run clinics to obtain parental consent for a COVID shot for anyone under 18. According to the National Conference of state legislatures, which has been tracking COVID-related billing, some states, including Tennessee and Alabama, are working on legislation to prevent public schools from ordering COVID shots.
The question of who can consent to COVID footage provides new context to legal, ethical and medical questions that go back decades. When parents disagree, who is the judge? At what age are children able to make their own health decisions and how should this be determined?
“Isabella wants it because her friends get it, she doesn’t want to wear a mask,” said Charice, a mother of a 17-year-old in Delray Beach, Florida, who asked that her family name be withheld from her family. Charice fears the episode could have an effect on her daughter’s reproductive system (a misconception that public health officials have repeatedly debunked).
It’s my body, Isabella said. And I said, ‘Well, it’s my body up to the age of 18’.
As both legal debates and family arguments develop, those who administer the vaccine in pharmacies, clinics and medical offices are trying to determine how to proceed when a young teen appears in a COVID shot without a parent.
“We may be in a legal gray area with this vaccine,” said Dr. Stirling Ranson Jr., a family physician in Deltaville, Virginia. In their health system, a parent can submit a signed consent form to vaccinate their teen. But because the COVID vaccine is only authorized for emergency use, the health system requires a parent to be present for a patient under 18 to get that shot.
Marina, 15, who lives in Palm Beach County, Florida — who, like others interviewed, asked to remain anonymous — craves the shot. But her mother says not at all. The topic is not open for discussion.
Thus, Marina was excluded from the social life she craved. She said, “Five of my friends are having a party and they invited me, but then they said, ‘Are you grafted? “So I can’t go. It hurts.”
As the epidemic subsides, some teens’ social circles are reshaping them based on their vaccination status. Marina said, “I see my friends posting on social media — ‘Woo-hoo I get it! – And now when I see them, they ask me things like, ‘Where have you been? Do you travel a lot? Are you sure you don’t have COVID? It’s annoying that I can’t get the shot.”
Frustrated teens are increasingly looking for ways to get vaccinated without their parents’ consent. Some have found their way to VaxTeen.org, a vaccine information site run by Kelly Danielpour, a teen from Los Angeles.
The site offers guides to state consent laws, links to clinics, resources on first-hand information about COVID-19 and advice on how teens can engage parents.
“Someone will ask me, ‘I need to agree at the vaccine clinic that is open on weekends and down the bus route.'” said Danielle Burr, 18, who will begin her first year at Stanford University in the fall.
I started the site two years ago, long before COVID. The daughter of a pediatric neurosurgeon and intellectual property attorney, she realized that most teens don’t know the recommended vaccine schedule nor their rights.
“We automatically talk about parents, not teens, who have opinions on this issue,” she said. “I decided I needed help.” Danielle Burr squabbled with experts to help her understand vaccination and consent laws, and she recruited teens to be “VaxTeen Ambassadors.”
“I want teens to be able to say to pediatricians, ‘Hey, I have that right,'” said Daniel Burr, who lectures at conferences for doctors and Department of Health officials.
Elizabeth surreptitiously got her vaccine at a school pop-up clinic.
After officials at her boarding school informed parents that they would provide the COVID footage, her mother gave permission. Her father forbade her. Elizabeth was upset by the school nurse, who said she could not be vaccinated without the consent of both. Elizabeth researched the state’s laws, learning that she wasn’t old enough to agree on her own.
It showed up anyway. At worst, I thought the school would keep her away.
Apparently, they only noticed her mother’s approval. Elizabeth didn’t say anything, holding her arm.
Now she is in trouble. The school requires students to be vaccinated in the fall and says her father has started fighting with the administration over the issue. Elizabeth fears that if he learns how she was vaccinated, he will be angry and tell the school, which will discipline her for deceiving the vaccinators, a disgrace on her record while applying to university.
Gregory Zimmet, a psychologist and professor of pediatrics at the Indiana University School of Medicine, noted the irony of legally preventing a teen from making a decision that has been strongly urged by public health officials. Developmentally, he said, teens as young as 14 and even younger are at least as good as adults in assessing vaccine risks. “That doesn’t mean adults are necessarily good at it,” he said.
In many states, young teens can make decisions about contraception and sexually transmitted diseases, which, he noted, are “in many ways more complex and fraught than getting a vaccine.”
Pediatricians say that even parents who have been vaccinated are themselves wary of their children. Dr. Jay Lee, family physician and chief medical officer of Share Our Selves, a community health network in Orange County, California, said parents say they’d rather risk their child contracting COVID than get the new vaccine.
He told me, “I will check on their concerns, but I point out that waiting to see if your child gets sick is not a good strategy. And that’s no, COVID is not just like the flu.”
Elise Yarnell, director of clinic operations in Portland, Oregon, in Providence, a large healthcare system, called a 16-year-old girl who showed up at a COVID vaccine clinic at her school in Yamhill County.
Her parents were against the vaccine, so she wanted to get it without their knowledge, which she can legally do because Oregon’s age of consent is 15. She is able to return that night without alerting her parents and has been vaccinated.
“She was very relieved,” Yarnell said.
Isabella, the 17-year-old daughter of Charice, a Florida mother who refuses to grant permission to use the vaccine. When asked why she wanted the shot, Isabella offered a host of reasons. “A lot of the elderly in my family are at risk of contracting COVID and possibly dying,” she said. “I want to get vaccinated so I can be around them, and they’ll be safe. And then I can go out with my friends again, and they won’t be in much danger either.”
Although doctors try to instill confidence in the vaccine in parents and patients alike, there is not much they can do when parents object. Recently, Dr. Mobin Rathore, a professor of pediatrics at the University of Florida College of Medicine in Jacksonville, told a patient whose mother had refused her consent that she could not get a COVID vaccine until she was 18, three weeks later.
“She was vaccinated for her birthday,” Rathore said. “She texted me saying it was her birthday present for her.”
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