From HPV to COVID-19: Adolescent Autonomy and Minor Consent for Vaccines

From HPV to COVID-19: Adolescent Autonomy and Minor Consent for Vaccines

Despite effective available vaccines for COVID-19, continued low vaccine uptake has contributed to the continued morbidity and mortality associated with the COVID-19 pandemic. The unique challenges of this pandemic and possible parental resistance to vaccination have opened the door to conversations surrounding the potential expansion of adolescent vaccine consent parameters. With state-by-state variability in adolescents’ ability to consent to health care, providers must navigate possible barriers in these instances with ethical and practical rationale. A recent policy brief published in the Journal of Pediatric Health Care examined the laws governing adolescent consent for health care, including instances of vaccination, to support and encourage access to health care.

Although parental consent is generally required for vaccination, certain exceptions are made based on location and the vaccine in question. Some states explicitly allow adolescent minors to consent to vaccines that protect against sexually transmitted infections, such as hepatitis B or human papillomavirus (HPV).

The conflict between parents, children and adolescents around the topic of vaccines is not new and has only grown in recent years. The COVID-19 pandemic has highlighted the public health importance of vaccines while prompting controversies about vaccine safety and mandates, and these issues have become increasingly politicized.

Despite this, research has shown that minors develop the ability to make reasoned decisions about health care, including vaccines, during adolescence. To help continue these patterns, parents and health care providers should include them in discussions about their health care when possible.

“Providers have an important role to play in helping families navigate vaccine decisions with their teens, especially as new vaccines emerge,” said Lisa Mihaly RN, MS, FNP, coauthor of the article.

By allowing for collaborative discussions with patients and patient families, providers can share the importance and safety of vaccines while helping to implement a vaccine plan that works for those involved.

One way to do so would be to allow “parents to consent remotely by either calling in or printing the vaccine permission form and signing it, which is a good start. But this still excludes families who cannot call in real-time, because of work or language barriers and who can’t afford a home printer, so the next step is allowing secure permissions from cell phones to the health plan’s portal,” shared Naomi A. Schapiro, PhD, RN, CPNP-PC coauthor of the article.

By addressing the complex legal, ethical, and clinical factors related to parental consent and adolescent autonomy, there is the chance to clarify where and when adolescents can consent to vaccines while exploring the possibility of expanding the scope of this matter.

The article, “From Human Papillomavirus to COVID-19: Adolescent Autonomy and Minor Consent for Vaccines,” was published in the November/December edition of the Journal of Pediatric Health Care and can be accessed here

Dec. 7, 2022

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