613 - Lowering the Age of Consent for COVID-19 Vaccination: It’s Worth a Shot

Poster Number: 613
Publication Number: 613.306

Margaret Irwin, Boston Children's Hospital, Cambridge, MA, United States; Christy L. Cummings, CHILDREN'S HOSPITAL BOSTON, DIVISION OF NEWBORN MEDICINE, BOSTON, MA, United States; Derek R. Soled, Harvard University, Boston, MA, United States

Background: COVID-19 vaccination hesitation is intensifying, especially for parents and guardians considering vaccinating their children. As of December 2021, only 53 percent of 12–17-year-olds in the US are fully vaccinated against COVID-19, versus 73 percent of adults 18+ who are fully vaccinated and 88 percent of adults 65+ who are fully vaccinated. The reasons for this disparity are complex and stem from a variety of structural and interpersonal barriers.

Objective: This proposal challenges preconceived notions surrounding a minor’s ability to provide informed consent in medical decisions. We argue that federal health law should be reformed to allow minors with capacity as young as age 11 to consent to their own CDC-approved COVID-19 vaccinations, regardless of parent or guardian consent. Such a law would align with and expand upon current exceptions to limitations on adolescent decision-making for other medical issues, such as mental health, sexually transmitted diseases, and birth control. 

Design/Methods: This analysis reviews the historic and ongoing anti-vaccination sentiment, the primary ethical arguments surrounding adolescent decision-making, and legal and policy guidelines regarding the age of capacity to give informed consent.

Results: The discrepancies in state regulations around informed consent laws in minors are striking: 23 states have laws allowing minors of varying ages access to certain vaccines, though these laws vary drastically. To date, only the District of Columbia has passed a law that permits patients as young as 11 years old to obtain all vaccinations without parental/guardian consent. Five states allow minors (albeit defined at different ages) to consent to COVID-19 vaccination without parental/guardian consent. Some of these discrepancies can be explained at least in part by cultural norms and legal precedent in those jurisdictions.Conclusion(s): A minor as young as 11 who demonstrates capacity to make non-life-threatening medical decisions should be given the right to receive a COVID-19 vaccine, regardless of parental/guardian consent. A law describing the age of capacity for informed consent for COVID-19 vaccination should be universal and uniform across all states. Grounded in respect for developing adolescent autonomy and the promotion of individual and public health, such a policy is particularly important in combating the current pandemic and in the future.