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As COVID-19 numbers among youth concern health officials, young people may face barriers to vaccination without parental consent

Student Miles Lewis receives a COVID-19 vaccine from Adam Phillips, an RN with Spokane Public Schools, in May at NC High School.   (Tyler Tjomsland/The Spokesman-Review)

OLYMPIA – Although vaccines are now available to children 12 and older, hesitant parents could be keeping vaccination rates among youth low – a worriesome scenario that health officials say is putting young people in the hospital.

About 28% of youth ages 12 to 15 in Washington are vaccinated and about 41% of 16- and 17-year-olds have received their first dose, according to the Department of Health. In Spokane County, about 17% of those ages 12 to 17 have received at least one dose, as of June 3.

A report from the Centers for Disease Control and Prevention released last week showed alarming trends in COVID-19 hospitalization rates for adolescents aged 12 to 17.

According to the report, hospitalizations among that age group rose from March 1 to April 24 after declining earlier this year. Nearly one-third of those required intensive care unit admission, and 5% required mechanical ventilation.

“Much of this suffering can be prevented,” said CDC Director Rochelle Walensky. “I ask parents, relatives and close friends to join me and talk with teens about the importance of these prevention strategies and to encourage them to get vaccinated.”

Part of the reason for low rates could be hesitancy among parents, even if their child wants a vaccine, University of Denver sociology professor Jennifer Reich said. Reich has studied how individuals and families weigh information about vaccines and healthcare and how they interact with service providers.

Reich said there’s a small group of parents who will never be swayed to vaccinate their children. A larger group is vaccine-hesitant, but not necessarily opposed to all vaccines in all circumstances.

“They treat each vaccine as their own decision,” she said, meaning they make separate decisions for each vaccine for each child.

If a parent is concerned about a new vaccine that is not entirely understood, Reich said parents may opt out because they fear the vaccine more than the actual disease.

In some cases, children may want vaccines but can’t get one without parental consent. State laws vary on vaccinating minors with or without consent, but generally, a person 12 to 17 can’t receive a vaccine without a parent signature.

In North Idaho, getting a vaccine without parental consent isn’t an option. The Panhandle Health District requires parental consent for anyone under the age of 18, district spokeswoman Katherine Hoyer said.

The consent form requires a parent or guardian to fill out a medical history and patient and parent information.

Hoyer said the district doesn’t have any data on whether there are many kids who want the vaccine but can’t get one because their parent won’t consent.

The district has provided schools with information addressing common concerns by parents, Hoyer said.

“We encourage anyone who is interested in receiving the vaccine to speak with their family physician or a trusted medical professional,” she said.

In Washington, the Department of Health encourages providers to treat the COVID-19 vaccine as it would other recommended vaccinations for adolescents. A parent or guardian must consent for a COVID-19 vaccine.

The Department of Health leaves it up to local organizations to determine what they consider consent. The Spokane Regional Health District requires a parent or guardian to fill out a consent form during the COVID-19 vaccine registration process.

Mature minors, emancipated minors and married minors are exempt from this rule. Washington has a “mature minor doctrine,” established in a Washington Supreme Court decision from 1967. It allows some providers to determine whether a minor has the capacity to understand the proposed health care service or treatment, according to the Department of Health.

The mature minor doctrine is often used to allow minors over the age of 14 to consent to STD diagnosis and treatment without permission from parents.

Health care providers are responsible for determining whether a mature minor situation applies, and each health district can draft its own standards for how to use the doctrine.

The Spokane Regional Health District follows the Department of Health guidance regarding the mature minor doctrine, spokesperson Kelli Hawkins said.

The department encourages providers to use “age, intelligence, maturity, training experience, economic independence, general conduct as an adult and freedom from the control of parents/guardians.”

The King County health department uses similar guidance for the mature minor rule. The department has a list on its website that providers can use to determine if minors can make their own health care decisions. A minor must meet one or more from a list of factors that includes freedom from parents or guardian, self-supporting or general conduct as an adult.

A provider must provide documentation that determines the minor can be considered mature.

Many young people have experienced other kinds of detrimental side effects during the pandemic by not being able to socialize or go to school, Reich said. Those who do go to school or socialize may worry about infecting family members if they do so.

“A vaccine provides a solution,” Reich said.

Many new parents have not lived through the process of a vaccination being made or are too young to remember new vaccines for polio or measles, Reich said. As more is learned about the COVID-19 vaccine and more people start to get it and talk about it, the likelihood that those hesitant parents will consent for their children will increase, she said.

It’s important that parents have access to answers about their concerns, Reich said.

“There are good answers to these questions, and parents should have opportunities to ask them and have conversations,” she said.

Laurel Demkovich's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.