As thousands of youth aged 12 and above line up to get their COVID-19 shots, parents and guardians may be surprised to learn that they don’t have to give permission for their kids to be vaccinated.
“Many people in the public are not aware of this, almost everyone in the province assumes there is an age for healthcare consent but there isn’t,” says Kerry Bowman, a bioethicist and professor at the University of Toronto’s Faculty of Medicine. “You have healthcare workers who are not aware of this legislation either.”
Under Ontario’s Health Care Consent Act, children have control over their own healthcare decisions, unless a doctor deems them incapable. When Peel Region updated its vaccination guidance to note that minors didn’t need parental permission, it touched off a wave of comments and confusion online.
CityNews spoke with viewers about their thoughts on vaccine consent for minors.
“Absolutely, its like any other significant decision in their life, and they’re not old enough in my mind to make it for themselves yet,” says Paul Greenberg.
“They should get their parents’ consent,” says Amy Profenna, who notes that young people could be swayed by peer pressure.
Some of the answers we received from teenagers differed from the adults.
“What if their parents are anti-vaxers, and they’re not anti-vaxers and they want to get the vaccine?” points out teen Nora Gallagher.
Adults and teens told CityNews that guardians and kids should have a family discussion.
“It’s a decision that both of you need to make,” says Owen Campbell. “You talk with each other and see how you both feel, and then I think that you go from there.”
The Canadian Paediatric Society says there is no national age of medical consent, and the only province to establish one is Quebec, where the consent of a parent or guardian is needed for treatment decisions for anyone under 14.
Bowman, who teaches about Ontario’s little-known consent law, notes the rules are meant to protect young people, as well as the elderly.
“The design of it is to protect human rights,” he says. “If a person is a frail elderly person in their 90s, or a young person, people have control and autonomy over their own bodies. That is the spirit of this legislation.”
Clinical studies are already underway to make the vaccine available to even younger children, and Bowman notes in the near future Ontario’s consent legislation could be tested further.
“Eventually as we go below 12, the assessment for the age of consent is going to be very, very important,” he explains. “If you’ve got a 12-year-old who really understands and appreciates — meaning they know what the vaccine is they know what its for they know this really small risk of side effects — they can consent.”
The paediatric society says it’s impossible to make blanket rules about capacity based on someone’s age. Instead, healthcare providers should look at each of their patients as an individual, and take into account “the patient’s emerging self awareness, developing values and beliefs [and] maturing cognitive skills” when confirming a young person is able to consent to a medical procedure.
While the ultimate decision to get vaccinated does rest with a person, no matter their age, the paediatric society also says family discussion is a best practice when a child’s capacity to consent is less certain.
“A family-centred, shared decision-making model best respects and supports the emerging capacity of the paediatric patient as well as parental authority and the knowledge and expertise of health care providers,” the society writes in its position paper on the topic. To help families make decisions, the City of Toronto is hosting several evening vaccination town halls for parents and students this week.
Bowman points out that the vast majority of children go to their medical appointments with their parents, and there’s usually a family discussion and general understanding. CityNews spoke with some who had that very conversation with their kids before taking them to receive their jab today.
“We felt it was important to explain and get him to say yes or no to it. He understands the reasons why we all have to be vaccinated,” says Gareth Roberts, who was taking his 13-year-old son Ethan to get inoculated today.
Ethan adds he and his parents talked about how the vaccine would help the world get back to how it was before the pandemic.
“I said, ‘I’d love to do it,’” he says.
Durham, Halton still working on 12+ vaccination availability
Ontario opened up vaccine eligibility to those aged 12 and up on May 23, ahead of schedule. Because of the early start, not everyone has had the opportunity to book an appointment. Halton and Durham are among the regions that have yet to open bookings to that age group. Both regions’ public health units operate their own booking systems.
Durham’s health department says they’re reviewing their current vaccine supply and appointments to try and accommodate the increased eligibility.
“We anticipate that we will open bookings before the end of this week,” says Glendene Collins, manager of community and resource development for the Durham Region Health Department.
Halton’s health team is working with local school boards on a youth vaccination program for those aged 12 to 17. A notice on Halton Region’s web site says “information on clinic locations and when the booking system will be updated to offer appointments for all 12- to 17-year-olds will be shared as the details of the program are confirmed.”