Adolescent Self-Consent for COVID-19 Vaccination: Views of Healthcare Workers and Their Adolescent Children on Vaccination Autonomy

• Published in: Journal of adolescent health 2023-05, Vol.72 (5), p.674-681
• Main Authors: Delgado, Jeanne R., Mansfield, Lisa N., Bruxvoort, Katia, Macias, Mayra, Grotts, Joseph, Lewin, Bruno, Bronstein, David, Munoz-Plaza, Corrine, Szilagyi, Peter, Chang, John, Choi, Kristen
• Format: Article
• Language: English
• Subjects: Adolescent; Child; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines; Health Personnel; Humans; Informed Consent; Medical autonomy; Original; Parents; Self-consent; Vaccination
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2022.12.018

This study explored the perceptions of healthcare worker parents (physicians, nurses, and staff) and their adolescents (aged 12–17 years) on adolescent self-consent to COVID-19 vaccination by applying the concept of positive deviance of those already vaccinated against COVID-19. We used a qualitative descriptive design to conduct individual, semi-structured interviews with COVID-19–vaccinated healthcare workers in Southern California and their vaccinated adolescent children. Separate interviews were conducted with parents and adolescents from November to December 2021 using digital phone conferencing software. All interviews were recorded and transcribed. Thematic and constant comparative analysis techniques were used to identify relevant themes and subthemes. Twenty one healthcare workers (9 nurses, one nurse practitioner, one technologist, and 10 physicians) and their adolescents (N = 17) participated. Three overarching themes were identified to describe participants' perspectives about adolescent self-consent for COVID-19 vaccination: (1) Family values and practices around adolescent vaccination; (2) Differences in parent and adolescent support for vaccine self-consent laws; and (3) Parent and adolescent uncertainty on readiness for vaccine self-consent laws. Adolescents largely supported self-consent while parents supported the policy if they would be able to have a discussion with their adolescent prior to the decision. Parents and adolescents supported adolescent self-consent for COVID-19 vaccination, with the reservation that adolescents should discuss the decision alongside their parents to exercise their medical autonomy with supportive guidance. Greater adolescent involvement in making decisions and providing self-consent for healthcare, including vaccines, could prepare adolescents to have a greater sense of autonomy over their health and contribute to population health measures.