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

Jeanne R Delgado; Lisa N Mansfield; Katia Bruxvoort; Mayra Macias; Joseph Grotts; Bruno Lewin; David Bronstein; Corrine Munoz-Plaza; Peter Szilagyi; John Chang; Kristen Choi

doi:10.1016/j.jadohealth.2022.12.018

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

J Adolesc Health. 2023 May;72(5):674-681. doi: 10.1016/j.jadohealth.2022.12.018. Epub 2023 Feb 10.

Authors

Affiliations

¹ National Clinician Scholars Program, Division of General Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California; Division of General Pediatrics, Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address: jedelgado@chla.usc.edu.
² National Clinician Scholars Program, Division of General Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California.
³ Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
⁴ Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
⁵ UCLA School of Nursing, University of California, Los Angeles, California.
⁶ Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena, California.
⁷ Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California.
⁸ Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; UCLA School of Nursing, University of California, Los Angeles, California; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, California.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Keywords: Adolescent; COVID-19; Medical autonomy; Self-consent; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
COVID-19 Vaccines*
COVID-19* / prevention & control
Child
Health Personnel
Humans
Informed Consent
Parents
Vaccination

Substances

COVID-19 Vaccines