Nearly all states require some form of parental or guardian consent for vaccine providers to administer Covid-19 shots to people ages 12 to 15, a CNN analysis finds. But there are a few exceptions.
Five states – Alabama, Iowa, North Carolina, Oregon and Tennessee – either allow some ages in that group to consent for themselves or leave requirements up to individual vaccine providers.
CNN reached out to all 50 states about their laws regarding parental consent to vaccinate people ages 12 to 15. The US Food and Drug Administration authorized the emergency use of Pfizer/BioNTech’s coronavirus vaccine in 12- to 15-year-olds in the United States on Monday and on Wednesday, the US Centers for Disease Control and Prevention recommended using the vaccine in that age group.
Expanding authorization to people 12 to 15 opened Covid-19 vaccination to another 5% of the US population, nearly 17 million more people. But not all parents of people in that age group want their children to be vaccinated against Covid-19
A Kaiser Family Foundation poll taken in April – before a Covid-19 vaccine for young teens was authorized – found that 30% of parents of people ages 12 to 15 said they would get their child vaccinated right away, and 26% said they would wait a while. However, 18% said they would get their 12-to-15-year-old vaccinated against Covid-19 only if it was required by schools and 23% said they definitely wouldn’t.
Parental consent requirements for vaccines are decided by states.
“The federal government does not actually govern over what kind of consent or assent you need for these teenagers,” CDC Director Dr. Rochelle Walensky said during a virtual event with The Economic Club of Washington, DC, on Thursday.
“Each person has to go to their state,” she said. “Many places will say, ‘Your parent doesn’t need to be there, but your parent needs to have information or your parent needs to have signed off.’ So it really does vary by state.”
In North Carolina, teens can consent for themselves for Covid-19 vaccines, “if they have the ability to understand and make decisions about their health,” Bailey Pennington, a spokesperson for the state’s Department of Health and Human Services, told CNN in an email.
“It is expected that in the majority of instances, communication is shared with parent and guardians and parent/guardian consent is obtained for COVID-19 vaccination for people under 18,” the email said in part, adding, “As part of normal development, most children are able to understand and make decisions about their health some point before the age of 18. There is no one age at which this always occurs; it varies from child to child. Some vaccine providers may ask for written consent for people under age 18 who are consenting on their own.”
“The Alabama Department of Public Health (ADPH) requires consent for vaccines for persons up to 14 years of age. Of course, ADPH wants parents and guardians engaged in the healthcare of their children,” Dr. Karen Landers, a health officer within the department, wrote in an email to CNN.
In Oregon, children 15 and older may give consent without a parent or guardian. In Iowa, CNN was told that individual health care providers or health systems consult with their legal counsel regarding requirements and documentation needed to administer Covid-19 vaccines.
Among the states that require parental consent to administer Covid-19 vaccines to ages 12 to 15, some noted rare exceptions to the requirement include if the person in that age group is married, pregnant or legally emancipated from their parents.
Where parental consent is required
Based on CNN’s outreach to health departments across all 50 states, here’s a list of where parental or guardian consent is now generally required for Covid-19 vaccinations among people ages 12 to 15:
- Alabama – Yes for younger than 14
- Alaska – Yes
- Arizona – Yes
- Arkansas – Yes
- California – Yes
- Colorado – Yes
- Connecticut – Yes
- Delaware – Yes
- Florida – Yes
- Georgia – Yes
- Hawaii – Yes
- Idaho – Yes
- Illinois – Yes
- Indiana – Yes
- Iowa – “It is up to each individual health care provider/health system”
- Kansas – Yes
- Kentucky - Yes
- Louisiana – Yes
- Maine – Yes
- Maryland – Yes
- Massachusetts – Yes
- Michigan – Yes
- Minnesota – Yes
- Mississippi – Yes
- Missouri – Yes
- Montana – Yes
- Nebraska – Yes
- Nevada – Yes
- New Hampshire – Yes
- New Jersey – Yes
- New Mexico – Yes
- New York – Yes
- North Carolina – No for teens
- North Dakota – Yes
- Ohio – Yes
- Oklahoma – Yes
- Oregon – Yes for younger than 15
- Pennsylvania – Yes
- Rhode Island – Yes
- South Carolina – Yes
- South Dakota – Yes
- Tennessee – Yes for younger than 14
- Texas – Yes
- Utah – Yes
- Vermont – Yes
- Virginia – Yes
- Washington – Yes
- West Virginia – Yes
- Wisconsin – Yes
- Wyoming – Yes
Additionally, some private businesses or pharmacies have their own rules.
For instance, CVS Health announced on Wednesday that Covid-19 vaccine appointments for adolescents ages 12 to 15 were available for scheduling at more than 5,600 CVS Pharmacy locations nationwide – but parental or legal guardian consent is required, and children must be accompanied by an adult.
In general, there’s “state-by-state variation” in terms of what is required for routine childhood immunizations, Jill Rosenthal, senior program director at the National Academy for State Health Policy, told CNN.
Get CNN Health's weekly newsletter
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
“It does look like it varies in terms of the age of the child, the issues facing the child, for instance if they were emancipated,” she said. “So it does seem like in terms of routine childhood immunizations, it really varies quite a bit.”
It comes as no surprise that the same variation is emerging in the rollout of Covid-19 vaccines for ages 12 to 15, said pediatric hospitalist Dr. Lisa Costello, of WVU Medicine Children’s Hospital in West Virginia and a member of the American Academy of Pediatrics’ Committee on State Government Affairs.
“As a pediatrician, this is certainly not a new issue,” Costello told CNN about parental consent.
“Every state has different rules that they follow,” she said. “Each state has a little bit of differences – and that’s why individuals work at their local level to determine what is needed for their community.”