Cross Country Checkup

When it comes to COVID vaccines, older teens may call the shots, say experts

As vaccines begin to roll out in parts of the country for those aged 12 to 17, the decision about whether or not to vaccinate could be left to teens — not parents.

Dr. Fatima Kakkar says many 13, 14-year-old patients 'able to discuss and to ask questions on their own'

A 13-year-old receives a COVID-19 vaccine at a vaccine clinic in Ann Arbor, Mich. Health Canada approved the vaccine for adolescents aged 12 to 15 earlier this month, followed by regulators in the United States. (Jacob Hamilton/Ann Arbor News/The Associated Press)

As vaccines begin to roll out in parts of the country for those aged 12 to 17, the decision about whether or not to vaccinate could be up to teens — not parents.

When it comes to medical decisions among teens — think 14 to 16 — the concept of maturity, not legal age of majority, is a key factor in the choices a patient makes with their physician, according to the Canadian Medical Protective Association.

While it can vary between jurisdictions, like in Quebec where the age of consent is 14, doctors will consider a teen's ability to make decisions about their own health, including on vaccines.

"It really is the health-care provider's judgment on whether the individual in front of them is competent," said Timothy Caulfield, Canada Research Chair in Health Law Policy at the University of Alberta.

"When you're talking about something like a vaccine, which is very straightforward ... the competency hurdle is going to be quite low."

Since Health Canada approved Pfizer-BioNTech's COVID-19 vaccine for use in people aged 12 and up earlier this month, provinces and territories have begun offering shots to younger Canadians.

Northwest Territories began immunizing people over 12 on May 6, with Alberta and Manitoba following suit last week. Saskatchewan and Ontario will drop vaccine eligibility to 12 and up later this month. Other provinces and territories, including British Columbia, have yet to announce set dates for wide availability.

WATCH | Dr. Fatima Kakkar and Caroline Colijn on vaccines for those 12 to 15

Health Canada authorizes Pfizer vaccine for adolescents

3 months ago
7:24
Dr. Fatima Kakkar, pediatric infectious diseases specialist, and Simon Fraser University professor Caroline Colijn, spoke to Canada Tonight about Health Canada authorizing the Pfizer vaccine for use in people as young as 12 years old. 7:24

With many younger Canadians still out of school and separated from friends, the change is welcome for Dr. Fatima Kakkar, a pediatric infectious diseases expert based in Montreal. 

She says immunizing people aged 12 to 17 will be a benefit, even if research shows a lower risk for severe COVID-19 illness among younger demographics, because it will help reduce the negative impact on mental health they are experiencing.

"Until they're vaccinated, they're not going to be able to have a normal school year with in-class learning and return to sports and return to activities, because while COVID continues to circulate, there will always be this need to quarantine in case of exposure," she said.

'They might disagree with their parents,' says doctor

Though Caulfield says the decision about whether to be immunized may ultimately fall to a teen patient, disagreements between parents and their children can arise.

Some parents, he notes, may have questions about the long-term effects of COVID-19 vaccines, including on fertility. There is no evidence vaccines cause fertility problems, according to the U.S. Centres for Disease Control.

Riley Oldford, 16, gets the Pfizer-BioNtech COVID-19 vaccine on Thursday, May 6, 2021. Janie Neudorf, right, is the nurse who administered it. She said Riley is "making history." (Mario De Ciccio/Radio-Canada)

Kakkar, who treats children and adolescents, will often speak with the patient and parent together. Then, in order to better understand their opinions, she will speak one-on-one with the patient.

"Around age 13, 14, kids are willing and able to discuss and to ask questions on their own," she said. "Sometimes things will come out in a one-on-one discussion that they haven't talked about to their parents. Sometimes they might disagree with their parents."

Kakkar notes that parents have a wide range of responses to COVID-19 vaccines, from enthusiasm to worry, but that being open to discussions and answering questions is essential.

"It's really not something that you can force or impose on people, but I think it's really important that we discuss them," she said.

Improved media and science literacy for teens needed: Caulfield

But Caulfield notes that there is research to suggest that young people may be more susceptible to misinformation, which could influence their decision to become vaccinated. He attributes it to the spread of misinformation on social media platforms popular among young users.

"The older generation is the generation that has actually been the most open — and understandably so, they're the most vulnerable — to vaccines, and the younger demographic, the most hesitant," he said.

Pfizer-BioNTech's COVID-19 vaccine is currently the only COVID vaccine in Canada approved for people 12 to 15. (Cagla Gurdogan/Reuters)

The Proof Strategies 2021 CanTrust Index regularly checks in on Canadians' trust levels. Its online survey of 1,517 Canadians conducted between May 1-3 found vaccine trust is the lowest among younger and low-income Canadians — at 58 per cent for those with household incomes under $35,000 and 57 per cent for people under 25.

The survey used a national opt-in panel administered by The Logit Group. A randomized sample of this size would yield a margin of error of +/- 2.5 per cent, 19 times out of 20.

Caulfield says that the pandemic presents a key opportunity to encourage better science and health literacy in education systems.

"I'm hopeful that this is going to be one of the legacies of the pandemic and the greater appreciation of the harm that misinformation does," he said.

"Give kids the tools to be able to have both media literacy, but also scientific literacy, so they can tease out what's real and what's not real."


Written by Jason Vermes with files from CBC News and Abby Plener.

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