Teens turn to COVID-19 vaccine advocacy as most state laws prohibit minors from being vaccinated without consent

There is a high school sophomore from Texas who wakes up at 6 a.m. on the weekends when she knows her parents are asleep, so she can secretly and quietly make calls as an ambassador for a teen pro-vaccine group, fighting off vaccine misinformation.

The reason for all the cloak and dagger secrecy? The 15-year-old, who asked to be called Rain (not her real name), is the daughter of QAnon followers who hold strident views against mask wearing, social distancing and the coronavirus vaccine.

Rain is part of a growing generational divide, experts say, in a nation where adults and their children are consuming two entirely different streams of information about the unfolding COVID-19 pandemic, with many holding sharply different views about how they should respond to it.

“Students are thinking for themselves,” said Dr. Douglas Diekema, a University of Washington Medicine Professor of Pediatrics and Seattle Children’s Physician. “Kids spent an entire year, in most places, not being able to go out and now, they want to go to school, they want to see their friends and they know that the quickest way to do that and the safest way to do that is to get vaccinated."

“And they’re mad about the fact that they can't accomplish that without their parents' permission,” Diekema said.

Rain works with Teens For Vaccines, an organization started in 2019 by Arin Parsa, a teenager from California who -- as a sixth-grader-- developed an interest in vaccine law and public policy at the height of the measles outbreak. The two connected after Rain took to social media publicly to express her frustration at local attitudes toward vaccination.

She said her social media post “was getting a lot of hate comments from conservatives when Teens For Vaccines reached out to me and said I was very brave,” Rain told ABC News. “And since joining them, I’ve seen that there’s a lot of teens in my shoes who can’t speak out, so I want to be a voice for them.”

Parsa’s interest in vaccine hesitancy predates the pandemic. He was inspired by Ethan Lindenberger, a teenager who gained national attention in 2019 when he posted on Reddit that he had never been vaccinated because his mother believed that vaccines are dangerous.

Lindenberger testified before a Senate committee about how misinformation that appears on Facebook, Twitter and other social media fuels the anti-vaccination movement.

Since then, Parsa began reaching out to teens with anti-vaccine and vaccine-hesitant parents on Reddit to answer their questions, guide them through state consent laws and help them educate and convince their parents to allow them to get vaccinated.

As misinformation, vaccine hesitancy and anti-vaccine sentiment have consumed the debate over a global pandemic response, the rift between some teens and their parents has increased. Teens For Vaccines has 30 state ambassadors like Rain across the country and has partnered with GENup, another teen organization with more than 4,000 student members.

The work of the organization has garnered national interest, with most recently, Parsa being invited to a back-to-school virtual event with Dr. Anthony Fauci, chief medical advisor to the White House and Douglas Emhoff, Vice President Kamala Harris’ husband, to encourage youth vaccinations.

“We are seeing a groundswell of teens from across the nation speaking up for public health and science in an era where truth and facts are being combated from all sides,” Parsa said.

Youth vaccination across the country

The Centers for Disease Control and Prevention expanded the COVID-19 vaccine eligibility in May to everyone in the U.S. 12 years and older. However, a Kaiser Family Foundation survey from August found that for parents of unvaccinated teens, their top concerns about the COVID-19 vaccine are around the potential for long-term or serious side effects.

The survey noted that the vaccination status of children “closely mirrors that of parents" with "larger shares" of Democrats, and those with higher incomes and college degrees saying their child is vaccinated, while nearly four in 10 Republican parents and half of parents who are unvaccinated themselves say they will not get their eligible children vaccinated.

And while 12-to-17-year-olds continue to be the least vaccinated eligible age group in the country, the vaccination rate among adolescents is growing faster than any other age group, White House coronavirus response coordinator Jeff Zients said in late August.

According to the White House, 50% of 12-to-17-year-olds now have at least their first shot.

But for the adolescents who are eligible to be vaccinated and cannot do so because their parents are vaccine-hesitant or anti-vaccine, there aren’t many options.

“Pretty much all states have created situations in which a minor can provide consent but they're pretty limited to the treatment and diagnosis of sexually transmitted diseases, the treatment and diagnosis of pregnancy and pregnancy-related conditions, the provision of psychiatric and substance abuse care," said Diekema “But vaccinations have never fallen into that category or those categories.”

“So in most states, vaccinations require parental consent and the COVID vaccine today is no exception to that,” Diekema said. “It’s kind of messy and it’s definitely different from state to state.”

As of May, teenagers ranging from 11 to 16 can consent to being vaccinated in Alabama, the District of Columbia, Oregon, Rhode Island and South Carolina, an analysis by the Kaiser Family Foundation showed. In Arizona, although parental consent is required, a child can be vaccinated if a court order is obtained.

A few states, said Diekema, have a “mature minor doctrine” in place that allows adolescents to give consent for medical care but not all include vaccination. Arizona, Idaho and Tennessee are among the states with mature minor doctrines in place.

In August, North Carolina, one of the states with a mature minor doctrine, passed legislation requiring minors to have approval from a parent before receiving the COVID-19 vaccine.

“Generally speaking, if you are in a state where parental consent is required for medical treatment for vaccines specifically or medical treatment, generally, then you are kind of out of luck if your goal is to be vaccinated and your parents are opposed to it,” said Brian Abramson, a vaccine law professor at Florida International University.

Abramson told ABC News that from a legal perspective, he believes some state vaccine laws that don’t permit children to give their own consent to be vaccinated are “not based in reality” because in some cases, minors who have children or are married can make their own health decisions.

“If a minor gets married, that certainly doesn't demonstrate that they have the capacity and the maturity to make those decisions,” Abramson said. “Sometimes it demonstrates the opposite. But that's the way the law is.”

“If you have a minor of a relatively mature age and they are seeking to be vaccinated to protect themselves from an infectious disease that has spread all over the country,” Abramson added, “that by itself is kind of an indication that they have a degree of maturity sign that they understand the consequences of their actions because they're seeking to receive a vaccine that's recommended by all the federal agencies and state agencies and by science.”

Because of how difficult it is for an adolescent to get vaccinated without their parents' consent, Parsa said that a lot of his work is focused on helping teens educate their parents and addressing concerns.

“We always try convincing parents first,” Parsa said. “If nothing works, we show them the minor consent laws for their state and help them find a local pharmacy. But ultimately, we need to be able to have a law that says high schoolers should be able to consent to all the vaccines.”

In Texas, where Rain lives, minors need parental consent to be vaccinated.

“I’m probably going to have to deal with the fact that I can’t get vaccinated for COVID until I turn 18,” Rain said. “Going to school is scary but I try my best to wear my mask, sanitize my hands after every class and stay away from large groups of people even though it’s hard.”