Teens of anti-vaxxers need the right to be vaccinated
On March 5, Ethan Lindenberger, a high school student whose mom didn’t believe in vaccination, testified to Congress about his decision to immunize himself. He said, “As I approached high school and began to critically think for myself, I saw that the information in defense of vaccines outweighed the concerns heavily.” Through his own research, Ethan realized he was vulnerable to diseases other students were immunized against: tetanus, polio, diptheria, measles, mumps, rubella, hepatitis, human papilloma virus and pertussis.
As a physician and ethicist at Lucile Packard Children’s Hospital, I take care of children and young adults who need protection from contagious diseases — kids with cancer and transplants, dysfunctional immune systems, and infants too young to be vaccinated. Just last year, 85 percent of children who died of the flu were unvaccinated. Stories of a Chicago man who survived the measles and a 6-year-old Oregonian who nearly died of tetanus highlight the suffering associated with these preventable diseases.
We have a small but growing population of parents who refuse vaccination and the disease outbreaks to prove it. Even small decreases in vaccination rates can threaten herd immunity — the protection a community gains when enough people are vaccinated that a disease cannot spread as easily. Ethan’s testimony took place as Washington state suffers the worst measles outbreaks in recent memory, with more than 70 cases this year, and more than 200 cases nationally.
California tightened its restrictions on vaccine exemptions, but in 17 states parents may still abstain from vaccinating their children for nonmedical reasons. Ethan’s parents refused to vaccinate, as least in part, due to a fear of autism. The largest study yet looking at autism and the measles, mumps and rubella vaccines, again confirms there is absolutely no correlation between the two.
Medical students sometimes ask me why teens can’t make health decisions without their parents. I tell them, “It’s super complicated.” The muddy question of what it means to be mature is convoluted by the complex United States legal system. Our country’s checkerboard of teen health care rights varies widely across states, ranging from very limited rights (like Ohio) to more expansive rights for teens that show that they can understand treatment (like Oregon). Only 12 states have laws guaranteeing children of a minimum age or evidence of maturity (such as high school diploma) the right to make these decisions. Thirty-four states have no rules to allow mature minors to make general medical decisions, so normally teens need a parent’s consent.
The legal system assumes parents will make more rational decisions than teens. But what if they don’t? Current laws do not account for parents who do not believe in vaccination.
Ethan had to wait until he turned 18 because in Ohio, he lacked the legal right to make his own health decisions. In Washington, if a child is 15 years old or older and can demonstrate her maturity, she could potentially consent to vaccination. In California, thanks to rights around sexual health, children as young as 12 consent to vaccines for HPV and hepatitis B. Ironically, many states grant teens parental rights, so a teen may have the right to vaccinate her own baby, but not herself.
While aggressively fighting vaccine misinformation is key, it will likely take decades to turn the anti-vaccination cultural tide. Last week, New York state introduced legislation allowing teens to vaccinate themselves. Every state that lacks a path to early teen vaccination should follow suit. Children are entitled to basic care regardless of a parent’s misinformed beliefs. We cannot afford to wait for parents: We must empower motivated teens to make this mature decision.