Now that all Albertans 12 years of age and older are eligible for COVID-19 vaccinations, some pharmacists may wonder if they are able to vaccinate a child under 18 years of age if the child’s parent is not present to give consent for the injection.
A “mature minor” MAY receive a COVID-19 vaccine without the consent of a parent or guardian.
A pharmacist must determine if a minor is “mature” and has the capacity to provide informed consent for treatment. Informed consent means the patient has agreed to undergo a treatment or procedure after being provided, in a manner the patient can understand, with the relevant information about the nature of the treatment or procedure(s), its benefits, potential risks and alternatives, and the potential consequences of refusal. In the case of COVID-19 vaccines, individual pharmacists must determine whether a minor is a “mature minor” capable of understanding the consequences of receiving or not receiving a vaccination in order to provide informed consent to receive a vaccination.
The pharmacist’s decision must consider factors unique to the minor. The pharmacist must give regard to the minor’s age, maturity, intelligence, capability to balance risk, level of freedom from parental control, and any other factors that may be relevant in the circumstances.
Generally, when a pharmacist considers a minor’s age, the closer the minor is to reaching 18 years of age, the more likely the child can provide informed consent for treatment. The College of Physicians & Surgeons of Alberta (CPSA) considers 16 years of age as a “threshold for maturity” and the CPSA guides physicians that children younger than 14 years of age are especially unlikely to be “mature minors.”1 This guidance from CPSA highlights that age is an important factor in a mature minor assessment; however, a pharmacist must also consider other relevant factors listed above. A pharmacist must have a conversation with the minor to determine if they are a “mature minor.” The pharmacist can ask questions to the minor about their life, as well as questions gauging the minor’s ability to understand the vaccine treatment and ability to foresee consequences.
If after considering the relevant factors, the pharmacist finds that the minor can provide informed consent to receive the vaccine, the pharmacist may provide the vaccine. In that case, the pharmacist must document the mature minor assessment in the minor’s patient record. The pharmacist does not need to obtain parental consent and the pharmacist should maintain the minor’s patient confidentiality.
1 College of Physicians & Surgeons of Alberta, Advice to the Profession: Informed Consent for Minors (pdf) at page 7 (last revised December 2015).