Will Quebec teens with vaccine-hesitant parents decide to get a shot? It's up to them
MONTREAL -- Quebec authorities made sure to repeat the point clearly several times this week: in this province, if you’re at least 14, you can decide on your own whether to get a vaccine.
Parents don’t need to agree, or even to know.
It doesn’t work quite like that in other provinces—Quebec is unique in the hard-and-fast age cut-off it draws for medical consent. And that system is soon going to be exercised like never before as the COVID-19 vaccine becomes available to the province’s teens, likely sometime in June.
“We will give the parents… good information, and even the kids, because some of them who are 14 years old and [older] can ask questions,” said the province’s public health director, Dr. Horacio Arruda, on Thursday.
“We will answer those questions.”
What’s less clear is how many teenagers with vaccine-hesitant parents quietly disagree with their views, at least on the COVID-19 vaccine.
Even less clear is how many, if they do disagree with their parents, will act on it.
It can be really hard, said one Montreal-area mother who says she helped one of her kids’ classmates catch up on childhood vaccines after he turned 14.
He had to do it secretly after the issue got heated at home and his parents threatened that he wouldn’t “live here anymore” if he got vaccinated.
“They were saying ‘Now that you’re 14, you could go, but [if you do] you’re kicked out,’” said the woman, Kathy.
Kathy works with many teens as the longtime manager of a youth sports team and has two teenagers of her own. CTV isn’t publishing her last name or where in Montreal she lives in order to avoid identifying the boy she described, whose parents still don’t know he got his vaccines.
“It was, to them, an affront. It was voluntarily going against their rules.”
A CLANDESTINE OPERATION
The boy told her how he’d started to diverge from his parents in Grade 4, when he didn’t get a routine vaccination and realized his classmates all did.
“His parents were telling him that every ailment under the sun was caused by vaccines,” she said.
A couple of years later, when his friends seemed healthy, he asked questions at home and the conflict began.
At 14, he mentioned it offhand to some peers, word got back to Kathy, and she contacted him privately.
“You are of age to do it,” she said, offering to answer any questions or help out if he wanted.
Over several weeks, he called her as he researched diseases like measles and as she, over FaceTime, helped him find “reputable sites.”
She also told him how she personally knew children, when she was young, who became deaf from mumps, which is very rare now.
He ended up coming up with his own logic: among his friends who were vaccinated, the worst health problems were issues like asthma. Even if his parents were right and the vaccines caused those problems, he told Kathy, he’d rather have asthma than get something like measles, especially as an adult.
Kathy drove him to a clinic four times to catch up on all the vaccines. His doctor knew, but doctors can’t inform Quebec parents of a child's private health decisions after age 14.
“When he was finished, he said he was really happy about it... [he] felt bad about not telling his parents,” but said they shouldn’t decide for him, she said.
Kathy said she ended up helping one other teenager also get his vaccines late, though he planned to tell his parents when he turned 18 and moved out.
EVEN SICK KIDS STAY 'MUTE'
Still, cases like that will likely stay pretty rare, said a Montreal doctor specializing in pediatric infectious disease, Dr. Earl Rubin.
“It’s an unusual scenario where the kid will want a vaccine and the parents don't,” Rubin told CTV.
With other vaccines, that’s partly because they’re scheduled for babies and toddlers, he said. The parents simply “won’t bring the kid to the doctor.”
This year, it’s different: “Every kid 12 and over… knows about COVID and vaccination,” Rubin said.
But, he predicts, if kids are “coming from a family that is vaccine-hesitant, they will very much go along with what the parents think.”
He’s seen plenty of preventable cases of meningitis, measles and other infections caught by Quebec kids who weren’t vaccinated, and most didn’t object even after getting sick.
“The majority of the time, the kids really are mute about it,” said Rubin.
Rubin’s 15-year-old daughter, Emma, said she predicts the same. One classmate of hers at a Montreal West school comes from a staunchly anti-vaccine family and has already weathered plenty of awkwardness over it.
“People definitely judged her,” Emma said.
All the same, the girl in question has already said she isn’t planning to get the COVID-19 vaccine.
“If your family is very outspoken about not getting vaccinated and talking about it from a young age, you're going to have it planted in your brain that it's going to cause bad things,” Emma said.
“You do trust what your parents say—they raised you.”
QUEBEC TEENS GIVEN UNUSUAL LEGAL CONTROL
Research suggests that parents’ influence on vaccines may not outweigh other influences.
One study of high-school students in Long Island, N.Y. found that 62 per cent saw doctors as the best source of information on vaccines, with only 24 per cent trusting their parents above all.
However, teenagers are also subject to the same sources of misinformation as adults and are just as stubborn if they’ve developed views against vaccines, others have pointed out.
Quebec authorities have reason to remind teens it's entirely their decision, since that's unusual.
In fact, COVID-19 vaccinations for local students will likely be rolled out at school, and parents will get an authorization form, even for 14-year-olds and possibly older students.
That’s in keeping with the way other at-school vaccinations are handled, Arruda explained Thursday.
However, if a parent doesn’t sign, any student over 14 will likely still be able to get the vaccine from the visiting public health nurse—or they could visit a mass vaccination centre on their own at another time.
Quebec is alone in having a clearly delineated age. Other provinces look at consent more on a case-by-case basis, asking doctors to decide if each patient, including young ones, has the capacity to understand the treatment and agree.
Some provinces, including New Brunswick and Manitoba, also set a guiding age below which people are presumed to be incapable, or less capable, of consent—unless they show otherwise. But both those provinces set that age limit at 16.
Quebec teens’ medical rights also seem to give them stricter confidentiality, with doctors and schools trained not to release health information of kids over age 14 to their parents.
“If the child says ‘Do not tell my parent’ for anything medical, you’re not allowed to tell the parent,” said Rubin.
An Ontario lawyer who’s studied medical consent, Jill McCartney, said that elsewhere in Canada, “the general rule of thumb is that… medical records would go hand in hand with who’s giving the consent,” meaning if the parent weighed in, he or she could have access, and if it was the child’s sole decision, the parent wouldn’t.
IN THE MINDS OF KIDS
There are hints of a wider trend towards creating systems more like Quebec’s. In December, Washington, D.C. passed a bill allowing children over 11 to make their own confidential decisions around vaccination.
Quebec parents on an anti-vax Facebook group complained this winter that the law is “criminal abuse” of children and that 14-year-olds are too young to decide, calling them “innocent” and also saying schools have “brainwashed” them about vaccines.
But Emma Rubin said she thinks that a major influence for people her age isn’t doctors, schools or parents—it’s celebrities.
Recently, for example, her classmates talked about it when one of their favourite stars got vaccinated: Olivia Rodrigo, an 18-year-old star of Disney’s High School Musical series.
“People copy what they see on YouTube or whatever,” Emma said. “She posted her vaccine ticket paper on her Instagram, and I think that honestly, that sends a message.”
Another thing she thinks might factor in for Quebec 14- and 15-year-olds? Knowing that summer camp may only be open to the vaccinated.
Vaccines “will help us get back to our teenage life,” she said.
Are you a teenager, or a parent, with stories to share on COVID-19 vaccination decisions? Email MontrealDigitalNews@bellmedia.ca.