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Fact check: Claim is missing context on WHO's parental-consent guidelines for vaccinating children

Sudiksha Kochi, USA TODAY
·6 min read

The claim: WHO guidelines say students can be vaccinated without parents present

The Centers for Disease Control and Prevention and the Food and Drug Administration approved the use of the Pfizer-BioNTech COVID-19 vaccine for children ages 5-11 in late October and early November.

Social media users, however, have raised concerns about informed consent regarding the vaccination of children at school – citing a different health agency.

"WHO now says your child's presence in school counts as 'informed consent' for vaccination – parental presence 'not required,'" reads the text of a Facebook post shared Nov. 5, which generated more than 2,900 shares in less than a week.

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"Pull your kids out of public school!" reads the caption, which includes a link to 2014 guidelines from the World Health Organization regarding consent for vaccinating children.

But the claim is off base on several fronts.

The WHO has no legal authority to enforce its health guidelines in the U.S., experts told USA TODAY. Vaccination guidelines for children are determined by individual states, as is the type of informed consent required.

Furthermore, parental consent in the U.S. typically requires a direct opting in or out, not implied consent as referenced in the post.

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USA TODAY reached out to the social media user who shared the post for comment.

States determine means of consent

The WHO guidelines are not automatically enforceable in individual U.S. states, Teneille Brown, professor of law at the University of Utah S.J. Quinney College of Law, told USA TODAY via email. States would have to agree to be bound by the guidelines.

"Even if (President Joe) Biden signed on to WHO guidelines, they are not given the force of law," Brown said. "Individual states would have to pass legislation that enacted these guidelines as law."

Since that hasn't happened, the WHO guidelines are merely that – guidelines.

Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law, confirmed the WHO has no legal authority in the U.S. in this situation.

The general rule in the U.S. is that parental consent is required for vaccination of a minor, according to Brian Dean Abramson, adjunct professor of vaccine law at Florida International University.

"However, there are a number of states that have provisions allowing minors to receive medical treatment, some specifically including vaccination, under certain circumstances without parental consent," Abramson told USA TODAY via email.

These apply to older minors, typically between the ages of 15 to 17, or to minors subjectively deemed by the vaccine administrator to have the maturity to make such decisions, such as those who are emancipated, married or are high school graduates, said Abramson.

Craig Palosky, spokesperson for the Kaiser Family Foundation, told USA TODAY the policy of informed consent varies from state to state. The foundation has put together an updated list of state policies regarding parental consent for the vaccination of children.

Forty states generally require parental consent until the age of 18, according to the chart. Nebraska requires parental consent until age 19, while North Carolina requires parental consent until age 16 because state law takes into account full FDA approval of the Pfizer-BioNTech vaccine for individuals 16 and older.

This means the mature minor doctrine, in which a provider determines the minor is mature enough to make health care decisions and can waive parental consent, can be applied to those 16 and 17 years of age in North Carolina. Four other states – Arkansas, Idaho, Tennessee and Washington – also have some form of the mature minor doctrine.

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In the remaining four states, there are specific laws that say minors of a certain age do not need parental consent.

Not all informed consent requires parental presence

In the U.S., parents generally need to explicitly opt in or out of vaccinations, said Jennifer Tolbert, director of state health reform at Kaiser. She said she can't say for certain implied consent isn't used anywhere, however, given the thousands of jurisdictions across the country.

A child's presence in school does not automatically equal implied consent in the U.S., according to Tolbert.

"In states that don't require that a parent be physically present, that does not mean that the parent is giving implied consent," Tolbert said. "These parents still have to actively consent either through an online form that they complete or provide that consent over the phone."

She said the type of informed consent states require varies. Some states require written consent, others require a parent or another adult acting on their behalf be present when the vaccine is administered.

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Schools can also get parental consent by sending home a consent form before a vaccine clinic so the parents do not actually have to be present, according to Dorit Rubinstein Reiss, professor at the University of California Hastings Law School.

"It's not true that just (a student's) presence would serve as consent. The parents would have to consent in some way," Reiss told USA TODAY via email.

Our rating: Missing context

Based on our research, we rate MISSING CONTEXT the claim that WHO guidelines say students can be vaccinated without parents present. The WHO has no legal authority to enforce its health guidelines in the U.S., experts told USA TODAY. Vaccination guidelines are determined by individual states, as is the type of consent required. Experts say implied consent, as referenced in this claim, typically isn't used in the U.S., as parents must directly opt in to vaccinations through a verbal or written response.

Our fact-check sources:

Contributing: Daniel Funke

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This article originally appeared on USA TODAY: Fact check: Claim about WHO and parental consent is missing context