Can my minor consent to vaccination in a school-based health clinic?
Many schools nationwide offer health services through school-based health centers (SBHC) to improve access to health care for underserved populations.1 These services may include vaccination. Parents and guardians have the right to be notified when SBHC services will be provided to a minor child.2
Federal Law & Parental Consent Rights
SBHCs were created in 2010 under the Affordable Care Act (ACA). Any SBHC receiving federal funds must obtain consent from parents and guardians when services are provided to minor children. But this provision may not apply if you live in a state that allows minors to consent to health procedures.3
However, the Protection of Pupil Rights Amendment (PPRA) of 1974 also requires schools receiving federal funding to notify parents and guardians of any activity requiring invasive physical examination, including, but not limited to, bodily injections, and the ability to opt a student out.4 5
Under PPRA, violations must be reported within 180 days of the violation. These complaints are filed with the form provided to parents and guardians on the U.S. Department of Education’s website.6
Federally Required Vaccine Information Statements
The federal National Childhood Vaccine Injury Act of 1986 requires that parents and guardians receive a Vaccine Information Statement (VIS) before a minor child can receive a routinely recommended vaccine.7
According to the U.S. Centers for Disease Control (CDC), in the SBHC setting, a VIS for each routinely recommended childhood vaccine must be given to the student’s parents or guardians before vaccination.8 9 Additionally, the CDC states that schools must verify that parents and guardians have received and reviewed the VIS10 and that it may be distributed several weeks before an SBHC event where vaccination may be provided, as long as the VIS is current.11
Additionally, while there is more pressure for minors to be able to consent to medical procedures without parental knowledge or consent, minor to consent to vaccination in the District of Columbia was successfully challenged in 2022.12
Make a Plan & Prevent Vaccination Bullying of Students
NVIC advises parents and guardians to be proactive and reach out to your child’s school with questions about SBHCs. Below are sample questions to consider:
- Does the school allow minor consent to vaccination?
- Are any vaccine clinics scheduled, and what process is in place to notify parents of the event, obtain parental consent or the ability to opt out?
- Are health services or vaccinations offered on a walk-in basis as opposed to a scheduled event? If so, what process is in place to notify parents of this policy, the services provided, and to obtain parental consent or provide the ability to opt-out?
- How far in advance will parents/guardians receive a VIS and what process is in place to verify parent/guardian receipt and review of the VIS – per CDC guidelines and federal law? How will the school ensure that the most current VIS is distributed to parents/guardians?
- What vaccine-related curriculum is being used in the classroom, when is it scheduled to be taught, and what provision is in place to opt out, if desired?
Learn about minor consent laws in your state. These laws vary from state to state and can change. A 2022 study published in the journal Pediatrics provided a state by state overview of types of minor consent laws with links to statutes. To confirm minor consent laws listed within this study, visit NVIC's state pages by scrolling down to the clickable U.S. map. Once on your state page, scroll down to the Minor Consent Vaccine Laws tab to view minor consent laws in your state. NVIC does its best to maintain and provide this information. To confirm this information and search for additional minor consent laws in your state use the link NVIC provides to your state legislature under the State Vaccine Registry and Other Vaccine Related Information tab on NVIC's state pages.
Talk to your child about vaccines and your vaccination decisions. Have a plan in place should your child be told that they must receive a vaccine without your consent or that they can agree to vaccination on their own. Many parents choose to tell their children to always say no until they can speak to their parents or to say they want to call and talk to their parents before vaccination.
Arm yourself with knowledge, empower, and protect your child with a plan to prevent coercion and bullying in the SBHC setting.
References:
1 42 USC 280h-5: School-based health centers. In: Affordable Care Act. U.S. House of Representatives – Office of the Law Revision Counsel United States Code Accessed: Aug. 12, 2023.
2 America First Legal. AFL: The AFL Protection of Pupil Rights Amendment: A Toolkit for Parents. Aug. 26, 2021.
3 42 USC 280h-5: School-based health centers. In: Affordable Care Act. U.S. House of Representatives – Office of the Law Revision Counsel United States Code Accessed: Aug. 12, 2023.
4 20 U.S. Code § 1232h - Protection of pupil rights. U.S. House of Representatives – Office of the Law Revision Counsel United States Code Accessed: Aug. 12, 2023.
5 U.S. Department of Education Student Privacy Policy Office. SPPO-21-01 Protection of Pupil Rights Amendment (PPRA). Nov. 24, 2020.
6 U.S. Department of Education. File a Complaint - PPRA Complaint Form. In: Protecting Student Privacy. Accessed Aug. 14, 2023.
7 42 USC 300aa-26: Vaccine information. U.S. House of Representatives – Office of the Law Revision Counsel United States Code Accessed: Aug. 12, 2023.
8 U.S. Centers for Disease Control and Prevention. Q: What are the acceptable methods of VIS provision to parents/legal representatives? In: VIS Frequently Asked Questions – Using Vaccine Information Statements. Apr. 5, 2019.
9 U.S. Centers for Disease Control and Prevention. Q: Our state allows parents/legal representatives to provide a single, one-time consent for vaccines that require multiple doses given over weeks or months. In this case, do we have to provide a VIS prior to every dose administered? In: VIS Frequently Asked Questions – Using Vaccine Information Statements. Apr. 5, 2019.
10 U.S. Centers for Disease Control and Prevention. Q: How early can VISs be provided to parents/legal representatives prior to vaccination? In: VIS Frequently Asked Questions – Using Vaccine Information Statements. Apr. 5, 2019.
11 U.S. Centers for Disease Control and Prevention. Q: How early can VISs be provided to parents/legal representatives prior to vaccination? In: VIS Frequently Asked Questions – Using Vaccine Information Statements. Apr. 5, 2019.
12 Parental Rights Foundation. DC Minor Consent Case. Nov. 22, 2022.
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