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Vaccinating Youth and Adolescents

Everyone ages 5 and up is eligible for COVID-19 vaccination. The U.S. Food and Drug Administration (FDA) has authorized only the Pfizer-BioNTech COVID-19 vaccine (also called Comirnaty) for those under 18 years old.

Below are resources and information for providers who are interested in vaccinating people under 18 years old.

Education Materials

Printable Resources

Web Resources

Communication Toolkits

Clinical Resources

Provider Trainings

Frequently Asked Questions

Why should minors get vaccinated against COVID-19?

The COVID-19 vaccines protect the health of youth and their family and friends. Vaccinated youth are much less likely to get seriously ill, be hospitalized, or die from COVID-19.

What can I do as a provider to support COVID-19 vaccinations for youth?

COVID-19 vaccine providers can help youth get their COVID-19 vaccine by:

  • Listening to your patient's concerns and answering their questions with empathy. You can use the COVID-19 mRNA vaccine discussion guide (PDF) for tips.
  • Clearly stating your available vaccine types during the scheduling process, on the registration form, and at the clinic site. Currently, youth 12 to 17 can only get the adolescent/adult Pfizer-BioNTech vaccine, and youth 5 to 11 can only get the pediatric Pfizer-BioNTech vaccine.
  • Making your consent process clear during the scheduling process. Provide any necessary forms and let youth know what they need to bring to confirm consent. You should include if your organization:
    • Requires an authorized adult to provide consent in person for the vaccine
    • Applies the Mature Minor Doctrine
    • Accepts consent from school nurses and school counselors for minors who are unhoused through the McKinney-Vento Homeless Assistance Act
  • Offering incentives to compensate youth for their time.
  • Asking youth to outreach to other youth. They'll be more likely to trust and listen to their peers. You can also get their input on how your clinic could better serve youth. If youth have a good experience with a provider, they are more likely to come back and more likely to tell their friends about it.
Which vaccine can I administer to someone under 18 years of age?

Currently, youth under 18 years old can only receive the Pfizer-BioNTech vaccine:

  • Adolescent/adult formula, ages 12 to 17
  • Pediatric formula, ages 5 to 11

The Moderna and Johnson & Johnson (Janssen) vaccines are not available to anyone under 18 years old.

Do youth need a booster dose?

Currently, booster doses are only recommended for people 12 years and older. People ages 17 and younger can only get the Pfizer vaccine for their booster dose.

What should I do if I accidentally give a child between ages 5 and 11 the adult dose of Pfizer vaccine?

If you give a child between 5 and 11 years old an adult dose (30 mcg) of Pfizer vaccine for their first dose, you should give them the pediatric dose (10 mcg) for their second dose 21 days later. They are considered fully vaccinated.

If you give a child between 5 and 11 years old an adult dose (30 mcg) of Pfizer vaccine for their second dose, they are considered fully vaccinated.

See the Center for Disease Control and Prevention's clinical considerations for more information.

What should I do if I accidentally give a minor the Moderna or Janssen vaccine?

If you inadvertently vaccinate someone age 17 years or younger with the Moderna or Janssen vaccine, you should report it as an administration error to the Vaccine Administration Error Reporting System (VAERS).

Moderna: The Centers for Disease Control and Prevention (CDC) recommends that the minor still receive the second dose of Moderna on time to complete the series.

Janssen: Do not administer additional doses of any vaccine presentation. The minor is considered fully immunized.

Check the CDC's vaccine administration error guidance document for more information and next steps.

Do I need to get consent from an authorized adult to vaccinate people under age 18?

Yes. People under age 18 may need consent from an authorized adult to get the vaccine, unless they are legally emancipated. You can treat consent for COVID-19 vaccination the same as you would for other recommended vaccinations for adolescents, such as Tdap or the meningococcal vaccine.

If you have questions about what you can accept as consent, please consult your legal counsel. You can use this sample consent for minor vaccination as a starting point.

Who can give consent for a minor?

The following adults are authorized to consent for a minor:

  • The parents of the minor
  • An appointed guardian or authorized legal custodian
  • A person authorized by the court to consent to medical care for a child in out-of-home placement (see chapter 13.32A or 13.34 of the Revised Code of Washington)
  • An individual to whom the minor's parent has given a signed authorization to make health care decisions for the minor patient
  • A competent adult relative who is responsible for the health care of the minor patient, or a competent adult who has signed and dated a declaration (see RCW 9A.72.085) stating this
  • A school nurse, school counselor, or homeless student liaison for a homeless youth or young adult who is not under the supervision or control of a parent, custodian, or legal guardian, and is not in the care and custody of the Department of Children, Youth and Families
What can I accept for consent?

Your organization must determine what it accepts as consent. For instance, is verbal consent enough or will you require written consent? Check whether your organization already has policies in place for minor consent. If they do, follow the guidelines. If there are not existing guidelines in place, discuss with your legal counsel to draft guidelines. DOH cannot offer legal advice in this matter. For written consent, you can refer to this sample consent for minor vaccination as a starting point.

Who doesn't need consent from an authorized adult?

Mature minors, emancipated minors, and married minors are exempted from this rule and do not need parent or guardian consent. If a minor is exempt, be sure to document the reason for the exemption for each dose.

What is the Mature Minor Doctrine?

The Mature Minor Doctrine was established by Smith v. Seibly in the Washington Supreme Court in 1967. This doctrine allows some providers to determine whether a minor has the capacity to understand the proposed health care service or treatment and is sufficiently mature to make their own health care decisions.

Health care providers are responsible for determining whether the Mature Minor Doctrine applies in each situation. Criteria that may be used in this determination include age, intelligence, maturity, training, experience, economic independence, general conduct as an adult, and freedom from the control of parents/guardians.

Only some providers may be able to make a Mature Minor determination. Discuss with your legal counsel to determine whether you are one of these providers.

Examples of applying the Mature Minor Doctrine:

Note: These are only examples of what other organizations have done. This is not a direction from DOH that you must follow any of these specifically.

Who is an emancipated minor?

An emancipated minor is someone who is 16 or 17 years old who has been legally declared an adult by the court system. An emancipated minor can give informed consent for all health care services, including immunization, without the need for parent or guardian approval.

Emancipated minors can show you their status with one of the following:

  • Certified Decree of Emancipation
  • Washington State driver license that says they are emancipated
  • Washington State ID card that says they are emancipated

Your organization should have a policy on what to do regarding proof of emancipation.

Do married minors need consent from an authorized adult?

A minor who is married to an adult or to an emancipated minor is considered an adult and can give informed consent for all health care services, including immunization, without the need for parent or guardian approval.

Can patients receive both COVID-19 and other routine vaccines at the same time on the same day?

Yes. The Advisory Committee on Immunization Practices (ACIP) changed their recommendation on May 12, 2021. You can now administer COVID-19 vaccines and other vaccines to patients without waiting 14 days.

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