Vaccinating Youth

Everyone ages 6 months and up is eligible for COVID-19 vaccination.

An mRNA bivalent booster dose is now recommended for people ages 5 and up. A monovalent booster dose is no longer authorized for people ages 5 and up.

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?

Since the beginning of the pandemic, over 14 million children in the United States have gotten COVID-19. New COVID-19 variants are more dangerous and infectious to children than the original strains and led to peak COVID-19 hospitalizations among youth.

While COVID-19 is often milder in children than adults, children can still get very sick and spread it to friends and family who are immunocompromised or vulnerable in other ways.

Children who are infected with COVID-19 can develop “long COVID-19” or persistent symptoms that often include brain fog, fatigue, headaches, dizziness and shortness of breath. Vaccination is the best way to keep kids healthy and safe.

Children who get infected with COVID-19 may be at greater risk for Multisystem inflammatory syndrome (MIS-C). MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. While it is still unknown what causes MIS-C, many children with MIS-C had COVID-19, or had been around someone with COVID-19. MIS-C can be serious, even deadly, but most children diagnosed with this condition have gotten better with medical care.

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:

Which vaccine can I administer to someone under 18 years of age?

At this time, the Pfizer-BioNTech (Pfizer) vaccine and Moderna COVID-19 vaccine brands are authorized for children ages 6 months and older. The Novavax vaccine is available for ages 12+ under an EUA.

Do youth need a booster dose?

An mRNA bivalent booster doses is recommended for people 5 years and older. Children 5 years old should only receive an updated bivalent Pfizer booster.

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 Janssen vaccine?

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

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.

What should I do if I accidentally mix and match the series for children ages 6 months-4 years? 

Children ages 6 months-4 years who receive different mRNA products for the first 2 doses of an mRNA COVID-19 vaccine series should receive a third dose of either mRNA vaccine 8 weeks after the second dose to complete the 3-dose primary series.

What should I do if I accidentally administer an incorrect formulation for children?
  • If the incorrect formulation is administered, resulting in a higher than authorized dose, do NOT repeat dose. A subsequent dose may still be administered at the recommended interval.
  • If the incorrect formulation is administered, resulting in a lower than authorized dose, repeat dose immediately (no minimum interval) with the age-appropriate formulation. If there are concerns of the patient being at risk of myocarditis, you can delay the repeated dose for 8 weeks after the invalid dose. 
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:

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 regard to timing of most other vaccines. Please see the following link for specifics: