29 July 2021
The Italian Committee for Bioethics (ICB), while reiterating that priority in the vaccination plan must continue to be given according to age group and particular fragilities, believes that the vaccination of adolescents can safeguard their health and help contain the spread of the virus from a public health perspective, particularly in view of their returning to school.
The Committee stresses that the vaccination of adolescents requires new and different attention and age-appropriate forms of communication, on the part of Institutions and physicians. It highlights the importance of the information addressed to parents, which must be tailored according to the age of the adolescent, paying particular attention to the balance of risks and benefits, different from those of adults and the elderly. The information must also be given to adolescents, hopefully by means of an information sheet before vaccination, in order for them to be able to participate in an informed manner. This information must be accompanied by awareness-raising actions and the educating of parents and teachers, with the activation of specific initiatives in schools. It is important to listen to adolescents and to value their right to express their choice, in relation to their capacity for discernment.
Should the mature minor’s wishes to be vaccinated conflict with those of the parents, the Committee believes that the adolescent needs to be heard by medical personnel with paediatric expertise and that the minor’s wishes should prevail, as they coincide with the best interests of his/her psycho-physical health and public health.
For adolescents with diseases and who fall into the categories identified by the Ministry of Health (in an updated list), for which vaccination is recommended, the duty of the parents (legal representatives) to guarantee the best interests of their child becomes even more pressing; it is important to have recourse to the clinical ethics committee or to an ethical space and, as extrema ratio, to the tutelary judge.
In the case of adolescents who refuse the vaccine in the face of parental consent, the Committee considers it important and desirable that adolescents should be informed that vaccination is in the interest of their own health, the health of people around them and of public health. Lastly, it seems, however, right, from a bioethical point of view, not to proceed with compulsory vaccination in the absence of a law expressly requiring it, but to put in place appropriate measures to safeguard public health.
The ICB deems it appropriate in the event of conflict between the parties, that their wishes should be certified in order to explain with the utmost clarity their respective positions, also with a view to better identify the differences in an attempt to reconcile them.