Talking to tamariki, whānau or family and caregivers about the COVID-19 vaccine

Information about the vaccine and why it's important

Vaccination not only reduces the likelihood and severity of illness from COVID-19, but also reduces the transmission rate of the virus. This means that people who are vaccinated are less likely to pass on the virus to other people. Some people cannot be vaccinated for medical reasons or are aged under 5 years – by getting vaccinated, you are helping to protect them as well.

Vaccination is a way we can whakamana and empower each other. We want tamariki, rangatahi, whānau or family and caregivers to be well, to have access to good-quality information and to experience oranga motuhake. We are not health practitioners, but we have a role to play in having productive, healthy and effective conversations about COVID-19 vaccination, supporting people to access factual information and offering support and assistance for people to access vaccination.

For tamariki and rangatahi in the care or custody of Oranga Tamariki, it is important that we support whānau or family and other guardians to participate in discussions about the vaccine before tamariki or rangatahi are booked to receive their vaccination or go to a walk-in vaccination centre.

Getting COVID-19 vaccines | Health New Zealand Te Whatu Ora

Consent for tamariki and rangatahi to receive the vaccine

Tamariki aged 5 to 11 years

For tamariki in the care or custody of the chief executive, consent must be obtained from their guardians before booking a vaccination or going to a walk-in vaccination centre.

Tamariki and rangatahi aged 12+ years

Tamariki aged 12+ can determine their own consent to receiving the COVID-19 vaccine. Tamariki can also decline to give their consent.

It is the role of the healthcare professional to determine whether a tamaiti or rangatahi is competent to give informed consent.

The Oranga Tamariki Act 1989 has different requirements for guardian consent to medical treatment for rangatahi in a youth justice residence under a section 311 supervision with residence order. Rangatahi under the age of 16 under a section 311 order require guardian consent to receive the COVID-19 vaccine.

If tamariki or rangatahi are unable to give informed consent

While all tamariki 5 years and older can receive a COVID-19 vaccination, there are important differences in how consent is given.

Consent must be sought from guardians for tamariki aged 5 to 11 years or tamariki and rangatahi aged 12 to 17 who are unable to give informed consent before any vaccination booking or attendance at a walk-in vaccination centre.

While everyone has the right to information to make an informed choice or give informed consent, the law relating to tamariki consent to medical treatment, including vaccination, is complex. There is no defined age at which tamariki can give their own consent to receive all health and disability services. Our approach for different age groups is consistent with the Ministry of Health policy statement.

Make sure you are familiar with the legal status and who the legal guardians are of any tamariki or rangatahi you are working with in relation to the COVID-19 vaccine.

Engage with the guardians for te tamaiti – clearly record their decision about consent, their views and those of te tamaiti as a casenote on CYRAS.

If the caregiver for te tamaiti is also a legal guardian, engagement must still occur with the other guardians, parents and whānau and any other guardians should also provide consent.

While a caregiver may be the adult accompanying te tamaiti for their vaccination, it is important that caregivers are aware of the consent process for tamariki aged 5 to 11 years or tamariki and rangatahi aged 12 to 17 who are unable to give informed consent. Caregivers are unable to take tamariki in their care to be vaccinated without the consent of the legal guardians.

Even if tamariki or rangatahi can’t provide informed consent, we should talk to them about the importance of vaccination and hear their views, considering their age and development.

Providing consent to the vaccinator

A guardian for te tamaiti must provide consent in order for te temaiti to receive the vaccination. If the adult accompanying te temaiti is not a legal guardian, the social worker needs to obtain consent before the vaccination and the vaccinator will need to confirm consent either:

• verbally by phone with a legal guardian that they consent to te tamaiti being vaccinated, or
• being provided with a signed copy of the COVID-19 vaccination consent form or other written consent (such as a letter or email) completed by a guardian.

If it is not practicable for the accompanying adult to provide a guardian’s phone number, then they must provide a signed copy of the COVID-19 vaccination consent form completed by a guardian.

Although the vaccinator only requires consent from a guardian, we engage with and require consent from all guardians for te tamaiti we are working with.

Whaikaha Ministry of Disabled People has information to support disabled people in making decisions about getting the COVID-19 vaccine.

COVID-19 | Whaikaha Ministry of Disabled People

The following situations apply when a tamaiti or rangatahi is not able to give their own informed consent.

When Oranga Tamariki can consent to vaccination

Oranga Tamariki practice leaders have the delegation to solely consent to the vaccination being administered where we hold:

• sole guardianship
• specific guardianship for medical purposes, or
• wardship of tamariki or rangatahi and our role as an agent of the court specifies guardianship responsibilities.

However, we should still engage with tamariki, rangatahi and their parents, any other guardians and whānau or family around the issue of consent for vaccination. We also talk with the lawyer for child.

If Oranga Tamariki holds additional guardianship

Where we hold additional guardianship, we must talk with other guardians about the importance of vaccination. If guardians do not provide their consent, we should respect their decision not to vaccinate. We inform te tamaiti or rangatahi lawyer for child of the outcome from these discussions.

If Oranga Tamariki holds custody but not guardianship

Where we have a custody order but no guardianship order, we cannot provide consent. We should encourage guardians to provide consent by helping them to access factual information about the benefits and known risks of the vaccine, but this is ultimately their decision to make.

If there is disagreement

If there is any disagreement from tamariki, rangatahi or guardians or between tamariki, rangatahi and guardians, seek advice from Legal Services and inform te tamaiti or rangatahi lawyer for child.

Only in extreme circumstances (for example, where not receiving the vaccination may result in serious health concerns for tamariki or rangatahi) would we consider further options to legally enable the vaccination to be administered. This would be by way of on-notice application to the court where all parties would have the opportunity to be heard. Discuss these situations with te tamaiti or rangatahi lawyer for child.

Consent for medical examinations and treatment

If you are unsure about any aspect, get in touch with your local solicitor.

Engaging with tamariki, whānau or family about vaccination

Talking to tamariki and rangatahi

It is important to talk to tamariki and rangatahi about COVID-19 vaccination in a way that is appropriate for their age, culture and stage of development.

For some tamariki and rangatahi, this may be the first vaccination they remember, and they may be anxious about it. We should assure them that feeling worried is normal and reiterate the safety and importance of getting the vaccine. It could be helpful to talk through any details if known, such as time and place and who will be there to support them (such as a teacher, nurse or whānau or family member). There are some great resources that help explain the vaccination:

COVID-19 immunisation in children | KidsHealth

Talking to whānau or family

Some whānau or family may have already been vaccinated as a part of their job or through the general national rollout. Others may have doubts or apprehension about getting the vaccine. Whānau or family may be worried about their tamariki or rangatahi not being able to be vaccinated or concerned about their tamariki or rangatahi living with vaccinated or non-vaccinated caregivers. Talk about who will accompany tamariki to their vaccination.

The adult who takes te tamaiti to their vaccination appointment should be advised that consent has been provided by the guardians. If the vaccinator needs confirmation of guardian consent, then the social worker’s contact details should be provided.

For tamariki aged 5 to 11, there are some differences to older tamariki or rangatahi and adults in number and frequency of doses:

Further advice on eligibility can be accessed through the Ministry of Health helpline or the Health New Zealand Te Whatu Ora website.

Phone: 0800 28 29 26

Getting COVID-19 vaccines | Health New Zealand Te Whatu Ora

Even when tamariki and rangatahi are able to make their own decision about the vaccine, we should be engaging with whānau or family to keep them informed and gather their views. We might need to explain that tamariki and rangatahi can make these decisions for themselves even if it goes against their own views.

Help whānau or family to access reliable information and listen to any concerns they have.

Support a whānau or family-based approach to vaccination. If whānau or family need support to be vaccinated themselves, ask how we can assist them (for example, transport or explore the possibility of them being vaccinated at the same time as their tamariki). Provide specific information about where and when whānau or family can be vaccinated in your community. Explore familiar environments and people who whānau or family trust.

Book My Vaccine | Health New Zealand Te Whatu Ora

Keeping others informed

Recording

We record in a CYRAS casenote conversations we have had, including people’s views and decisions that have been made. We include the words COVID-19 vaccination in the casenote header and clearly record whether consent has been given by guardians.

Update the All About Me plan for te tamaiti or rangatahi, including if te tamaiti or rangatahi has been vaccinated or has chosen not to be vaccinated.