Guidance
Talking with tamariki, whānau or family and caregivers about the COVID-19 vaccine
This guidance supports kaimahi who work directly with tamariki and rangatahi and their whānau or family and caregivers to help them to have conversations about vaccination against COVID-19.Updates made to this guidance
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, including tamariki or rangatahi and caregivers who cannot be vaccinated.
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.
Our role is to talk with tamariki, rangatahi and whānau or family about the importance of vaccination, supporting people to access factual information, including the benefits and known risks, 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 speak with parents and other guardians about vaccination for their tamaiti or rangatahi.
How many COVID-19 vaccines to get and when | Health New Zealand Te Whatu Ora (this webpage is available in other languages and formats)
If we are working with a disabled tamaiti or rangatahi, parent or guardian, we can talk to a trained advisor in the Healthline disability team about getting COVID-19 vaccinations. The disability team is available Monday to Friday from 8am to 6pm:
- Phone: 0800 28 29 26 and select option 2
- Free text: 8988
- Email: accessiblecovidvaccinations@whakarongorau.nz
Consent to receive the COVID-19 vaccine
We make sure we are familiar with the legal status of the tamariki and rangatahi we are working with and know who their legal guardians are.
Only guardians can consent to tamariki or rangatahi aged below 16 years being vaccinated, including COVID-19 vaccination. The capacity of the tamariki or rangatahi to consent to a COVID-19 vaccination (as assessed by a vaccinator) is discussed later in this guidance.
We speak with the guardians of tamariki and rangatahi about vaccination and clearly record their views and decisions about whether or not they consent to their tamaiti or rangatahi receiving a COVID-19 vaccination.
Rangatahi aged 16 years and older can give their own consent for vaccination
Rangatahi aged 16 years and older do not require a guardian to give consent to receive the COVID-19 vaccination – they can give their own consent. They can also decline to give their consent.
Even when rangatahi aged 16 years or older make their own decision about being vaccinated, we should (with their consent) speak with their guardians and keep them informed about their decision about COVID-19 vaccination.
When Oranga Tamariki can consent to vaccination
Oranga Tamariki practice leaders have the delegation to solely consent to a COVID-19 vaccine being administered where we have:
- sole guardianship
- specific guardianship for medical purposes, or
- wardship of te tamaiti or rangatahi and our role as an agent of the court specifies guardianship responsibilities that include approving health or medical treatment.
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 has additional guardianship
Where we have additional guardianship of te tamaiti or rangatahi, we must speak with the other guardians about the importance of vaccination and seek their consent to the vaccination of their tamaiti or rangatahi.
If the other guardians do not provide their consent, we cannot proceed with vaccination of their tamaiti or rangatahi using our consent alone.
We should inform the lawyer for child (where one is appointed) about the outcome of our discussions.
If Oranga Tamariki has custody but not guardianship
Where we have custody of te tamaiti or rangatahi but no guardianship order, we must speak with the guardians about the importance of vaccination and seek their consent to the vaccination of their tamariki and rangatahi. If they do not provide their consent, we cannot proceed with vaccination for their tamaiti or rangatahi (unless te tamaiti or rangatahi is deemed by the vaccinator to be competent to consent).
If there is disagreement to providing consent
Only in extreme circumstances (for example, where not receiving the vaccination may result in serious health complications for te tamaiti or rangatahi if they contract COVID-19) would we consider further options to legally enable a COVID-19 vaccine to be administered. This would be by way of an on-notice application to the court where all parties would have the opportunity to be heard.
When we have identified guardians for te tamaiti or rangatahi, we should seek advice from Legal Services and inform the lawyer for child when there is disagreement about consenting to the COVID-19 vaccine between:
- tamariki, rangatahi and their guardians
- other guardians.
If we are unsure about any aspect, we get in touch with our local solicitor.
Capacity to consent for tamariki and rangatahi to receive the vaccine
While everyone has the right to information to make an informed choice or give informed consent, the law relating to tamariki and rangatahi consent to medical treatment, including vaccination, is complex.
In general, tamariki and rangatahi should be involved as much as possible in decisions about vaccination (depending on their age) and information will be given to them in a way that they can understand.
Consent is always based on the assessed capacity of a tamaiti or rangatahi to understand the medical information and the implications of their decision to be vaccinated.
It is the role of the healthcare professional to determine whether a tamaiti or rangatahi is competent to give informed consent.
Even when tamariki and rangatahi can make their own decision about the vaccine, we should be engaging with other guardians, whānau or family to keep them informed and gather their views.
Providing consent to the vaccinator
A guardian for tamariki or rangatahi aged up to 15 years of age must provide consent for te tamaiti or rangatahi to receive a COVID-19 vaccineation.
If the adult accompanying te tamaiti or rangatahi is not their legal guardian, the social worker needs to obtain consent before the vaccination and the vaccinator will need to confirm consent from a legal guardian either:
- verbally by phone with a legal guardian, or
- by 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.
Although the vaccinator only requires consent from a guardian, we engage with and require consent from all guardians for te tamaiti or rangatahi we are working with.
If guardians have given consent to vaccinate their tamaiti or rangatahi but someone else is accompanying them, we make sure that we keep the whānau or family informed about the vaccination and the wellbeing of their tamaiti or rangatahi.
Speaking with tamariki, rangatahi, whānau, family and caregivers about vaccination
Speaking with tamariki and rangatahi
It is important to speak with 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 caregiver, nurse or whānau or family member). There are some great resources that help explain the vaccination:
COVID-19 immunisation in children | KidsHealth
Speaking with whānau or family
Some whānau or family may have already been vaccinated, while others may have doubts or apprehension about getting vaccinated. They may be worried about their tamariki or rangatahi being vaccinated or not being able to be vaccinated. They may also be concerned about their tamariki or rangatahi living with vaccinated or non-vaccinated caregivers. We need to work with whānau or family to access reliable information about the COVID-19 vaccine and listen to any concerns they have.
We may also need to explain that rangatahi can make these decisions for themselves even if it goes against views held by whānau or family members.
Role of caregivers
It's important that caregivers are aware that consent is a guardianship right and they cannot consent to the vaccination of a tamaiti or rangatahi they are caring for on behalf of the Oranga Tamariki chief executive. Speak with caregivers about the steps we are taking to promote vaccination for te tamaiti or rangatahi in their care and keep them informed of the outcome.
If the caregiver for te tamaiti or rangatahi is also a legal guardian, they still need to seek the consent of the other guardians before a vaccine can be given.
Type of COVID-19 vaccines, doses and boosters will vary by age of tamariki and rangatahi
The type of vaccine and doses/boosters that tamariki and rangatahi are eligible for will vary by their age. Updated advice is available on the Health New Zealand Te Whatu Ora website:
COVID-19 vaccines | Health New Zealand Te Whatu Ora
Further advice on eligibility can be accessed through the Ministry of Health helpline.
Phone: 0800 28 29 26
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 and rangatahi). We provide specific information about where and when whānau or family can be vaccinated in the community. Explore familiar environments and people who whānau or family trust.
Keeping others informed
Where there are multiple kaimahi working directly with tamariki, rangatahi, whānau or family, such as in a residence, we should consult with each other and keep everyone informed about the conversations we have been having, sharing the views where appropriate and with consent. This will minimise tamariki, rangatahi, whānau or family having to have multiple conversations about the same thing.
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.