Why don't providers ask for ID when giving a COVID vaccine? A health and social policy researcher weighs in

Identification requirement can hamper outreach, exacerbate inequity, researcher says

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On Jan. 25, Littleton Public Schools made the decision to stop hosting COVID-19 vaccine clinics after two minors, a 15-year-old Littleton High School student and a homeschooled 16-year-old, lied to clinic staff in videos to see if they could get approved for a shot without parental consent. 

The deception worked, with the 15-year-old giving staff a fake consent form and the 16-year-old lying about his age, saying he was 20, though neither ended up going through with getting a vaccine. Still, their parents said the videos proved that clinics need better guidelines to ensure younger people cannot get a vaccine without a parent's OK. The most obvious solution, they said, was to check IDs. 

 “(The Colorado health department) took away the ability for us to determine how old somebody is that opened up a giant loophole to put children in harm's way,” said Gregg McGough, the father of 15-year-old Owen McGough, one of the two minors involved. 

But according to a social policy and healthcare researcher, avoiding ID requirements has been an essential pillar for avoiding vaccine inequity. And the guideline of allowing minors some healthcare without parental approval is nothing new. 

“It really is a crucial component in ensuring equitable access to healthcare in general,” said Jennifer Greenfield, an assistant professor at the University of Denver, whose work focuses on the intersection between social policy and health disparities.

For children with families who may be undocumented in the U.S., as well as families with disabilities and transportation issues, IDs can be out of reach and the need for one would pose a barrier to healthcare access, Greenfield said. The same is true for those who may be experiencing homelessness. 

“Housing insecurity, not having stable permanent addresses, certainly can get in the way of getting an ID,” Greenfield said. 

By removing the need to show ID, vaccine providers can reach more vulnerable populations who may not otherwise feel comfortable, or have the ability, to show up for a shot. This was front of mind for the Colorado Department of Public Health and Environment (CDPHE), when it issued guidelines on Jan. 17, 2021, telling providers to not ask for ID, though they may seek a name, date of birth, or address. 

“We understand that while vaccine supply is limited, providers are looking to verify age so that they know they are vaccinating groups within the current prioritization phase(s),” the agency said in a letter to vaccine providers. “However, requiring proof of ID, especially a government-issued ID, can exacerbate distrust and accessibility inequities for many critical groups. This requirement is a barrier for people who are unable to get identification or have trouble accessing services that issue IDs, such as those who are undocumented, experiencing homelessness, have a disability, or others on the margins of society who are unable to get an ID.”

Greenfield said the practice of allowing minors to access healthcare at schools without their parents' consent is nothing new.

“It's actually a longstanding policy for school-based health clinics in Colorado,” she said, adding that this could apply for some mental health resources, STD testing and birth control.  

When it comes to the COVID vaccine, Greenfield said the benefits of reaching great swaths of vulnerable populations outweigh the risks of approving shots for kids who haven't gotten their parents' OK. 

“There's more potential harm for the kids going unvaccinated,” she said. “If you look at all of the data about the efficacy of the vaccines, the potential side effects … when you compare all of that information it becomes clear that having a higher percentage of our population vaccinated and a higher percentage of our kids vaccinated is good for kids, good for families and good for our communities.” 

Fears have spread online and throughout communities about the safety of vaccines for children. Greenfield said that the risks posed by contracting COVID are far greater, especially from the still-unknown effects of long COVID. 

“That's a huge public health concern,” she said, adding that there are also immediate impacts such as hampering a family member's ability to return to work. 

Still, she said she understands the contention at play in Littleton.  

“There's this sort of tension between parents' rights to determine their child's healthcare versus the social good of having children have access to healthcare … and I think that is definitely at play here.” 

But Greenfield said she wants parents to know that maintaining easy accessibility to school-based healthcare, whether for the COVID vaccine or other resources, is crucial. 

“We know that school-based health clinics have been incredibly effective in reducing barriers for healthcare for kids,” adding that it has ripple effects on a child's well-being when they don't have to leave the school for healthcare. 

As a working parent herself, Greenfield said she knows too well the stress of having to schedule appointments with pediatricians and take her children out of school for several hours, something she had to do when she vaccinated her kids. 

“They missed reading and math that day,” she said.

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