What are the current consent processes for adolescent vaccination in Canada? An environmental scan of practices, challenges and alternative approaches.

OBJECTIVES

Consent processes for adolescent vaccination in Canada have been identified as potential barriers to vaccine uptake. This study examined current practices for obtaining consent for adolescent vaccines across Canadian jurisdictions to better understand the variation, complexity and opportunities for improvement.

DESIGN

An environmental scan.

SETTING

The study was conducted between 25 March 2025 and 27 February 2026, across public health systems in Canada. Data were drawn from relevant written documents and from key informants (KIs) representing public health, vaccine administration and immunisation policy in each province and territory.

PARTICIPANTS

We included 76 written records and input from 17 KIs.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was adolescent vaccination consent process, including the age of majority, legal age of consent for vaccination and consent modalities. The secondary outcomes included challenges associated with the existing consent processes and proposed recommendations for improvements.

RESULTS

The age of majority was 18 or 19 years in all jurisdictions. The legal age at which adolescents could consent to vaccination ranged from 13 to 16+ years in some jurisdictions, while others did not specify a formal age threshold. Paper-based consent remained the predominant modality, although implied, verbal (in-person) and telephone consent were also used. Electronic consent (e-consent) was being piloted in some jurisdictions. General challenges include logistical burden of paper-based processes and language barriers, whereas adolescent-specific challenges include inconsistent assessment of adolescent capacity and parental concerns about reduced authority. Suggested improvements included simplifying and standardising consent processes, expanding opportunities for adolescent self-consent and integrating e-consents alongside existing modes.

CONCLUSIONS

Despite considerable variation, there is broad recognition of the need to improve the consent process for adolescent vaccination. Simplifying consent processes may promote more timely and equitable access to immunisation and support efforts to improve adolescent vaccination coverage in Canada.