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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


May 13, 2021


TO:
To all Californians

SUBJECT:
Pfizer Vaccine Minor Consent Guidance



Background

Administration of COVID-19 vaccines to as many Californians as possible is critical to control the pandemic. Based on evidence of safety and efficacy, the U.S. Food and Drug Administration (FDA) has now reduced the minimum age for its Emergency Use Authorization of Pfizer COVID-19 vaccine from 16 years of age down to 12 years.

In an ongoing clinical trial, two doses of this vaccine given three weeks apart has been shown to prevent illness, hospitalization, or death from COVID-19. The duration of protection against COVID-19 is currently unknown. More information on the risks and benefits of the Pfizer vaccine can be found on the Pfizer COVID-19 Vaccine Benefits and Risks Fact Sheet

Options for Consent

Persons younger than 18 years must have parental or guardian consent given by a legally authorized representative (parent or guardian). An emancipated minor may consent for him/herself. Currently, only the Pfizer vaccine has received Emergency Use Authorization for people under 18.

Allowable consent includes:

  • Parent/guardian accompanies the minor in person.
  • If the parent/guardian cannot accompany the minor, a signed written consent is acceptable. The written consent must verify the parent/guardian has been provided the Pfizer EUA Fact Sheet.
  • Phone or video consent is possible if the parent/guardian confirms that they have been provided the Pfizer EUA Fact Sheet or the Fact Sheet is read to the parent/guardian.

To learn more about risks, benefits, and side effects of the Pfizer vaccine, check the CDPH website Get the Facts on Vaccines (ca.gov) and/or read the U.S. Food and Drug Administration's Fact Sheet for Recipients and Caregivers.


Download the Sample Consent Form:

  • Fillable PDF form

  • Spanish: Fillable PDF form



Originally Published May 13, 2021