Like many 18-year-olds, Kelly Danielpour is preparing to start college in the fall, planning out her classes, buying dorm necessities and wondering what her roommate will be like. Unlike many 18-year-olds, she’s also spending her spare time helping teens across the country navigate vaccine-hesitant parents and get their COVID-19 vaccines.
As the highly contagious Delta variant spreads, posing a greater risk for people who are unvaccinated and stoking fears of a fourth wave of COVID-19 cases, health experts are urging more Americans to get vaccinated. “This is becoming a pandemic of the unvaccinated,” Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a press briefing on July 16. And the looming start of a new school year has fueled debates over vaccine and mask requirements for returning students.
“There are so many teenagers who are unvaccinated. There are so many adults,” Danielpour tells TIME. Danielpour founded VaxTeen last year to help young people access vaccines and learn about their options if their parents don’t want them to get vaccinated. “A vaccine is a collective health measure. We all have to take part for it to be truly effective.”
Vaccination rates are lagging, particularly among young people. Just 42.6% of 18- to 24-year-olds in the U.S. are fully vaccinated against COVID-19 — a smaller percentage than any older age group, according to a Mayo Clinic tracker. Among minors, 38% of 16- to 17-year-olds and 25% of 12- to 15-year-olds were fully vaccinated as of July 14, according to an American Academy of Pediatrics analysis of CDC data.
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That analysis also found the pace of child vaccinations is slowing, dropping to 315,000 new vaccinations during the week of July 14 — down from a peak of 1.6 million child vaccinations at the end of May, when children ages 12 and older became eligible to receive the Pfizer-BioNTech COVID-19 vaccine.
That’s what worries Danielpour, who just graduated from high school and lives in Los Angeles, where county leaders recently reinstituted a requirement to wear masks indoors due to rising COVID-19 cases. She started the research for VaxTeen before the pandemic, after coming across a Reddit post from a teenager who wanted to get their routine adolescent immunizations but whose parents opposed vaccines. Danielpour fell down a social media “rabbit hole” and encountered lots of other teens in similar situations. Most wanted to know if they could consent to vaccines on their own, without parental permission, and how they could go about getting them. “I was just in awe, and I also realized how many barriers were in place,” she says. “Whenever we talk about sort of the anti-vaccine movement, we always just talk about parents. We don’t really think about kids having their own opinions on this, or being part of this conversation or having the potential to be the decision makers.” She wanted VaxTeen to be a resource for those teens, and her work became newly urgent amid the COVID-19 vaccine rollout and the pervasiveness of vaccine hesitancy.
Nearly a quarter of parents say they will definitely not get their child vaccinated against COVID-19, and 18% said they will only get their child vaccinated if schools require it, according to a recent survey by the Kaiser Family Foundation.
“The best thing you can do for yourself and for everyone else is to get vaccinated if you can,” says Joshua Petrie, an assistant professor at the University of Michigan School of Public Health who studies epidemiology and the transmission of respiratory viruses. “The vaccines have been incredibly effective, and they’re our best shot at keeping things at lower levels, particularly with the Delta variant picking up speed here in the U.S.”
Ahead of the new school year, the issue of youth vaccinations and school vaccine requirements has grown more divisive. The American College Health Association recommends that colleges require the COVID-19 vaccine for all on-campus students this fall, but some states have prohibited K-12 schools and colleges from imposing such requirements. This week, a federal judge upheld Indiana University’s requirement that all students and faculty be vaccinated against COVID-19. The student plaintiffs, who object to the vaccine mandate, plan to appeal.
Read more: A Fourth Wave of COVID-19 Is Brewing in the U.S. Is There Enough Time to Stop It?
Facing pressure from conservative lawmakers as vaccine misinformation spreads, the Tennessee Department of Health plans to end adolescent vaccine outreach and stop holding COVID-19 vaccine events at schools, according to a report by the Tennessean on July 13. And lawmakers in other states have introduced legislation on either side of this issue.
To the extent that teens aren’t getting vaccinated because of apathy or lack of awareness, the Biden Administration has ramped up outreach to young people, launching a COVID-19 Student Corps to get teens to advocate for the vaccine among peers and the COVID-19 College Vaccine Challenge to encourage colleges to boost vaccination efforts.
VaxTeen has focused on teens who want to be vaccinated but who can’t get the shot because of their parents. Young people consistently email Danielpour and reach out over Twitter and Instagram, asking for help and advice. She also scrolls through Reddit and Twitter for posts from teens sharing their vaccination questions and dilemmas. “I just want to be able to go to school in person,” wrote one student on Reddit, who identified herself as a 16-year-old who “can’t change my parents’ minds” about vaccines. “I feel like my health and my concerns are just being completely disregarded,” wrote another 16-year-old girl on Reddit, referring to her mother. “Any advice on how to convince her?”
Danielpour responded to both of them, sharing guides on which states allow teens to be vaccinated without parental consent. She has focused her efforts both on access—helping teens find a vaccine clinic along their bus route that’s open on weekends, for example—and awareness, sharing fact-based vaccination information for them to take back to skeptical parents. “In many cases, convincing a parent is a teen’s only option,” she says.
Danielpour has received pushback and some hateful comments on social media and in emails from people who disagree with the work she’s doing. Some argue that vaccination decisions should be a discussion only between parents and their children. Others have pushed baseless conspiracy theories that VaxTeen is run by a pharmaceutical company.
“They said that a teenager couldn’t have possibly created the site,” Danielpour says—an accusation she tried to take as a compliment. “They don’t think a teen could have possibly done it, and I did.”
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She usually reads the opposing comments anyway to better understand vaccine polarization. “It is coming from a place of fear, and the better I understand that, the better VaxTeen’s work will be,” she says.
The website directs teens to resources on debunking vaccination myths and talking to parents about vaccines, including questions parents might ask and how best to answer them with factual medical information. If that doesn’t work, the site also includes a guide to each state’s laws on parental consent.
Forty states currently require parental consent for children under 18 to be vaccinated, and Nebraska requires it until age 19. Some states allow a minor to “self-consent” at a certain age—14 in Alabama and 16 in South Carolina, for example. And other states, without specifying an age, give healthcare providers the ability to decide if a minor is mature enough to consent to vaccination on their own.
In some parts of the country, legal challenges have been issued that would reduce teen access to vaccines. A bill under consideration in South Carolina would prohibit minors from getting the COVID-19 vaccine without parental consent. Meanwhile, two federal lawsuits filed this month are challenging a law passed in Washington, D.C., last year that allows children 11 and older to get vaccines without their parents’ consent.
Danielpour would like to see all states let teenagers be vaccinated without parental permission. “I don’t deny that a parent’s job is to keep their child safe. And if you’re encountering a lot of misinformation, then that can scare you,” she says. “But I also think that there’s a line in some sense, and that the more present fear—and the fear based in fact—is of the virus and seeing what it’s doing to everyone.”
More than 600,000 people in the U.S. have died from COVID-19. And while children have been less likely to get seriously ill from the virus, they also lost out on formative experiences and rites of passage during the pandemic. Danielpour, who got a COVID-19 vaccine as soon as she could, acknowledges that the return of a traditional high school experience or typical life on a college campus hinges on widespread vaccinations.
“There’s so much that depends on that — going back to school or back to normal life, having friends, being in a classroom,” she says. “There are invaluable experiences that are part of growing up that depend on our vaccine success.”
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Write to Katie Reilly at Katie.Reilly@time.com