Finland began offering Covid vaccines to children aged 12-15 on Monday and decisions about whether or not to get the jab are left up to the kids themselves.
Twelve-year-old Otto Suksi from the city of Vantaa was among the first of his age group to sign up for the vaccine.
"I read in [newspaper] Helsingin Sanomat that vaccinations are being offered to my peer goup. I told my mother right away that I wanted to take it as soon as possible. If I get [Covid], it won't be too serious," he said.
His mother did not oppose her son's decision.
That choice is, at least in principle, being left up to the roughly 250,000 youngsters across Finland who belong to the 12-15 year-old age group.
Following brief consultations, healthcare professionals will determine whether kids are capable of making such decisions, based on their age as well as their developmental level, according to Hanna Nohynek, a vaccinologist and chief physician at the Institute for Health and Welfare (THL).
"It depends on how mature the child is, whether they understand what's at stake and whether they want to make the decisions for themselves. If the care worker determines a child is mature enough and wants to make the decision, then it will be dealt with accordingly," Nohynek said.
Consultations and decisions
According to the country's Patient Act, people have the right to decide about medical treatment for themselves. So the issue needs to be handled on a case-by-case basis, she explained.
"Children are very different in terms of development levels. Of course age gives some indication of that, but it's not the only factor," she said.
During the vaccine consultation, healthcare workers will explain to youngsters what they are being vaccinated against , what the effects of Covid-19 are, as well as describe what the vaccine will do in terms of effectiveness and its potential harms
"The children are asked if they've understood those things and if they have any questions. If they do, then they will be answered," she continued.
Another 12-year-old from Vantaa, Nooa Kaukinen, was the city's second person her age to sign up for the jab.
"I had to read things about the vaccination and sign a form. [The document] explained possible symptoms after the vaccination," she said.
If a young person is unwilling or unable to decide about whether to get the Covid vaccine, a parent or guardian needs to do it for them, either in writing or orally, chief physician Nohynek said.
"However, in the majority of cases, the decision [of kids and their parents] is a common one — the child decides but also wants their parents' approval. It's less common that a child wants to make the decision completely on their own," she said.
"If parents want their child to be vaccinated but the child doesn't, we try to reach an agreement through negotiation," Nohynek said, adding that no one is forcibly vaccinated in Finland.
Ombudsman: No one should be pressured either way
In an interview with Yle last week, the Ombudsman for Children, Elina Pekkarinen, said that children and young people should be offered reliable and understandable information when making decisions about vaccinations. She added that kids should also be given opportunities to talk about the issue, especially if there are disagreements about the matter with their parents.
"No one should be pressured into taking the vaccine, while at the same time no one should be forced to refuse it. The child has a right to self-determination, it's a question about their bodies and they must be able to independently make decisions," she said.
Pekkarinen also noted that people's vaccine choices belong to personal medical records and that health information does not need to be shared with others.
Meanwhile, the THL's Nohynek said she hoped as many children as possible would get vaccines to protect themselves and others around them.
However, it is rare for Covid-19 to cause severe health complications among children and young people.
The physician said that as of June, around 0.2 percent of 10-19 year-olds who got Covid required special medical care. A total of five patients in that age group needed intensive care.
"Children are less likely to become seriously ill, but the possibility is there. The vaccines being used are effective and safe enough. However, weighing the pros and cons [about the matter] is good for everyone to do so they understand what is at stake," Nohynek said.
Finland's national child vaccination task force is in the process of mapping the prevalence of severe and mild reactions to coronavirus infections among children under the age of 12, an effort also being carried out internationally.
"Studies and a discussion about the pros and cons of vaccinating people under 12 are still ongoing, but if the vaccine receives approval to be used among them as well, then we will hopefully be ready to make immediate recommendations about vaccinating them," Nohynek said.