Why a suburban teen went to Philly to get his COVID-19 vaccine

Even during the pandemic, Nicolas Montero has managed to keep busy. The high school junior stays on top of his schoolwork at Neshaminy High in Bucks County. He runs track, works night and weekend shifts at Burger King, participates in about every club and extracurricular you can think of.

But for Montero, his packed schedule is also strategic: It’s a way to stay out of the house.

Things have been tough at home for a while. Montero and his parents are separated by a political and cultural rift that divides many families and communities throughout the country: His parents are a part of a small but vocal minority who oppose COVID-19 vaccinations, and refused to let him get the shots.

“The thing about these beliefs is that they alternate by the day,” said Montero, who is 16. “It’s not one solid thing that they’re going with, so it’s just really baseless. It’s like one thing they see on Facebook, and then they completely believe it.”

The impasse eventually led to an act of quiet defiance: Montero traveled to Philadelphia, where a little-known regulation permits children over the age of 11 to be vaccinated without parental consent.

Montero’s parents did not respond to multiple attempts by WHYY News to get in touch with them for this article. Montero said he thinks most of their beliefs about the vaccine come from social media. He would try time and again to reason with them, he said, but their goalposts kept shifting.

“I try to explain to them that the vaccines are safe. They’re effective,” said Montero. “I try to explain that we know people that have been vaccinated, even our own family members who’ve been vaccinated for months and experienced no side effects. But nothing seems to get through to them.”

Though he was able to find a loophole that addressed his own situation, Montero worried there would be others like him who wouldn’t be able to travel 25 miles to a county where the laws were different. So he penned an op-ed in his high school paper, the Neshaminy Playwickian, advocating for the age of consent for vaccines in Pennsylvania to be lowered to 14.

“I know that this is something that teenagers all across the country are experiencing right now,” said Montero. “And I think that it should cause concern for a lot of people because these ideologies don’t just rupture public health. They also put cracks in our democracy.”

His passion can make it sound like he’s stumping on the campaign trail, or addressing the opposing party in a courtroom rather than his own parents. But he said he’s made it political, in part, because he’s given up on making amends.

“It’s like a fundamental break in how we see the world,” he said. “It makes it difficult to even talk with them.”

It hasn’t always been this way, Montero said. He traces his parents’ views back to Donald Trump’s election as president. As the pandemic progressed, he said, their political stance evolved into an anti-vaccine attitude, which the couple had never had before.

“The way I would describe the past four or five years in general would be like a snowball effect,” said Montero. “Like it just keeps building up.”

He tries to avoid conflict by spending as much time away from home as possible, visiting often with his aunts and grandmother in Philadelphia.

Last summer after school let out, he didn’t need to be in the suburbs to go to class, so he asked his aunts if he could come for a visit.

“He gets to roam the city, get the city life. He loves that,” said Montero’s aunt, Brittany Kissling, who lives in Port Richmond. “The kid did not want to leave.”

A week turned into the entire summer.

While Montero was staying in Philadelphia, bouncing between his two aunts’ houses, his friends were getting their first COVID shots. He was worried he might get sick. Worse, he was concerned he might transmit a coronavirus infection to his elderly grandmother.

“My abuela, she’s completely vaccinated, boosted and everything,” said Montero. But he said he was still worried he could transmit a breakthrough infection.

So he started doing some research. And he found that not all states require parental consent for vaccination. Alabama allows teenagers over 14 to consent to their own medical care. In Oregon, the age is 15; in Kansas and South Carolina, 16. In Delaware, you only need to be 12 to get vaccines related to sexually transmitted infections. In Pennsylvania, minors can make their own medical decisions in specific circumstances — if they get married, are legally emancipated from their parents, enlist in the military, or are pregnant, for example.

To his surprise, Montero discovered that a bill proposing the law be changed in Pennsylvania had been introduced in the state House of Representatives. If the measure were to become law, it would mean that anyone over 14 could give informed consent to be vaccinated for any vaccine approved by the U.S. Advisory Committee on Immunization Practices. So, ever politically minded, Montero resolved to write an op-ed advocating for the bill’s passage.

As his research deepened, he learned that not only was it possible for minors to get vaccinated without parental consent in other states, it was legal in Philadelphia.

How Philadelphia’s rule came to be

In 2007, the city’s Board of Health passed a regulation that allows anyone over the age of 11 to get vaccinated without a parent, provided the young person can give informed consent.

Current Health Commissioner Cheryl Bettigole said she wasn’t involved in the regulation’s drafting, but her understanding based on her time working in city health centers was that it was designed to remove any additional barriers to vaccination.

“It can be very difficult, especially for lower-income parents, to get time off work to go to those appointments,” Bettigole said. “These are low-risk interventions. It just makes it easier for parents and families to be able to make sure their kids are vaccinated.”

The regulation also went into effect the year after the Food and Drug Administration approved a three-shot regimen of the human papiloma virus (HPV) vaccine for young people, recommended in the years before they become sexually active.

It is common for states and municipalities to create specific legislation for minors with the aim of increasing access to vaccines that prevent sexually transmitted infections, according to Brian Dean Abramson, an author and adjunct professor of vaccine law at Florida International University College of Law.

“The rationale behind this was that you may have children who are being abused and don’t want their parents necessarily to be informed of the fact they’re seeking medical interventions for that, or children who may be sexually active and are afraid that their parents will react very negatively to that if they seek some kind of medical treatment.”

In turn, said Abramson, those policies have laid the groundwork for children to get vaccinated in the event of a disagreement like the one between Montero and his parents.

A November 2021 Kaiser Family Foundation poll found that 30% of parents with 12- to 17-year-olds said they will definitely not vaccinate their children. In light of this, two National Institute of Health scholars wrote a piece in the New England Journal of Medicine advocating for states to expand their existing statutes to include COVID-19 vaccines as a medical treatment to which minors can consent.

Montero was thrilled to learn of Philadelphia’s regulation. One summer afternoon while his aunt was at work, Montero found a Philadelphia pop-up clinic offering vaccines. He was anxious on his bus ride there — not about needles or side effects, but that his parents would somehow catch him and prevent him from getting his second shot.

He knew his aunts would support him being vaccinated — both of them had been, and Kissling manages a pediatrics office. But he was worried if they knew, word would get back to his parents. So he didn’t tell them.

He returned to Langhorne for the start of the school year and arranged for a weekend visit in early September to see his aunts and grandmother again. He planned the trip just in time for his second dose.

“I did feel really liberated when I got my second shot,” Montero said. ”I felt like I was protected.”

When Kissling and her sister learned their nephew had gotten vaccinated, they were amazed.

“He was so proud,” recalled Kissling. “He had his card, and we were like, wait, when did this happen? How did this happen?”

They agreed not to tell his mother. They knew how angry it would make her, and figured what was done was done.

Just before Thanksgiving, though, someone let it slip, and Montero’s parents found out. They reacted the way Montero and his aunts worried they would: Kissling said Montero’s mother blamed her and her sister for influencing her son, and for being neglectful enough to allow him to get vaccinated.

“Now, there’s a divide,” said Kissling. “It’s sad because at the end of the day, family should be family.”

Kissling said she doesn’t think of herself as a political person, and is friends with Democrats and Republicans alike. She said her family would rarely even discuss politics until recently. Now though, she said, it’s hard for the whole family to spend time together. She has left in the middle of dinners to drive back home to Philadelphia because the discussion got so heated. She’s not expecting a resolution anytime soon — her family is one that’s more likely to sweep conflict under the rug than resolve it, she said.

“They are not the type of family that acknowledges their wrongdoings,” Kissling said. “They’re not the type of family that apologizes.”

For Montero, ever since his parents found out he got vaccinated behind their back, things have been even more tense at home. He’s upped his extracurriculars: He’s learning to pole vault for the track team. He joined the school paper, on top of world language and environmental action clubs. He wants to start doing model U.N, and spearhead a politics club to get his classmates involved in the legislative process and registered to vote.

He’s also deeply involved in his studies.  Each evening after school, he lays claim to one of the private rooms at the Langhorne public library, where he spreads out his books across a small desk and diligently does his homework. Recently, he was working on a paper about the history of U.S. involvement in Puerto Rico, where his grandmother is from. He thumbed through a thick book on the Puerto Rican independence movement, dozens of sticky notes punctuating every few pages.

“When I started reading this book, like almost every single page, my mouth is just wide open,” said Montero. “Like, I couldn’t believe that these things happened to my people.”

He hopes to visit the island one day, and is learning to cook Puerto Rican dishes from his grandmother in the meantime, which he can now do without worrying as much that he might infect her.

Montero has ambitions to leave the state for college. He likes the idea of Washington, D.C., of being close to the White House and the Capitol building. From there, he said, he wants to go to law school.

He ended up publishing his op-ed in his high school paper, advocating for the passage of HB1818, which would lower the age of consent in Pennsylvania for vaccines to 14. He acknowledged it doesn’t have much chance of passing the state’s Republican-controlled legislature. Still, he wanted to raise awareness of the issue, especially for other young people in positions like his who wouldn’t be able to travel to Philadelphia.

“Not allowing teenagers to consent to their own vaccinations or other medical treatments and requiring parental consent, it just provides a barrier for people that live in dysfunctional households, live with neglectful parents, or people that are homeless,” said Montero.

He counts himself in that number.

“It’s like I don’t even have parents, to be honest,” he said. ”I’m the only parenting figure in my life, so I had to be really mature for my age.”

Kissling understands her nephew has had to adopt this attitude in order to cope, and she’s genuinely inspired by his independence. But she knows he’s still a kid who needs support and guidance. That’s why she tries to stay in touch with him every day: texting, joking, asking him what he wanted for Christmas. (She expected Airpods or Amazon gift cards. Instead, he sent her a wish list of more history books about Puerto Rico.)

“He plays it off with a smile, and he laughs about it, and he says, `Aunt Britt, it’s just giving me more motivation to do what I need to do and get where I want to get,’” Kissling said of her nephew’s relationship with his parents. “But deep down, I know it has to affect him. I’m 34. It would affect me.”

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Editor’s note: An earlier version of the story misspelled Nicolas Montero’s first name.