Immunisations for children in care

Sarah Fahy considers the correct approach to be taken when it comes to immunisations for children in care.

It is perhaps not commonly appreciated that the programme of immunisations for children in this country is not compulsory. A parent has the right to refuse for their child to be vaccinated. Where this issue becomes more contentious is where a local authority shares parental responsibility for a child.

It is not appropriate for a local authority to give its consent to the immunisations when faced with parental objection on this issue pursuant to s.33(3) Children Act 1989.

A recent case which sets out succinctly the correct approach when faced with this situation and the considerations for the court is Barnet London Borough Council v AL and others (Fam D) [2017] 4 WLR 53, also known as Re SL (Permission to Vaccinate) [2017] EWHC 125 (Fam). Keehan J also recently reaffirmed the principles set out within this case in a similar case which was before the High Court in December 2017 (published judgment awaited at the time of writing). The correct approach is as follows:

1. The local authority cannot simply apply for a specific issue order.
2. The correct approach is to apply under the inherent jurisdiction to the High Court for declaratory relief as to whether it is in the best interest of the child to receive the immunisations in question.
3. When applying under the inherent jurisdiction, the local authority must apply for leave to do so and the court must consider the criteria under s.100(4) Children Act 1989.
4. There will be a need for expert opinion as to the immunisations being sought, the risks they pose, possible side effects to the specific child and their circumstances and the benefits of the immunisations being sought.
5. The court must accord a significant degree of weight to the view of the parents given that ordinarily, this is not an issue upon which the State would intervene due to its non-compulsory nature.
6. The child’s welfare and what is in their best interests is the court’s paramount consideration.
7. The court must be convinced that the benefits of the immunisation(s) outweighs the risks to the specific circumstances and/or health history of the child in question. It is important that any alleged contra-indications and risks are evidenced by the party alleging them, e.g. a family history of bad reactions to immunisations.
8. A decision by the court to authorise immunisation in the face of parental objection is an interference with their Article 8 rights. Therefore, the court must be satisfied that such an interference is lawful, necessary and proportionate to protect the child’s best welfare interests.
9. Any declaratory order that the court makes should set out specifically the list of immunisations that the court has determined are in the child’s best interests to receive.

Sarah Fahy is a barrister at St Ives Chambers. She can be contacted on 0121 236 0863 or This email address is being protected from spambots. You need JavaScript enabled to view it..