Advice and resources : Consent for vaccinations
Overview
We work closely with schools to plan and schedule immunisation sessions and arrange for communication to go out to parents regarding consent for vaccinations.
We would be grateful if you could ensure that electronic consent forms are completed and submitted as soon as possible after receiving, even if you prefer your child not to be vaccinated. If you have not completed a consent form, we will not be able to vaccinate your child. This allows the staff to check your child’s immunisation history before they give the vaccines.
If you do not wish to give consent
If you do not consent for your child to be vaccinated please complete a non-consent form for your child for each programme. We do not accept emailed or phoned declines as consent needs to be documented via our electronic system. Please follow the consent link within the original details emailed to you, complete your child’s demographic details and indicate whether you consent or decline.
Children giving their own consent
Children under the age of 16 can consent to their own treatment if they're believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment. This is known as being Gillick competent. There is no set of defined questions to assess Gillick competency. Professionals need to consider several things when assessing a child's capacity to consent, including:
- the child's age, maturity and mental capacity
- their understanding of the issue and what it involves - including advantages, disadvantages and potential long-term impact
- their understanding of the risks, implications and consequences that may arise from their decision
- how well they understand any advice or information they have been given
- their understanding of any alternative options, if available
- their ability to explain a rationale around their reasoning and decision making.
It is important to our team to ensure that this assessment is made thoroughly and in an appropriate confidential space and that the child has sufficient opportunity to make a fully informed decision. For this reason, if a child approaches our team during a school session and states that they wish to self-consent to a vaccination (in the absence of parental consent) we will:
- Provide them with information about the vaccine and the associated risks and benefits, the consent process and how to contact us should they have further questions
- Encourage the young person to read the information provided and speak to their parents/carers about the information they have received and discuss their decision, if they feel able to do so
- If they still wish to consent to the vaccination they can contact the service and we will advise them about how to access this.
Young people can also, by law, override parental consent if they do not wish to receive vaccination.
For further information visit: Gillick competence and Fraser guidelines | NSPCC Learning
Changing your mind about consent
Please only submit one consent form per child and vaccine, if more than one form is submitted this results in duplicates and can result in a delay in vaccination due to mismatching of information.
We ask that you instead email the immunisation team with the below information:
- Child’s full name
- Child’s DOB
- Child’s school
- Vaccination
- Consent status and reason for change
Conflicting parental consent
It is not uncommon that parents may have differing views on whether to agree to consent to this vaccine and indeed other vaccinations or treatments, which is why the training we provide is comprehensive. We aim to work in partnership with parents and carers, but our primary focus remains the needs and wishes of the young person. As professionals we respect that others hold different views, however within the Nurses’ Code of Conduct, staff are also required to act in the best interests of their patients (in this case young people), and where appropriate, enable young people to express their preference.
In such circumstances they would annotate the child’s record to this effect and record the differing parental views regarding consent.
The Department of Health publishes guidance to all health professionals on matters relating to informed and voluntary consent, and the training our team receive covers both the Mental Capacity Act 2005, (updated 2020), which applies to those over 16 years and the concept of Gillick competence (see link below). The test of Gillick competence “enables professionals to assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.”.
The link to the Department of Health document is below, but the main principles are:
- For consent to be legal it must be informed (the patient must be given sufficient information about the benefits and risks of any proposed treatment/procedures and provided with an opportunity to ask questions).
- It must be given voluntarily; there should be no coercion or undue pressure on an individual to provide their consent
- Withholding their consent should not disadvantage an individual or prevent them from changing their mind.
Making changes once consent form has been submitted
If you have already submitted your consent form but need to make changes:
- Demographic Details – name, address, DOB, GP - Unless a significant error has occurred eg completely wrong name and date of birth details then the nursing/admin team can update your child’s electronic consent form on the day of vaccination. Please prompt your child to inform the nursing staff on the day that changes need to be made.
- Medical Conditions/changes to health - If there are significant changes to your child’s health that may impact them being able to be vaccinated on the day eg increased use of oral steroids for flu, recent positive PCR test for COVID-19, then please provide a written note with your child’s full name, DOB and updating information to give to the nursing team on the day.
If your child is too young or unable to relay this information, then please hand the letter to the school reception for the urgent attention of the School immunisation team.
Issues with the consent form
If you cannot access the consent form
Select the form for the vaccination mentioned in your letter and only complete ONE form per child. You will know you have successfully submitted a form as you will see a large green tick on your screen and you will receive a confirmation message via email. If you need support to access and complete an electronic consent form please contact the School Aged Immunisation team.
If the consent form is closed when you attempt to access it
The School Immunisation team are required to shut down access to electronic consent forms 48 hours in advance of planned school sessions. This is done to allow enough time for the clinical team to check and triage all forms submitted, and to plan the correct staffing for the school session. If a consent form is not submitted before the system closes, we are unfortunately unable to vaccinate the child in the school session on the day.
We re-open the system 24 hours after the session has finished and parents are then be able to complete a flu consent form and follow the link within the original email to book a clinic appointment.
If you do not know my child’s NHS number
There is now a website where you can search for your child’s NHS number here, alternatively this can be viewed on a recent prescription or via their personal child health record (PCHR).
If your child has a medical condition but it’s not mentioned on the consent form
Each consent form asks different clinical questions based upon the vaccine itself and identifies any child or young person who may not be able to have the vaccine. If your child has a medical condition and you are not asked about it on the form, this is because it is not a contra-indication to having that particular vaccine, although we understand it may be something you wish to discuss with us.