Advice and resources : Consent for vaccinations

Overview

We work closely with schools to schedule immunisation sessions and arrange for communication to go out to parents regarding consent. 

Consent means to give permission. You can approve (yes) or decline (no).

Please make sure you complete and submit our online consent forms as soon as possible when you get them, even if you prefer your child not to be vaccinated.

This gives our staff time to check your child’s immunisation history before they offer vaccines.

We will not be able to vaccinate your child if you have not completed a consent form.

Both you as the parent, and the child or young person, have legal rights with consent.

Giving consent

If you as the parent/guardian do not give consent

If you do not consent to your child being vaccinated, please complete a non-consent form for your child for each programme.

We do not accept non-consent by email or phone, as it 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 confirm whether you consent (yes to vaccines) or decline (no to vaccines).

Changing your mind about consent

Please only submit one consent form per child and vaccine.

More than one form being submitted can cause duplicates, which can result in a delay in vaccination due to mismatched information.

We ask that you instead email the immunisation team with:

• Child’s full name
• Child’s DOB
• Child’s school
• Vaccination
• Consent status and reason for change

• Visit NSPCC Learning

Conflicting parental consent

As professionals, we respect that others hold different views. We know that some parents may have different views on agreeing to consent to vaccines.

While we will always work together with parents and carers, and provide comprehensive training to our teams, our primary focus will always be on the needs and wishes of the young person. 

Within the Nurses’ Code of Conduct staff are required to act in the best interests of their patients. In this case, it is to make sure young people express their care preferences.

In such circumstances we would annotate the child’s record to this effect and record the differing parental views regarding consent.

Gillick competence test

The Department of Health publishes guidance to all health professionals on matters relating to informed and voluntary consent. Our team training covers both the Mental Capacity Act 2005, (updated 2020), which applies to those over 16 years and the concept of Gillick competence.

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 which means the patient must be given sufficient information about the benefits and risks of the treatment/procedure, and given the opportunity to ask questions
• It must be given voluntarily, meaning they should not be forced or pressured to give their consent
• Withholding their consent should not disadvantage an individual or prevent them from changing their mind

Visit NSPCC Learning website for more information about Gillick competence and Fraser guidelines.

• Visit NSPCC Learning

Making changes to the consent form

Follow these steps if you have already submitted your consent form, but need to make changes.

Changes to demographic details, like name, address, DOB, GP

Unless a significant error has occurred, such as a 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 ask your child to inform the nursing staff on the day that changes need to be made. 

Changes to 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, such as 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 updated 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.

Children giving their own consent (Gillick competence)

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 are no defined set of 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 for 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, including risks and benefits, the consent process, and how to contact us should they have further questions
• Encourage them to speak to their parents/carers about the information and discuss their decision, if they feel able to
• Ask them to contact our service if they still wish to consent to the vaccination 

By law. young people can also override parental consent if they do not wish to receive a vaccination.

Visit NSPCC for more information. 

• Visit NSPCC Learning

Issues with the consent form

If you can't access the consent form

Select the form for the vaccination mentioned in your letter and only complete ONE form per child.

You will see a large green tick on your screen and receive a confirmation message via email.

Please contact our Immunisation Service for children and young people if you need support to access and complete an electronic consent form.

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, and to plan the correct staffing for the school session.

If a consent form is not submitted before the system closes, we won't be able 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.

Find your child’s NHS number

Visit the NHS website to find your child’s NHS number.  You can also find it on any recent prescription, or on 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 related to the vaccine itself.

This helps our team find out if there are any children or young people who may not be able to have it.

If your child has a medical condition and you are not asked about it on the form, this is because it is not harmful (a contraindication)  to having that particular vaccine.

You can still discuss this with us if you need further advice. 

• Visit NHS website to find your NHS number