F v F

In a dispute between parents about vaccination, the court must determine the issue by applying the welfare principle to the individual child. The child’s wishes and feelings are important, especially where the child is mature, but they are not determinative. The court must assess the child’s understanding of the issue and the influences upon the child’s views. It must balance the emotional consequences of overriding those views against the health benefits and risks of vaccination. Parents should support children in managing the consequences of a welfare decision. Each case is fact-specific. The court declared that vaccination with the MMR vaccine was in the interests of both children.

The father applied for a declaration and specific issue order concerning his two daughters, aged 15 and 11, seeking their vaccination against measles, mumps and rubella. The mother opposed the application, relying on the children’s wishes, concerns about vaccine ingredients and side effects, and the parents’ earlier joint decision not to vaccinate. The children had discussed the issue with a CAFCASS officer, their general practitioner and the judge. The central issue was whether vaccination accorded with each child’s welfare, having regard to their wishes and feelings, understanding, emotional needs and the medical risks.

1. Outcome. The court declared that it was in the interests of both children to receive the MMR vaccination. The vaccinations were to take place before 11 October 2013, on a date arranged by the parents and the general practitioner. The parents were also directed to arrange a consultation with a paediatrician with expertise in vaccination.
2. The children’s welfare was the paramount consideration under section 1 (3) of the Children Act 1989. The court’s task was to exercise parental responsibility by deciding the issue on the evidence available in the individual case. The decision did not establish that vaccination should be ordered in every case.
3. The children’s wishes and feelings required careful consideration. Their weight depended on their age, understanding and the factors influencing their views. Here, both children had become focused on vaccine ingredients and side effects without balancing those concerns against the consequences of contracting serious diseases or the contents of medication that might later be required. Their views had also been influenced by the mother’s strongly held opposition.
4. The emotional impact of overriding the children’s wishes was a relevant welfare consideration. It did not, however, prevent the court from making an order where vaccination was otherwise in their interests. The parents remained responsible for supporting the children and managing the consequences of the decision.
5. The medical evidence and accepted medical position favoured vaccination. The risks of side effects were acknowledged, but the diseases prevented by the vaccine were serious and capable of causing long-term health consequences. The court treated the earlier vaccination authorities as confirming that the issue was one of preventative healthcare and that each case required a fact-specific welfare assessment.