SL (Permission to Vaccinate), Re

Where holders of parental responsibility disagree about vaccination, the court may determine the dispute under the appropriate jurisdiction. The child’s welfare is paramount. The court must make an independent and objective assessment of the evidence, giving proper weight to the parent’s views but not treating them as determinative.

In a care case, a local authority sharing parental responsibility may require relief under the inherent jurisdiction where the seriousness of the decision makes reliance on ordinary parental-responsibility powers inappropriate. The court must also consider whether authorisation is a justified and proportionate interference with family life under Article 8 of the ECHR. The decision remains fact-specific and does not determine the general merits of vaccination.

The local authority sought a declaration under the inherent jurisdiction that it should be permitted to arrange Hib and PCV vaccination for SL, an infant subject to an interim care order. SL’s mother opposed those vaccinations, relying principally on alleged adverse reactions suffered by older children. The local authority and Children’s Guardian supported vaccination.

The court considered expert medical evidence, the statutory framework governing care orders and parental responsibility, the mother’s Article 8 rights and the child’s rights under Article 24 of the UNCRC. The central issue was whether vaccination was in SL’s best interests.

1. Jurisdiction and governing principles. Where holders of parental responsibility dispute vaccination, the court has jurisdiction to determine the issue. The child’s welfare is paramount. The court must exercise an independent and objective judgment on the totality of the evidence, while according appropriate weight to the parent’s assessed views.
2. Care proceedings. Because SL was subject to an interim care order, the local authority could not apply for a specific issue order under section 9(1) of the Children Act 1989. Given the gravity of the decision, it was also inappropriate simply to rely on the local authority’s power to consent under section 33(3). The court therefore granted permission under section 100(4) to pursue relief under the inherent jurisdiction.
3. Best interests. The unchallenged expert evidence established that Hib and pneumococcal infections could cause serious, rapidly progressive and potentially fatal illness, while vaccination carried only a very low risk of serious reaction and generally mild, transient side effects. SL had no medical contraindication to vaccination. The balance of risk plainly favoured immunisation.
4. The mother’s views were carefully considered, but their weight was reduced because they conflicted with the expert evidence and were unsupported by medical records or other evidence establishing the alleged reactions in the older children. Even if such reactions had occurred, the expert evidence was that they would not generally contraindicate vaccination.
5. The authorisation interfered with the mother’s Article 8 rights, but the interference was in accordance with the law, necessary to protect SL’s health and proportionate. It was reinforced by Article 24 of the UNCRC. A declaration was made that it was in SL’s best interests for the local authority to arrange the Hib and PCV vaccinations.
6. The decision was confined to SL’s particular circumstances and evidence. It was not a general ruling on whether immunisation is beneficial.