What happens if parents disagree on vaccinations? A UK family law guide

The question of whether a child should be vaccinated remains a contentious issue, particularly where parents hold opposing views. While public health policy and clinical guidance strongly support vaccination as a key tool in preventing the spread of infectious diseases, disputes can and do arise within families.

This article explains how vaccination disagreements are approached under family law in England and Wales, how courts make decisions when parents disagree, and what the key legal principles and case law say.

Consent, parental responsibility and Gillick Competence

Vaccination is not mandatory in the UK and as with all medical treatment, it requires valid consent. Where a child is under the age of 16, consent must generally be provided by an individual with parental responsibility. However, a child under 16 may consent to medical treatment, including vaccination, if assessed as “Gillick competent”. This means the child must have sufficient understanding and intelligence to fully comprehend the nature, purpose, and potential consequences of the proposed treatment.

What happens when parents disagree about vaccinations?

When parents cannot agree on whether a child should be vaccinated, either may apply to the Family Court for a Specific Issue Order under section 8 of the Children Act 1989. It is well established that neither parent has primacy over the other in exercising parental responsibility. In the absence of agreement, it falls to the Court to decide what is in the child’s best interests.

How courts decide: best interests and the judicial approach

The Court’s paramount consideration is the welfare of the child (Children Act 1989, s.1(1)). In determining whether a child should receive a vaccine, the Court will assess what is in the child’s best interests, based on the specific facts supported by medical evidence.

In F v F (Welfare of Children: Immunisation) [2013] EWHC 2683 (Fam), the Court emphasised that there is no legal presumption in favour of either parent’s view. The father applied for two daughters, aged 15 and 11, to be vaccinated against MMR. Despite the opposition of the mother and children, the Court concluded that, on the medical evidence, vaccination was in their best interests.

In Re B (A Child: Immunisation) [2018] EWFC 56, the Court held that, for it to conclude that a vaccine is not in a child’s best interests, there would need to be:

• A credible and recent development in peer-reviewed medical science indicating significant concern about a vaccine’s efficacy and/or safety; or
• A well-evidenced medical contraindication specific to the individual child.

This threshold has been reaffirmed in several subsequent cases.

Case Law on routine childhood immunisation

In M v H (Private Law Vaccination) [2020] EWFC 93, the father sought a Specific Issue Order for the children to receive the MMR and COVID-19 vaccines. The Court declined to address the COVID-19 issue prematurely, as no public guidance had yet been issued. However, it reaffirmed that routine immunisation in accordance with NHS schedules was in the children’s best interests. The mother’s objections lacked credible medical support. The Court commented that it was very difficult to foresee a situation in which a vaccine approved for children and endorsed by official guidance would not be in a child’s best interests.

In Re H (A Child) (Parental Responsibility: Vaccination) [2020] EWCA Civ 664, the Court of Appeal confirmed that vaccinations approved by Public Health England (now the UK Health Security Agency) and included in the routine immunisation schedule are highly likely to be in a child’s best interests. The Court also reiterated that, in private law disputes, neither parent has greater authority than the other in decision-making, and where agreement cannot be reached, a judicial determination is required.

Vaccination in the COVID-19 Context

During the COVID-19 pandemic, further questions arose regarding whether family courts would authorise vaccination with newly developed COVID-19 vaccines, particularly in the face of parental objection.

In Re C (Looked After Child) (COVID-19 Vaccination) [2021] EWHC 2993 (Fam), the High Court held that COVID-19 and flu vaccinations were not of such “gravity” as to require Court adjudication. Pursuant to section 33(3)(b) of the Children Act 1989, a local authority holding a care order could consent to vaccination, even where the parent objected. The Court made clear that unless exceptional circumstances arise, such as new scientific evidence or a specific medical risk, routine applications for COVID-19 or similar immunisations would not be necessary.

Conclusion

The Courts have consistently held that, in the absence of robust, credible medical evidence raising significant concern about safety or efficacy, vaccination is likely to be considered in a child’s best interests.

If you are involved in a dispute regarding your child’s medical treatment, or you are unsure how parental responsibility operates in relation to vaccination decisions, please contact our family team on 020 7940 4060 or at mail@anthonygold.co.uk to arrange a confidential appointment with one of our specialist family solicitors.

FAQs: Vaccination Disputes and Family Law

Can one parent refuse a vaccination for their child?

If both parents hold parental responsibility, neither can make the decision alone if the other disagrees. In such cases, either parent can apply for a Specific Issue Order, and the court will decide based on the child’s best interests.

What is a Specific Issue Order?

A Specific Issue Order is a court order under section 8 of the Children Act 1989 used to resolve disputes over specific matters concerning a child’s upbringing, such as medical treatment or vaccination.

Can a child decide on vaccination without parental consent?

A child under 16 can consent if they are deemed Gillick competent, meaning they fully understand the nature and consequences of the treatment.

Will the Family Court always order vaccination?

Unless there is significant, credible medical evidence against it, courts consistently rule that routine, approved vaccinations are in a child’s best interests.