Age of consent for vaccinations

Some jurisdictions in Australia have legislation that addresses the issue of a child’s consent to medical treatment. In the states and territories that have not specifically legislated in relation to the issue of children’s consent to medical treatment, the common law applies. In Queensland the principles of common law apply.

The common law position relating to a child's competency to consent to treatment was established by the English House of Lords decision in Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112.

That case determined that children may authorise medical treatment when they are old enough and mature enough to decide for themselves, provided they are capable of understanding what is proposed and of expressing their own wishes.

This is commonly referred to as the Mature Minor or Gillick competent child.

Queensland

In Queensland, a child can consent to a vaccination if they have the capacity to give or withhold consent. This will require an assessment on a case by case basis to determine if the child is Gillick competent.

A child of 15 years or above would normally be expected to have sufficient maturity, intelligence and understanding to fully understand the proposed treatment in order that they are able to provide valid and informed consent.

In Queensland, children up to the age of 15 generally receive their scheduled vaccinations as part of the school immunisation program. They may also receive their vaccinations at a local immunisation clinic or by their General Practitioner.

Assess capacity for consent

Assessing capacity is a matter for professional judgement. Judgement about a child's competence involves consideration of:

• the age, attitude and maturity of the child or young person, including their physical and emotional development
• the child or young person’s level of intelligence and education
• the child or young person’s social circumstances and social history
• the nature of the child or young person’s condition
• the complexity of the proposed healthcare, including the need for follow up or supervision after the healthcare
• the seriousness of the risks associated with the healthcare
• the consequences if the child or young person does not have the healthcare
• where the consequences of receiving the healthcare include death or permanent disability, that the child or young person understand the permanence of death or disability and the profound nature of the decision he or she is making.

Obtain consent

The service provider must assess the capacity of each child, and be satisfied that the child has sufficient understanding and intelligence to:

• fully comprehend the proposed treatment
• discuss the vaccination
• provide their written consent prior to administering the vaccine.

Provide relevant information

To enable the child to make an informed decision, they must be provided with information about:

• the relevant disease and the vaccine to be administered
• risks and benefits of receiving the proposed treatment
• common side effects and reactions to vaccinations
• more serious but rare, side effects or inherent risks of the proposed treatment.

Provide the child with sufficient time to ask questions for further information.