TY - JOUR T1 - Clinical ethics: consent for vaccination in children JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 3 LP - 4 DO - 10.1136/archdischild-2021-322981 VL - 107 IS - 1 AU - Dominic Wilkinson AU - Antonia Kathryn Sarah McBride Y1 - 2022/01/01 UR - http://adc.bmj.com/content/107/1/3.abstract N2 - The prospect of vaccinating children and young people against COVID-19 raises questions that apply more widely to vaccination in children. When can children or adolescents consent, on their own, for vaccination? What should happen if children and their parents disagree about the desirability of a vaccine? When, if ever, should vaccination proceed despite a child’s dissent or apparent refusal? A range of ethical dilemmas may arise (box 1). In this article, we will address general ethical issues relating to consent for vaccination, highlighting their relevance to COVID-19. We will not address the wider ethical questions of whether or when children should be vaccinated against COVID-19.Box 1 Ethical dilemmas relating to vaccine consent for children and young peopleA. Two parents disagree about vaccination for a young child (one supports, the other is opposed).B. Both parents support vaccination, but a 3-year-old child cries vigorously and tries to escape when vaccination is attempted.C. A 12-year-old requests a vaccine in the absence of parental permission (eg, in a school vaccination programme).D. Parents decline vaccination, but an adolescent requests vaccination.E. Parents support vaccination, but an adolescent refuses.In general, parents play a key role in making decisions about medical treatment and procedures in their children. Except in an emergency, informed consent is always sought from a caregiver with parental responsibility prior to significant medical interventions. For childhood vaccinations in the UK, consent from parents is currently routinely required, although some groups have argued that mandatory vaccination would promote children’s best interests. If parents decline immunisations after being counselled about the evidence for vaccine safety and efficacy, their decision would usually be respected. Rarely vaccination may proceed against parental wishes; for example, for a child in care, or a child at particularly high … ER -