Several years ago, the World Health Organization published a paper on various levels of “consent” required for vaccinating children. It also introduces the idea of “implied consent for children”. Apparently, just going to school after a notice has been given will suffice.
Approaches to obtain informed consent:
- 1. Written consent
- 2. Verbal consent
- 3. Implied consent
It’s the third type that is the most nefarious.
3. An implied consent process by which parents are informed of imminent vaccination through social mobilization and communication, sometimes including letters directly addressed to the parents. Subsequently, the physical presence of the child or adolescent, with or without an accompanying parent at the vaccination session, is considered to imply consent. This practice is based on the opt-out principle and parents who do not consent to vaccination are expected implicitly to take steps to ensure that their child or adolescent does not participate in the vaccination session. This may include not letting the child or adolescent attend school on a vaccination day, if vaccine delivery occurs through schools.
Implied consent procedures are common practice in many countries. However, when children present for vaccination unaccompanied by their parents, it is challenging to determine whether parents indeed provided consent. Therefore, countries are encouraged to adopt procedures that ensure that parents have been informed and agreed to the vaccination. Comprehensive data on whether the approach countries use to deal with consent has changed or evolved over the last decades is not available.
Based on concepts of vaccines as a public good, or on public-health goals of disease elimination and outbreak control, some countries identify one or more vaccines as mandatory in law, or in their policies. Vaccination may, for example, be made a condition for entry into preschool or primary school, or to enable access to welfare benefits. Whether consent is needed for mandatory vaccination depends on the legal nature of the regulations. When mandatory vaccination is established in relevant provisions in law, consent may not be required. If the mandatory nature of vaccination is based on policy, or other forms of soft law, informed consent needs to be obtained as for any other vaccines. Some countries allow individuals to express non-consent (opt-out) and obtain an exemption for mandatory vaccines. This may come with certain conditions, like barring unvaccinated children from attending school during disease outbreaks
Have to cringe at how getting informed consent, or having the parents involved, is seen as an inconvenience. Then again, many concerned parents would put a stop to such things.
(2) WHO Schools And Implied Not Direct Consent