Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T15:08:59.299Z Has data issue: false hasContentIssue false
  • English
  • Français

Voluntary vaccination: the pandemic effect*

Published online by Cambridge University Press:  02 January 2018

Emma Cave
Emma Cave*
Affiliation:
Durham University
*
Emma Cave, Professor, Durham Law School, Durham University, The Palatine Centre, Stockton Road, Durham DH1 3LE, UK. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Justification of a voluntary vaccination policy in England and Wales rests on tenuous foundations. Two arguments against voluntary vaccination are gaining ground. The first is that globalisation necessitates preparedness strategies for pandemics. Assuming sufficient supply, compulsory vaccination of adults and children constitutes a potential policy option in the context of a severe, vaccine-preventable pandemic outbreak. The second argument is that children have a right to preventive medicine and thus to vaccination. The influence of the UN Convention on the Rights of the Child and its emphasis on parents as the trustees of their children's best interests, and the increasingly global nature of our collective and individual responsibilities with respect to the transmission of vaccine-preventable disease present challenges to the right to refuse vaccination on our own behalf and on behalf of our children. Exploring methods of compulsion and persuasion utilised across Europe, the USA and Australia, this paper argues that necessity and proportionality must be reassessed, and national public health law and policy setting out a graduated and proportionate approach to compulsory vaccination developed as a matter of priority.

Type
Research Article
Information
Legal Studies , Volume 37 , Issue 2 , June 2017 , pp. 279 - 304
Copyright
Copyright © Society of Legal Scholars 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

I am most grateful to the reviewers for their helpful comments.

References

1. Fidler, DP and Gostin, LO Biosecurity in the Global Age: Biological Weapons, Public Health, and the Rule of Law (Stanford, CA: Stanford Law and Politics, 2007) p 145 Google Scholar.

2. London Borough of Newham v KA (Mother) & Ors [2016] EWFC B11; F v F [2013] EWHC 2683 (Fam); LCC v A, B, C and D [2011] EWHC 4033; Re B (Child) [2003] EWCA Civ 1148; Re C (Welfare of the Child: Immunisation) [2003] 2 FLR 1095 (discussed below).

3. England, NHS Pandemic Influenza: NHS Guidance on the Current and Future Preparedness in Support of an Outbreak (London: NHS England, 2014)Google Scholar Ref 02616.

4. Vaccines Europe ‘How are vaccines developed?’ available at http://www.vaccineseurope.eu/about-vaccines/key-facts-on-vaccines/how-are-vaccines-developed/ (accessed 12 June 2016).

5. WHO ‘Immunisation’, available at http://www.who.int/topics/immunization/en/ (accessed 12 June 2016).

6. WHO ‘Isolated gains in immunization need to become the norm’ (11 December 2015), available at http://www.who.int/immunization/en/ (accessed 12 June 2016).

7. See eg McAllister, L et al ‘Needle-free jet injection for administration of influenza vaccine: a randomised non-inferiority trial’ (2014) 23(384) Lancet 674 CrossRefGoogle Scholar.

8. European Centre for Disease Prevention and Control Narcolepsy in Association with Pandemic Influenza Vaccination (A Multi-Country European Epidemiological Investigation) (Stockholm: ECDC, 2012)Google Scholar.

9. Hotopf, M et al ‘Role of vaccinations as risk factors for ill health in veterans of the Gulf war: cross sectional study’ (2000) 320 BMJ 1363 CrossRefGoogle ScholarPubMed; C Bates and J Parkinson ‘Why hasn't the mystery of Gulf War Syndrome been solved?’ BBC News Magazine (16 January 2016).

10. ‘Loveday v Renton’ The Times 31 March 1982. See

11. Pywell, S ‘A critical review of the recent and impending changes to the law of statutory compensation for vaccine damage’ (2000) 4 J Personal Injury L 246 Google Scholar.

12. By 2011, Canada and Russia were the only G8 nations without national no-fault compensation programs: Collier, R ‘No-fault compensation program overdue, experts say’ (2011) 183(5) Can Med Assoc J E263 CrossRefGoogle ScholarPubMed. And see Looker, C and Kelly, H ‘No-fault compensation following adverse events attributed to vaccination: a review of international programmes’ (2011) 89 Bull WHO 371 Google ScholarPubMed.

13. Or injured by vaccination in pregnancy: Vaccine Damage Payments Act 1979, s 1(3) and the Vaccine Damage Payments Regulations SI 1979/432, reg 5A. Serious disablement is defined as ‘disablement to the extent of 60% or more, assessed as for the purposes of s 103 of the Social Security Contributions and Benefits Act 1922 or s 103 of the Social Security Contributions and Benefits (Northern Ireland) Act 1992 (disablement gratuity and pension)’. The list of relevant vaccines is regularly updated. Most recently, rotavirus and influenza (other than influenza caused by a pandemic influenza virus) were added by the Vaccine Damage Payments (Specified Disease) Order 2015, SI 2015/47.

14. Vaccine Damage Payments Act 1979 Statutory Sum Order, SI 2007/1931.

15. See Brazier, M and Cave, E Medicine, Patients and the Law (Manchester: Manchester University Press, 2016)Google Scholar 10.15; Tindley, R ‘A critical analysis of the vaccine damage payments scheme’ (2008) 19(2) Eur Bus L Rev 321 Google Scholar.

16. Public Health England (2015) 9(45) Infection Report (18 December 2015): eg MMR 92.1% for 2 year olds and 94.9% for 5 year olds, narrowly missing the WHO target of 95%.

17. See recommendations of Nuffield Council on Bioethics Public Health: Ethical Issues (London: Nuffield Council on Bioethics, 2007)Google ScholarPubMed para 4.32.

18. ‘Retracted – Wakefield, AJ et al ‘Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children’ (2010) 275 Lancet 445 Google Scholar.

19. NHS Website ‘MMR catch-up campaign targets a million children’ (25 April 2013), available at http://www.nhs.uk/news/2013/04April/Pages/New-MMR-catch-up-campaign-one-million-children-targeted.aspx (accessed 12 June 2016).

20. NHS Public Health Wales Measles Outbreak Data (July 2013), available at http://www.wales.nhs.uk/sitesplus/888/page/66389 (accessed 12 June 2016).

21. Calandrillo, SP ‘Vanishing vaccinations: why are so many Americans opting out of vaccinating their children?’ (2004) 37(2) U Mich J L Reform 353 Google ScholarPubMed.

22. See Ritov, I and Baron, J ‘Reluctance to vaccinate: omission bias and ambiguity’ (1990) 3 J Behav Decis Mak 263 CrossRefGoogle Scholar.

23. Offit, P Bad Faith: When Religious Belief Undermines Modern Medicine (New York: Basic Books, 2015)Google Scholar.

24. NHS Choices ‘Swine flu (H1N1)’, available at http://www.nhs.uk/conditions/pandemic-flu/Pages/Introduction.aspx (accessed 12 June 2016).

25. J Gallagher ‘Ebola: $5 m vaccine deal announced’ BBC News (20 January 2016).

26. See eg Felsen, G, Caetelo, N and Reiner, P ‘Decisional enhancement and autonomy: public attitudes toward overt and covert nudges’ (2013) 8(3) Judgm Decis Mak 202 Google Scholar.

27. See http://www.nhs.uk/conditions/vaccinations/Pages/childhood-vaccination-schedule.aspx (accessed 12 June 2016).

28. C Price ‘GPs to be paid £1.50 for each child invited under MMR catch-up campaign’ Pulse (1 May 2013).

29. Middleman, AB and Tung, JS ‘School-located immunization programs: do parental preferences predict behavior?’ (2011) 29(19) Vaccine 3513 CrossRefGoogle ScholarPubMed.

30. Media Statement: S Ley MP ‘$26 m booster to immunise Australia’ (19 April 2015), available at https://www.health.gov.au/internet/ministers/publishing.nsf/Content/B13A5C4233686A99CA257E2E0013E611/$File/SL044.pdf (accessed 12 June 2016).

31. Ibid.

32. T Abbott (Prime Minister) and S Morrison (Minister for Social Services) ‘No jab – no play and no pay for child care, media release’ (12 April 2015); S Morrison (Minister for Social Services) ‘Government ends religious ‘No Jab No Pay’ of benefits exemption, media release’ (19 April 2015).

33. News.cam.au ‘Editorial: Time to stop keeping kids immune from jab’ (9 May 2013); and see Victoria's subsequent Public Health and Wellbeing Amendment (No Jab: No Play) Act 2015, introduced 1 January 2016.

34. Such policies are fiercely opposed. See eg the Canadian case of Clowes v Edmonton School District No. 7, 1915 CarswellAlta 56 Alberta Supreme Court, where it was held that regulations issued under the Public Health Act, s 68 requiring that no pupil could be admitted to school without proof of vaccination, were ultra vires due to conflict with the Truancy Act requirement that all children attend school.

35. Majumder, M et al ‘Substandard vaccination compliance and the 2015 measles outbreak’ (2015) JAMA Pediatrics (May 2015)CrossRefGoogle ScholarPubMed.

36. SB 277, Pan. Public health, approved June 2015; available at http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277 (accessed 12 June 2016).

37. See Gostin, LO et al ‘The Model State Emergency Health Powers Act: planning for and response to bioterrorism and naturally occurring infectious diseases’ (2002) 288(5) JAMA 622–628 CrossRefGoogle ScholarPubMed.

38. Barquet, N and Domingo, P ‘Smallpox: the triumph over the most terrible of the ministers of death’ (1997) 127(8) Ann Int Med 635 CrossRefGoogle Scholar.

39. See Kotar, SL and Gessler, JE Smallpox: A History (Jefferson, NC: McFarland, 2013)Google Scholar.

40. R v Southwark Guardians’ Vaccination Officers [1928] 1 KB 65 involving a petition to search the vaccinations register to assess compliance with the terms of the tenancy agreement.

41. Cooney, JE ‘Legal decisions affecting medical men and the public health’ (1899) Med Ann 623 Google Scholar.

42. See eg Allen v Worthy (1869-70) LR 5 QB 163.

43. Herschell, Lord Report of the Royal Commission Appointed to Inquire into the Subject of Vaccination (London: HMSO, 1889–1897)Google Scholar.

44. Herschell, above n 43, para 510.

45. Victoria State Government No Jab, No Play: Frequently Asked Questions (Melbourne: Health and Human Services, 2015)Google Scholar.

46. Lamond, G ‘The coerciveness of law’ (2000) 20(1) Oxford J Legal Stud 39 at 41CrossRefGoogle Scholar.

47. Coggon, J What Makes Health Public? A Critical Evaluation of Moral, Legal, and Political Claims in Public Health (Cambridge, UK: Cambridge University Press, 2012) p 129 Google Scholar.

48. Ibid.

49. Diekema, DS ‘Physician dismissal of families who refuse vaccination: an ethical assessment’ (2015) 43(3) J L Med Ethics 654 Google Scholar; Block, SL, ‘The pediatrician's dilemma: refusing the refusers of infant vaccines’ (2015) 43(3) J L Med Ethics 648 Google ScholarPubMed.

50. See US National Vaccine Information Center State Law & Vaccine Requirements, available at http://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx (accessed 12 June 2016).

51. Dan-Cohen, M ‘In defense of defiance’ (1994) 23 Phil & Pub Aff 24 CrossRefGoogle Scholar.

52. Ibid, at 25–26.

53. Austin, J The Province of Jurisprudence Determined (New York: Noonday Press, 1954)Google Scholar.

54. Hart, HLA The Concept of Law (Oxford: Clarendon Press, 1961)Google Scholar.

55. Dan-Cohen, above n 51, at 31.

56. Ibid, at 49.

57. Coggon, above n 47, p 133.

58. Ibid.

59. Cooney, above n 41.

60. The new law would not compel ‘those who are honestly opposed to the practice to submit their children to vaccination, and, at the same time, leave the law to operate, as at present, to prevent children remaining unvaccinated owing to the neglect or indifference of the parent’. Ibid, at 524.

61. Herschell, above n 43, para 510.

62. Dissent of Collins and Picton, Alanson Report of the Royal Commission Appointed to Inquire into the Subject of Vaccination (London: HMSO, 1889–1897)Google Scholar para 296. And see para 300: ‘We believe the methods of isolation of the infected, disinfection, and the observance of strict cleanliness are both more successful and more legitimate methods for the State to encourage. They have the advantage of applying the preventive only where it is required: and they do not necessitate an operation upon the person of every health individual.’

63. Ibid, para 301.

64. Ibid, para 302.

65. Brundtland, GH ‘Global health and international security’ (2003) 9 Global Gov 417 Google Scholar; Bonventre, EV, Hicks, KH and Okuntani, SM US National Security and Global Health: An Analysis of Global Health Engagement by the US (Washington, DC: Center for Strategic and International Studies, Department of Defence, 2009)Google Scholar.

66. HM Government National Security Strategy and Strategic Defence and Security Review 2015: A Secure and Prosperous United Kingdom Cm 9161 (London, 2015) paras 3.16–3.17 Google Scholar; US National Security Strategy (Washington, DC: The White House, 2015) p 4 Google Scholar.

67. See eg Flear, ML ‘‘Supra-stewardship’: a tool for citizen participation in European Union pandemic preparedness planning’ (2011) 62(5) NI Legal Q 677 Google Scholar.

68. WHO ‘What is a pandemic?’ (24 February 2010), available at http://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/ (accessed 12 June 2016).

69. Buzan, B, Waever, O and de Wilde, J Security: A New Framework for Analysis (London: Lynne Reinner, 1998)Google Scholar.

70. Yuk-Ping, C and Thomas, N ‘How is health a security issue? Politics, responses and issues’ (2010) 25 Health Pol'y & Planning 447 at 447CrossRefGoogle Scholar.

71. For criticism of the UK's over-reliance on the WHO, see House of Commons International Development Committee Ebola: Responses to a Public Health Emergency Second Report of Session 2015–16, HC 338, January 2016, p 22.

72. WHO Statement ‘Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa’ (8 August 2014), available at http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/ (accessed 12 June 2016).

73. WHO Statement ‘Statement on the 1st meeting of the IHR 2005 Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations’ (8 April 2016), available at http://www.who.int/mediacentre/news/statements/2016/1st-emergency-committee-zika/en/ (accessed 12 June 2016).

74. Moon, S et al ‘Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard–LSHTM Independent Panel on the Global Response to Ebola’ (2015) 386(10009) Lancet 2204 CrossRefGoogle ScholarPubMed.

75. Gostin, LO, Sridhar, D and Hougendobler, D ‘The normative authority of the World Health Organisation’ (2015) 129(7) Pub Health 854 at 854CrossRefGoogle Scholar.

76. See Gostin et al, above n 37.

77. See The Centre for Law and the Public's Health ‘The Model State Emergency Health Powers Act’ (15 July 2006), available at http://www.publichealthlaw.net/ModelLaws/MSEHPA.php (accessed 12 June 2016), which reported that the Act was introduced in whole or part in 44 states.

78. See eg Annas, GJ ‘Bioterrorism, public health, and civil liberties’ (2002) 346(17) New Eng J Med 1337 CrossRefGoogle ScholarPubMed.

79. UN Resolution 59/27 Enhancing Capacity-Building in Global Public Health Resolution (New York: UN General Assembly, 2005)Google Scholar.

80. WHO International Health Regulations (Geneva: WHO, 2005, updated 2008Google ScholarPubMed), available at http://apps.who.int/iris/bitstream/10665/43883/1/9789241580410_eng.pdf (accessed 12 June 2016).

81. Ibid.

82. Ibid, para 9. And see Art 12 on ‘determination of a public health emergency of international concern’.

83. Ibid, and see Arts 15, 48 and 49.

84. Ibid, Art 18(1).

85. HM Government, above n 66, para 4.1.

86. Civil Contingencies Act 2004. And see England, NHS Emergency Preparedness, Resilience and Response Framework (Leeds: NHS England, 2015)Google Scholar.

87. NHS England, ibid, para 14.3.

88. Established by the NHS (Standing Advisory Committees) Order 1981, SI 1981/597.

89. SI 2009/38.

90. JCVI Code of Practice (2013), paras 61 and 66.

91. Ibid, para 5.140.

92. HM Government, above n 66, para 5.138.

93. Keeling, MJ and Danon, L ‘Mathematical modelling of infectious diseases’ (2009) 92(1) Br Med Bull 33 CrossRefGoogle ScholarPubMed.

94. Taubenberger, JK and Morens, DM ‘1918 Influenza: the mother of all pandemics’ (2006) 12(1) Emerging Infectious Diseases (Centers for Disease Control and Prevention) 15 CrossRefGoogle Scholar.

95. Cabinet Office Independent Review into the Response to the 2009 Swine Flu Pandemic (2010), chaired by Dame D Hine, s iv, available at https://www.gov.uk/government/publications/independent-review-into-the-response-to-the-2009-swine-flu-pandemic (accessed 12 June 2016).

96. Smith, RD et al ‘The economy-wide impact of pandemic influenza on the UK: a computable general equilibrium modelling experiment’ (2009) 339 BMJ b4571–b4571 CrossRefGoogle ScholarPubMed.

97. Pandemic Influenza Preparedness Team Factors Associated with Uptake of Vaccination Against Pandemic Influenza (London: Department of Health, 2011) p 8 Google ScholarPubMed. And see Cabinet Office Independent Review into the Response to the 2009 Swine Flu Pandemic (2010), chaired by Dame D Hine, available at https://www.gov.uk/government/publications/independent-review-into-the-response-to-the-2009-swine-flu-pandemic (accessed 12 June 2016).

98. El-Masri v the former Yugoslav Republic of Macedonia (Application no 39630/09), ECtHR (13 December 2012) § 239.

99. Guzzardi v Italy (Application no 7367/76), (1980) ECHR 5, § 98.

100. (2005) ECHR 56529/00. See Martin, R ‘The exercise of public health powers in cases of infectious disease: human rights implications’ (2006) 14(1) Med L Rev 132 CrossRefGoogle ScholarPubMed.

101. de Londras, F and Davis, F ‘Controlling the executive in times of terrorism: competing perspectives on effective oversight mechanisms’ (2010) 30 Oxford J Legal Stud 19 at 21CrossRefGoogle Scholar.

102. Greene, A ‘Questioning executive supremacy in an economic state of emergency’ (2015) 35 Legal Stud 594 CrossRefGoogle Scholar.

103. ‘Court: Health Ministry can continue with mandatory child vaccination’ Prague Daily Monitor 24 February 2015, available at http://www.praguemonitor.com/2015/02/24/court-health-ministry-free-order-child-vaccination (accessed 12 June 2016).

104. Presidential Commission for the Study of Bioethical Issues Ethics and Ebola Public Health Planning and Response (Washington, DC, February 2015) p 26.

105. Ibid, pp 27–28.

106. 274 US 200 (1927), p 207 per Holmes J.

107. Martin, R et al ‘Pandemic influenza control in Europe and constraints resulting from incoherent public health laws’ (2010) 10 BMC Pub Health 532 CrossRefGoogle ScholarPubMed.

108. World Economic Forum Global Risks Report 2015 (Geneva: WEF, 10th edn, 2015)Google Scholar para 2.3; available at http://www.weforum.org/reports/global-risks-report-2015 (accessed 12 June 2016).

109. UN The Millennium Development Goals Report 2015 (New York: UN, 2015) p 51 Google Scholar; available at http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf (accessed 12 June 2016).

110. Fidler and Gostin, above n 1, p 145.

111. Gostin, LO Global Health Law (Cambridge, MA: Harvard University Press, 2014) ch 2CrossRefGoogle ScholarPubMed.

112. HM Government, above n 66, para 3.17.

113. Dan-Cohen, above n 51, at 24.

114. See J Coggon above n 47, p 45.

115. As amended by the Health and Social Care Act 2008.

116. Health Protection (Notification) Regulations 2010, SI 2010/659, Sch 1.

117. Health Protection (Local Authority Powers) Regulations 2010, SI 2010/657, reg 2.

118. Health Protection (Part 2A Orders) Regulations 2010, SI 2010/658. Public Health (Control of Disease) Act 1984 ss 37, 38. See Department of Health Health Protection Legislation (England) Guidance 2010 (London: Department of Health, 2010) p 47 Google Scholar. See also Public Health England Health Protection Regulations 2010 Toolkit (2011, revised 2015), available at http://www.cieh.org/policy/health-protection-regulations-toolkit.html (accessed 12 June 2016).

119. Brazier, M and Harris, J ‘Public health and private lives’ (1999) 4(2) Med L Rev 171 at 177.CrossRefGoogle ScholarPubMed

120. R v Dica [2004] EWCA Crim 1103. See criticisms in M Phillips and A Sukthankar ‘Imprisonment for non-intentional transmission of HIV: can it be supported using established principles for justifying criminal sentencing?’ (2013) 89 Sexually Transmitted Infections 276. And see Stanton, C ‘Criminalising contagion’ (2014) 40 J Med Ethics 792 CrossRefGoogle ScholarPubMed.

121. [2009] EWCA Crim 60.

122. Law Commission Reform of Offences Against the Person, Law Com 361 (November 2015) para 6.8.

123. R v Golding [2014] EWCA Crim 889.

124. Home Office Violence – Reforming the Offences Against the Person Act 1861 (Consultation Paper, 1998).

125. Law Commission, above n 122.

126. Ibid, para 6.5.

127. See Gostin, L ‘The politics of AIDS: compulsory state powers, public health and civil liberties’ (1989) 49 Ohio St L J 1017 at 1051Google ScholarPubMed. Note that the Crown Prosecution Service Intentional or Reckless Sexual Transmission of Infection Guidance (London: CPS, 2012)Google ScholarPubMed advises: ‘Those who choose not to be tested will not necessarily avoid prosecution for the reckless transmission of a sexually transmissible infection if all the circumstances point to the fact that they knew that they were infected.’

128. Brazier and Harris, above n 119, at 182.

129. Glover-Thomas, N and Holm, S ‘Compulsory vaccination: going beyond a civic duty?’ in Stanton, C et al Pioneering Healthcare Law: Essays in Honour of Margaret Brazier (London: Routledge, 2016) p 35 Google Scholar.

130. Department of Health The NHS Constitution (London: DH, 2015)Google ScholarPubMed: ‘3b Patients and the Public: Your Responsibilities, ‘Please participate in important public health programmes such as vaccination.’

131. Department of Health News ‘New social contract between the public, health and care services’ (15 July 2015), available at https://www.gov.uk/government/news/new-social-contract-between-the-public-health-and-care-services (accessed 12 June 2016).

132. For a fuller account of the criminalisation of disease transmission (from multidisciplinary and international perspectives), see Stanton, C and Quirk, H (eds) Criminalising Contagion: Legal and Ethical Challenges of Disease Transmission and the Criminal Law (Cambridge, UK: Cambridge University Press, 2016)CrossRefGoogle Scholar.

133. Brazier and Harris, above n 119, p 183.

134. Jordan, W ‘Majority want compulsory vaccinations’ (YouGov, 2013)Google Scholar, available at https://yougov.co.uk/news/2013/04/11/majority-support-compulsory-vaccinations/ (accessed 12 June 2016).

135. Montgomery v Lanarkshire Health Board [2015] UKSC 11, at [108] per Lady Hale; at [80] per Lord Kerr and Lord Reed.

136. Children Act 1989, s 3(1).

137. An NHS Trust v MB [2006] EWHC 507 (Fam), at [107] per Holman J: ‘[Parental] wishes, however understandable in human terms, are wholly irrelevant to consideration of the objective best interests of the child save to the extent in any given case that they may illuminate the quality and value to the child of the child/parent relationship.’

138. Children and Young Persons Act 1933, s 1(1).

139. R v Lowe [1973] QB 702.

140. Children Act 1989, s 31(2).

141. Re Ashya King (A Child) [2014] EWHC 2964 (Fam), at [31].

142. The NHS Trust v A [2007] EWHC 1744, at [16] per Holman J.

143. See Re C (Welfare of Children: Immunisation) [2003] 2 FLR 1095, at [22] per Thorpe J.

144. [2003] 2 FLR 1095, CA.

145. [2011] EWHC 4033.

146. [2013] EWHC 2683. And see London Borough of Newham v KA (Mother) & Ors [2016] EWFC B11, per Carol Atkinson J, at [117]–[118].

147. [2013] EWHC 2683, at [5].

148. Cave, E ‘Adolescent refusal of MMR inoculation: F (Mother) v F (Father) [2013] EWHC 2683 (Fam)’ (2014) 77(4) Mod L Rev 630 CrossRefGoogle Scholar.

149. RK and AK v the United Kingdom (no 38000/05), ECtHR, 30 September 2008.

150. Rights of Children and Young Persons (Wales) Measure 2011, s 1.

151. As opposed to human rights that apply to children: see Ferguson, L ‘Not merely rights for children but children's rights: the theory gap and the assumption of the importance of children's rights’ (2013) 21 Int'l J Children's Rts 177 CrossRefGoogle Scholar.

152. UN CRC 1989, Arts 24(2)(a) and 24(2)(f).

153. See Engelhardt, JT Jr ‘Beyond the best interests of children: four views of the family and of foundational disagreements regarding pediatric decision making’ (2010) 35(5) J Med & Phil 499 CrossRefGoogle ScholarPubMed.

154. Children Act 1989, s 1(1): ‘When a court determines any question with respect to – (a) the upbringing of a child; or (b) the administration of a child's property or the application of any income arising from it, the child's welfare shall be the court's paramount consideration.’

155. R (HH) v Deputy Prosecutor of the Italian Republic, Genoa; and two other cases [2012] UKSC 25, at [15] per Lady Hale; R (on the application of SG) and Others v Secretary of State for Work and Pensions [2015] UKSC 16, at [256].

156. Engelhardt, above n 153.

157. Pandemic Influenza Preparedness Team Factors Associated with Uptake of Vaccination Against Pandemic Influenza (London: Department of Health, 2011) p 25 Google ScholarPubMed.

158. Ibid.

159. WHO, above n 80.

160. Public Health England, above n 16.

161. CRIN ‘Compulsory vaccinations’ (CRINMail 1435, 1 July 2015).

162. CRIN ‘Mandatory vaccinations’ (CRINMail 34, 22 April 2014).

163. Editorial ‘Court: health ministry can continue with mandatory child vaccination’ Prague Daily Monitor 24 February 2015, available at http://www.praguemonitor.com/2015/02/24/court-health-ministry-free-order-child-vaccination (accessed 12 June 2016).

164. CRIN ‘Compulsory vaccinations’ (CRINMail 1435, 1 July 2015); Editorial, ‘Parental permission not needed for child vaccination, top court rules’ Hurriyet Daily News Turkey 22 June 2015, available at http://www.hurriyetdailynews.com/parental-permission-not-needed-for-child-vaccination-top-court-rules-.aspx?pageID=238&nid=84292 (accessed 12 June 2016).

165. Editorial ‘Parental consent needed for vaccination: Turkey's top court’ Hurriyet Daily News Turkey 16 November 2015, available at http://www.hurriyetdailynews.com/parental-consent-needed-for-vaccination-turkeys-top-court.aspx?pageID=238&nID=91200&NewsCatID=373 (accessed 12 June 2016).

166. Data Team ‘Ebola in graphics: the toll of a tragedy’ The Economist 30 December 2015.

167. The development process was escalated and recent Phase III trials point to a highly efficacious candidate: Henao-Restrepo, AM et al ‘Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial’ (2015) 386(9996) Lancet 857 CrossRefGoogle ScholarPubMed; WHO ‘News release: World on the verge of an effective Ebola vaccine’ (31 July 2015), available at http://www.who.int/mediacentre/news/releases/2015/effective-ebola-vaccine/en/ (accessed 12 June 2016).

168. Considerable debate surrounds the equitable distribution of scare resources in a pandemic. See eg McLachlan, HV ‘A proposed non-consequentialist policy for the ethical distribution of scarce vaccination in the face of an influence pandemic’ (2012) 38 J Med Ethics 317 CrossRefGoogle Scholar.

169. Department of Health and The Rt Hon Jeremy Hunt MP New Social Contract Between the Public, Health and Care Services (London: DH, 2015)Google Scholar.

170. Department of Health, above n 130.

171. See eg Booy, R et al ‘Mandating influenza vaccination in health-care workers’ (2011) 378(9803) Lancet 1626 CrossRefGoogle ScholarPubMed.

172. ‘Should childhood vaccination be mandatory?’ BMJ.com (14 May 2012), available at http://www.bmj.com/press-releases/2012/05/14/should-childhood-vaccination-be-mandatory (accessed 12 June 2016).