B (A Child: Immunisation)

Factual and Procedural Background

The case concerns a 5-year-old child ("B") whose separated parents disagree about immunisation. The mother applied for a child arrangements order and specific issue orders, including one to permit immunisation of B. Only the immunisation issue remains contested. Both parents consented to initial immunisations during their cohabitation. Currently, three vaccinations recommended by the national immunisation schedule are overdue for B: a combined diphtheria/tetanus/pertussis/polio vaccine, the MMR vaccine, and the influenza vaccine. The court appointed a medical expert and a Children's Guardian. The mother and Guardian support immunisation; the father objects.

Legal Issues Presented

1. Whether it is in the best welfare interests of the child to receive the recommended vaccinations despite parental disagreement.
2. How the court should exercise its jurisdiction to resolve disputes between parents holding parental responsibility on medical decisions concerning immunisation.
3. The extent to which parental objections based on safety concerns and alternative research affect the court’s welfare evaluation.
4. The application of Article 8 of the European Convention on Human Rights regarding interference with family life in the context of immunisation decisions.

Arguments of the Parties

Mother's Arguments

• Supports the child receiving the three vaccinations recommended by Public Health England's routine immunisation schedule.
• Relies on expert medical evidence indicating the vaccines are safe and in the child's best interests.
• Supported by the Children's Guardian who concurs with the mother’s position.

Father's Arguments

• Objects to the vaccinations on grounds of safety, necessity, and concerns about vaccine ingredients and potential adverse effects.
• Contends that the child may already be immune, as no immunity testing has been done before or after vaccinations.
• Raises concerns about the reliability of vaccine safety data and the influence of pharmaceutical industry interests.
• Asserts that the Green Book guidance favors non-immunisation without both parents’ agreement or court approval, emphasizing the child’s safety as paramount.
• Conducted extensive personal research, relying on anecdotal reports and non-peer-reviewed sources.

Expert Witness (Dr Elliman) Response to Father's Concerns

• Rejects the likelihood that the child is already immune without vaccination and explains why routine immunity testing is not recommended.
• Confirms the vaccines proposed are safe, with only minor and rare side effects, and no evidence of harm from ingredients at vaccine levels.
• Acknowledges some vaccines have been withdrawn historically due to safety concerns but views this as evidence of effective monitoring systems.
• Rejects the father's assertion that vaccine promotion is primarily financially motivated, explaining the rigorous and independent evaluation process by expert committees.
• Emphasizes the importance of balancing risks, with the risks from disease outweighing the risks of vaccination.

Table of Precedents Cited

Court's Reasoning and Analysis

The court began by categorizing the issue as preventative health care, noting vaccination is not compulsory but entrusted to parental responsibility. The court acknowledged the father’s extensive research but found it biased and unreliable compared to the expert medical evidence. The court accepted the expert’s opinion that the vaccines are safe and effective, and that the risks of disease outweigh the risks of vaccination. It rejected the father's contention that immunity testing should precede vaccination, citing impracticality and lack of reliability.

The court emphasized its statutory duty under the Children Act 1989 to prioritize the child's welfare and applied the welfare checklist, particularly focusing on the risk of harm to the child. It recognized the engagement of Article 8 rights but held that interference is justified and proportionate to protect the child’s health.

In considering precedent, the court noted consistent judicial decisions affirming immunisation as in children's best interests despite parental objections. The court reiterated that it must exercise independent judgment and not simply defer to parental views, even if sincerely held.

Given the child's healthy medical history and absence of contraindications, and the expert evidence supporting immunisation, the court concluded the child should receive the recommended vaccines. The judgment explicitly avoided making a general statement on vaccination but focused on the specific welfare interests of the child before it.

Holding and Implications

The court's final decision is to grant a declaration and a specific issue order permitting the child to receive the three vaccinations recommended by the routine immunisation schedule.

Holding: The child shall receive the combined diphtheria/tetanus/pertussis/polio vaccine, the MMR vaccine, and the influenza vaccine as being in her best welfare interests.

Implications: This decision resolves the parental dispute by authorizing immunisation despite paternal objection, reaffirming the court’s role as an independent arbiter prioritizing child welfare under the Children Act 1989 and Article 8 ECHR. The judgment aligns with prior case law establishing that parental disagreement does not preclude the court from ordering immunisation when it is in the child's best interests. No new legal precedent is established; the ruling applies the established principles to the facts of this case.