School did not ask for permission to give child injection

[puddingsforsandy]

Child is 14 years. He has a plaster on his arm. He casually says he had an injection at school. I told him I don't remember signing permission slip. He says "oh the teacher said we don't need parental consent for this".

I have checked the slip and it's for immunisation for:
Tetanus, Diphtheria, Polio and Men C.

I don't know how to feel. Would they not ask for permission from parents?

DS (14) recently brought home a consent form for his DTP/men C booster to be done at school. This fortunately gave me the opportunity to decline it, because he had had an allergic reaction when he had a DTP jab as a toddler. I was told at the time to make sure he had any further DTP jabs in a secure environment where he could be monitored afterwards. I therefore declined the school jab, but arranged for him to have it done elsewhere.

I'd never felt the need to discuss this allergic reaction with DS previously. Why would I? He was too young to remember at the time, and it's only relevant when you are planning to have another injection. So if DS had been offered a jab at school without my knowledge, he would have agreed to it, which would have been medically the wrong thing to do. I would have been furious.

I think the school /NHS are on very shaky grounds if they are expecting 14 year olds to remember if they had adverse reactions to previous jabs given when they were babies/toddlers.

My youngest age 15 has just received a letter regarding vaccination from his GP.
It states that he can take a parent if he wishes or leave them in the waiting room and this is an opportunity for you to start taking responsibility for your own health.
I agree with this BTW - he could get married at 16 or have a child !
I doubt very much that the DS was given the vaccine without his consent.
There has been rather a lot of misinformation regarding consent on the thread - there are several different types of consent- verbal, written and implied.
The crucial thing is that consent must be fully informed ,full information given in a form that can be understood by the person and followed by the HCP checking that the decision has been made openly and the risks understood

Verbal - what you would expect .usually documented by the HCP as "verbal consent given by pt for X sample to be taken etc.

Written- usually a consent form, all risks documented as being discussed. Usually before a procedure another HCP will check that the pt understands fully what they have consented for as part of the pre op checks.
Implied- this is when you for example go to the GP surgery to have your BP checked - you attend, you hold your arm out, your BP is checked. This action implies you are giving consent for your BP to be checked.

Best to find out OP what has happened and maybe starting discussing healthcare with your DS.

So much misinformation on this thread, it's shocking.

from what I can remember when I was at school the forms sent home were opt out.

Agree about the amount of misinformation.

DD had all her jabs she and I have discussed her health and any issues, including organ donation and contraception. We were sent an opt out/ info form - her consent was given at the time. She is 16 now but this has been the case since she was 12/13.

If your DC have any sort of health allergy or reason for not having a medical procedure then let the school know, make sure it is on the medical records, make sure your DC know.

They're expecting parents to tell children of this age of any adverse reactions

Surely if what you are saying is true, they are also expecting children of this age to remember (accurately) what their parents have told them.

Even if I had known a school could give children innoculations without parental consent, so I had told my DS of his history when aged 12, would he really remember this two years later when put on the spot? Would he remember exactly which jab he had had the reaction to? And would he feel too embarrassed to speak up about it when lined up with his peers?

I still think it's a bit of a risk and am glad that DS's school did indeed ask for parental consent.

I agree with the poster who said about the cervical cancer jab. I believe I was 15 when I had mine, my mother didn't want me to have it. But I had it anyway, it was my choice, not hers. If she had not wanted me to have it due to an allergy or something then I wouldn't have. Your child is deemed old enough to make the decision himself, whether that is a good or bad thing is debatable!

14 yr olds can get contraception without parents consent imo a 14 yr old can decide on their own

"14 yr olds can get contraception without parents consent imo a 14 yr old can decide on their own"

That's likely to be following a proper consultation in which competency is assessed, not in a "line up and stab" immunisation clinic where there simply is not time to make such an assessment.

I agree that it is mildly shocking if parents have not discussed their medical history with their 14yos.

Having said this, it would seem to be good practice to issue a reminder of a vaccination in advance to give families a chance to remind their children of any potential medical issues.

While I agree that a 14yo can be competent, the worrying aspect of this seems to be that nobody did consult these 14yos individually. It's as if they'd lined up all the girls in the school and given them the pill without any individual discussion. It's the conveyor belt atttiude to medicine.

I don't think it is reasonable to expect all the 14 yar olds in a school to be ready to make an informed decsion in regard to a vaccination if it is something that is sprung upon them one day. They need notice, and I would think should be encouraged to discuss vaccinations with their parents and/or GP so they can understand about their medical history and any cultural issues. So while I think it's generally OK for it to be your son's decision not yours, I am skeptical they were that concerned about it being an informed decision if it had to be made on the same day he was told about the injection, and if it was done in the conveyor belt fashion I remember injections being given in my youth. I think it would have been good practice to let you know about it in advance.

I know it must be hard for a health service with limited funds to contemplate spending resources engaging patients to get tehm to do something that's (almost always) in their best interests, but I do think the NHS often has a very cavalier attitude to consent when it comes to children. My 4 year olds have just had an eyesight test at school which I wasn't informed of, let alone asked permission for. Apparently the school sent out an opt out form to parents, but they are appalling at communication and we frequently don't get letters, so it's not surprising I didn't see it. I called the hospital that did the test and asked how they thought that could possibly be informed consent and the program director muttered about it being cleared by their committee and their lawyers. He did not explain how it could be informed consent though. It was just a test, so no harm done, I can't imagine I would have objected had I known about it. Nevertheless, I have no idea what they were actually tested for, or how the test was carried out, and that surely is part of the point of informed consent. So it was of no use to me as their primary carer and I will still need to get them tested by an optician.

I work in health research and Tiggy is correct - a normal 14yo will be considered able to consent to a routine vaccination. The question in the OP's case remains - was appropriate verbal consent sought before the vaccination? I would not automatically rule it out - it does not have to take long.

My DD went through the HPV vaccination cycle, finishing this week. We had the consent form, discussed it - and it was made clear as Tiggy said that the final decision was hers, not mine - but at each follow-up, the nurse sought explicit verbal consent from her. If this was not done for the OP's DS then that is bad practice and should be flagged up.

That's how it should be done, and can be done. Yes, parents should be informed, but letters do get lost in school bags unless you're me who checks all bags at the end of each school day.

I seriously doubt that the OPs son only found out about the injection on the day it happened.

Events like this are usually publicised in advance via school bulletins/Register class announcements etc. and every school I've worked in has them marked on the term calendar which is on the school website.

Vaccination clinics are never just sprung on pupils.

That was in response to BoomBoom's first paragraph by the way.

That may be the case Salmon. But given my experience over the hearing test I'm skeptical that there is anymore consideration of informed consent now than there was when I was in school. Which doesn't mean it wasn't exmplary practice, it could have been, but nothing the OP has siad indicates it was anything more than a production line.

And just knowing there is a vaccination date isn't really what someone needs to make an informed decision is it? They need to know what the vaccination protects them from and to what extent, what side effects are possible and how common they are, if there are any contraindications and how to find out if they apply, and they need to know it is just fine for them to say "no". Not just a few "Year 9[?] vaccination on Friday 7th" notices.

In theory it could be an excellent opportunity for PSHE or whatever the newest incarnation of that is. A chance to discuss the cultural, ethical and philosophical issues around vaccination, think about how they apply to each individual, consider what they need to know to make an informed decision and then go and find that sort of thing out (like asking their parents if they've ever had an adverse reaction). Wonder if any school ever does anything like that?

*eyesight test, not hearing!

My eldest is in S3 (so 14/15 year olds) and they are getting a similar injection soon. We got a permission slip, a leaflet and contact details for a person in the local health board if we had any problems. You could opt out and no one would be given the injection without written parental consent.

I suspect that there is a bit of paper in the OPs sons bag under a squashed banana and last weeks lunchbox

Boom we had a whole pack about the HPV vaccination, which included all the information you set out above. These vaccinations are organised by the local NHS trust, not by the school, and there is bound to be variation in the quality of how it is managed, but it really isn't the school who organise it all.

DS'S year group had these last summer and we definitely had a consent form at home.

I casn't claiming the school organize it. I was saying the schools could support children in developing their capacity to give informed consent through the PSHE (or whatever it is) curriculumn and tieing that in with vaccinations.

The responsibility for information about a particular vaccine and the duty to ensure informed consent is given resides with the health provider.

Salmotrutta, I have been surprised at how things can happen in an individual school which you would have said beforehand couldn't possibly happen because this isn't how schools do things.

Of course, on balance the probability for a banana squashed note in the bottom of a book bag is much stronger. But I would never rule out the possibility of any individual establishment getting things wrong, just because most of them don't.