Brabin et al’s success in achieving an uptake of 70% of two doses of human papillomavirus vaccine among adolescent schoolgirls is extremely encouraging.1 However, this pilot study has raised important issues that will need to be addressed before the vaccination programme is rolled out nationally.
Guidance is currently ambiguous in situations where there is a disagreement between a parent and child’s decision about vaccination. Parental opinion is divided as to whether a girl should be able to seek the vaccine without parental knowledge.2 The principle of “Gillick competence” might apply if a girl sufficiently understands the concepts involved and wishes to make the decision for herself.3 However, given that the long term effects of this vaccine are not known, is it safe for children to be vaccinated without those with parental responsibility knowing? Furthermore, would it be ethical to apply Gillick competence in such a setting?
Competing interests: None declared.
References
- 1.Brabin L, Roberts SA, Stretch R, Baxter D, Chambers G, Kitchener H,. et al. Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort study. BMJ 2008;336:1056-8. (10 May.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Brabin L, Roberts SA, Kitchener HC. A semi-qualitative study of attitudes to vaccinating adolescents against human papillomavirus without parental consent. BMC Public Health 2007;7:20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Gillick v West Norfolk and Wisbech Area Health Authority and Department of Health and Social Security [1983] 3 WLR (QBD).