S v London Borough of Islington (Application to Prevent Vaccination)

MR JUSTICE MACDONALD: The court is concerned with P, born in February 2025 and now aged 8 months old. Within the context of ongoing care proceedings in respect of P, in which she has been made the subject of an interim care order under s.38 of the Children Act 1989, the mother, S, applies for an order under the inherent jurisdiction of the High Court preventing the local authority from having P vaccinated, pursuant to the authority conferred on it by s.33 of the 1989 Act. That application is opposed by the local authority and by the Children’s Guardian on behalf of P.

In determining this application, which comes before the court in the Urgent Applications List, I have had the benefit of reading the mother’s application form, the Position Statements filed by the local authority and the Children’s Guardian, and of hearing oral submissions from the mother, who acts in person, and Mr Coutts on behalf of the local authority and Mr Lamb of counsel on behalf of the child.

P currently lives at home with her mother. The identity of her father is unknown. P is represented in these proceedings through her children’s guardian, Sharon Hadley. The mother has four older children, three of whom were the subject of ongoing public law proceedings, which had been consolidated with the proceedings for P. The care proceedings in relation to those children concluded on 29 September 2025 with the making of care orders in relation to them.

P has been subject to an interim care order since 18 February 2025, due to concerns around the mother being unable to meet the older children’s basic care needs, concerns around engagement with school, and poor supervision of the children and their anti-social behaviour. The mother’s engagement with health professionals during her pregnancy with P was described as sporadic and inconsistent, as well as with social work professionals prior to proceedings being issued.

The local authority’s care plan, dated 24 July 2025, had proposed that P remain with the mother at home under a 12-month supervision order while P is also subject to a child in need plan. However, hair strand test results were filed on the day before the final hearing, on 23 March 2025 which were positive for illicit substances and for frequent and excessive consumption of alcohol. The Guardian also raised an issue about whether the mother and the father of the elder children may have been in contact with one another and expert evidence was ordered from Evidence Matters in relation to those concerns.

Within this context, whilst a FCMH is due to be listed shortly on a date to be fixed, there is at present no settled timetable to the adjourned final hearing. In the circumstances, whilst the mother suggested during her submissions that it will only be a number of weeks until it is known whether there will be a supervision order made, and hence whether she will have unfettered parental responsibility, I am satisfied that it will be a number of months before a final decision in the substantive proceedings will be made.

In the circumstances I have outlined, the mother declined consent for P to have her routine Vaccinations. The local authority therefore took the decision that P should be vaccinated and arranged an appointment for P’s vaccinations to take place at 2.45pm on 7 August 2025. The mother confirmed she disputes this decision, and at a hearing on 5 August, she was advised that she would need to make an application to prevent the vaccinations by 6 August.

In the circumstances, P has not been in receipt of the first set of 6-in-1 vaccine, which protects against Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Haemophilus influenzae type b (Hib) and Hepatitis B. The immunisation was due to be administered at 8 weeks old.

The second set of routine immunisations are typically completed by P’s present age. They include T Meningococcal group B (MenB), which protects against meningitis and septicaemia caused by MenB bacteria, and Rotavirus vaccine, which protects against rotavirus gastroenteritis (a common cause of diarrhoea and vomiting in babies).

The mother’s present application was issued on 6 August 2025. That application seeks an “Order to prevent the Local Authority from carrying out vaccinations for P.” There is no statement in support of that application, but the mother’s objections can be summarised as follows:

The mother elaborated on these points during the course of her oral submissions to the court. Her primary submission was that, in circumstances where the care proceedings are ongoing, where, accordingly, it is not known whether P will be placed with her under a supervision order and where, if that were to be the outcome, she would be free to decide in the exercise of her unfettered parental responsibility whether to have P vaccinated, the local authority is acting prematurely in deciding to have P vaccinated now. Within this context, the mother emphasised what she characterised as “her human right as a mother” to decide whether or not P should be vaccinated.

The mother further submits that the local authority’s decision to have P vaccinated is wrong where, in her personal experience with two of her other children, and from her work as a support worker, she has seen many cases where vaccination is followed by the development of autism and ADHD. Within this context, she is convinced of a link between childhood vaccination and ASD and ADHD disorders.

I gently pressed the mother on the fact that there are no cogent scientific studies linking childhood vaccination to the development of ASD or ADHD. In response, the mother fell back on her belief that she was entitled to exercise “my right to decline” and her contended for personal experience of seeing children suffer developmental issues consequent, she believed, on the administration of vaccines. The mother also told the court that she had seen evidence online that there had been some 4,500 child deaths as the result of preventable diseases compared to a much larger population of children in the country. When I suggested that 4,500 dead children was a very high number, the mother again sought to place the figure in the context of the population of children in the country overall, in an apparent effort to demonstrate that only a small risk is attached to declining vaccination. In response to my observation that absent vaccination there was a risk that P would be included in the figure cited by the mother, she told me that “It is possible that she could be one of those dead children, but it is possible she could not” and that nobody knows what will happen in the future.

It is proper to record that the mother did not present as wholly opposed to vaccination, telling me that whilst P was, in her strongly held belief, “too tiny to be pumped with vaccinations, with all those chemicals”, the position might be different if P was older and required vaccination prior to entering school. The mother emphasised that at that point she might be prepared to consider vaccination.

Responding on behalf of the local authority, Mr Coutts referred the court to the decision of the Court of Appeal in Re H (A Child) (Parental Responsibility: Vaccination) [2020] EWCA Civ 664, [2021] Fam 133 to which I shall come shortly. Mr Coutts made three points in response to the mother’s submission that it would be appropriate to await the outcome of the care proceedings before the issue of vaccinations is determined in circumstances where, if a supervision order was made, it would be for her to make the decision.

First, Mr Coutts submitted that the period before the care proceedings are determined is, in fact, much longer than the three or so weeks suggested by the mother in circumstances where a further FCMH is to be listed and there is no current listing for an IRH or final hearing. Second, Mr Coutts submitted that, in light of developments prior to the adjourned final hearing, it is by no means certain that a supervision order will be the outcome in these proceedings. Third, and finally, Mr Coutts made the wider point that, if the court acceded to the mother’s submission that the court should wait to determine issues of vaccination until the final outcome of proceedings is known, there would never be a case where the issue was determined under an ICO because the court is always ignorant at that stage of the final outcome.

On behalf of the children, Mr Lamb submitted that it remains the case that the NHS vaccination programme provides for the vaccination of children of P’s age with the vaccines that are in issue by virtue of the mother’s application. Within this context, Mr Lamb submits that there is no scientific basis for establishing a link between autism and vaccination and relies on Re H (A Child) (Parental Responsibility: Vaccination) and the risk versus benefit analysis highlighted in that authority. Further, Mr Lamb submits that there no evidence before the court to suggest that P is in a specific category of children justifying departure from the NHS vaccination programme, LAC health checks having not identified any underlying fragility or other condition in P that would contraindicate vaccination.

With respect to the mother’s contention that the decision should await the final outcome of proceedings, Mr Lamb submits that Re H (A Child) (Parental Responsibility: Vaccination) makes clear that there is no distinction to be made between an interim care order and a final care order when considering the local authority’s powers under s.33. Further, in the context of the proceedings currently having no listed final hearing, Mr Lamb submits that the risks to P as an unvaccinated child are such that it would not be in her best interests, and indeed dangerous, to delay her standard vaccinations until the conclusion of the proceedings. In respect of the mother’s submission regarding her “right” to make the decision as a parent, Mr Lamb reminds the court that in making an interim care order, the court has concluded that it is necessary and proportionate for the local authority to share parental responsibility with the mother.

The case of Re H(A Child) (Parental Responsibility: Vaccination) considers in detail the issues that arise where there is a dispute between a local authority holding parental responsibility under an interim care order or final care order and a parent with respect to the administration of the childhood vaccines provided under the NHS vaccination programme. The decision in Re H(A Child) (Parental Responsibility: Vaccination) centres on s.33 of the Children Act 1989, which provides as follows:

“33 Effect of care order.

(1)

Where a care order is made with respect to a child it shall be the duty of the local authority designated by the order to receive the child into their care and to keep him in their care while the order remains in force

(2)

Where—

(a)

a care order has been made with respect to a child on the application of an authorised person; but

(b)

the local authority designated by the order was not informed that that person proposed to make the application,

the child may be kept in the care of that person until received into the care of the authority.

(3)

While a care order is in force with respect to a child, the local authority designated by the order shall—

(a)

have parental responsibility for the child; and

(b)

have the power (subject to the following provisions of this section) to determine the extent to which

(i)

a parent, guardian or special guardian of the child; or

(ii)

a person who by virtue of section 4A has parental responsibility for the child,

may meet his parental responsibility for him.

(4)

The authority may not exercise the power in subsection (3)(b) unless they are satisfied that it is necessary to do so in order to safeguard or promote the child’s welfare.

(5)

Nothing in subsection (3)(b) shall prevent a person mentioned in that provision who has care of the child] from doing what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting his welfare.

(6)

While a care order is in force with respect to a child, the local authority designated by the order shall not—

(a)

cause the child to be brought up in any religious persuasion other than that in which he would have been brought up if the order had not been made; or

(b)

have the right—

(i)

...

(ii)

to agree or refuse to agree to the making of an adoption order, or an order under section 84 of the Adoption and Children Act 2002, with respect to the child; or

(iii)

to appoint a guardian for the child.

(7)

While a care order is in force with respect to a child, no person may—

(a)

cause the child to be known by a new surname; or

(b)

remove him from the United Kingdom,

without either the written consent of every person who has parental responsibility for the child or the leave of the court.

(8)

Subsection (7)(b) does not—

(a)

prevent the removal of such a child, for a period of less than one month, by the authority in whose care he is; or

(b)

apply to arrangements for such a child to live outside England and Wales (which are governed by paragraph 19 of Schedule 2 in England, and section 124 of the Social Services and Well-being (Wales) Act 2014 in Wales).

(9)

The power in subsection (3)(b) is subject (in addition to being subject to the provisions of this section) to any right, duty, power, responsibility or authority which [F6a person mentioned in that provision] has in relation to the child and his property by virtue of any other enactment.”

Within this context, the following observations from Re H (A Child) (Parental Responsibility: Vaccination) are salient when the court is considering the mother’s application in this case:

Finally, in Re H(A Child)(Parental Responsibility: Vaccination) King LJ, giving the lead judgment, stated as follows with respect to the position arrived at regarding childhood vaccinations generally:

“I do not share the inhibition felt by the judges in some of the decided cases in expressing the view that the scientific evidence now establishes that it is generally in the best interests of otherwise healthy children to be vaccinated. As Theis J said in F v F:

‘With due consideration for established contraindications to vaccination in an individual case, it is otherwise in every child’s interest to be protected’

It follows therefore that in my judgment, an application to invoke the inherent jurisdiction or to seek an injunction with a view to preventing the vaccination of a child in care is unlikely to succeed unless there is put before the court in support of that application cogent, objective medical and/or welfare evidence demonstrating a genuine contra-indication to the administration of one or all of the routine vaccinations.”

As I have noted, in Re H (A Child) (Parental Responsibility: Vaccination) the Court of Appeal anticipated “an application to invoke the inherent jurisdiction or to seek an injunction” as the methods that would likely be employed where a parent sought to prevent a local authority from vaccinating a child pursuant to its powers under s.33 of the 1989 Act, making clear that such an application would be unlikely to succeed unless there is put before the court in support of that application cogent, objective medical and/or welfare evidence demonstrating a genuine contra-indication to the administration of one or all of the routine vaccinations. At paragraph [99] the Court of Appeal stated as follows with regard to the routes to relief available to parents:

“99.

It is axiomatic that any local authority must involve parents in decision-making and take their views into account. Section 33 CA 1989 is not an invitation to local authorities to ride roughshod over the wishes of parents whose children are in care. As was recognised by the judge at paragraph [17], in the event that a local authority proposes to have a child vaccinated against the wishes of the parents, those parents can make an application to invoke the inherent jurisdiction and may, if necessary, apply for an injunction under section 8 Human Rights Act 1998 to prevent the child being vaccinated before the matter comes before a court for adjudication.”

The decision of the Court of Appeal in Re H (A Child) (Parental Responsibility: Vaccination) does not address in detail the test to be adopted when considering an application by a parent to invoke the inherent jurisdiction, or to apply for an injunction under section 8 Human Rights Act 1998, to prevent the local authority from exercising its powers under s.33 of the Children Act 1989 to arrange and facilitate the vaccination of the child.

In this case, the relief applied for by the mother under the inherent jurisdiction is for an order preventing the local authority from implementing its decision under s.33 of the 1989 Act to prescribe the extent to which the mother may exercise her parental responsibility by arranging to have P vaccinated against her wishes. The mother’s C66 application form seeks an “Order to prevent the Local Authority from carrying out vaccinations for P”.

The local authority’s statutory power under s.33 of the 1989 Act to determine the extent to which the mother may exercise her parental responsibility, in this instance by arranging to have P vaccinated, may only be exercised if the local authority is satisfied that it is necessary to do so in order to safeguard or promote P’s welfare. In this case, having considered the matter, the local authority has taken the decision that the statutory requirements are met and that its statutory power should be exercised.

Accordingly, the question that the mother’s application gives rise to is whether the local authority is right to have decided that it is necessary to exercise its statutory power in order to safeguard or promote P’s welfare. Viewed in this context, the issues arising for the court in determining the mother’s application take on a distinctly public law flavour in circumstances where, in determining the merits of the order sought, the court is required to review the exercise by a local authority of a statutory power conferred on it by Parliament. I am satisfied therefore, that in determining whether to prevent the local authority from implementing the decision it has taken under the statutory power conferred on it by s.33 of the Children Act 1989, in this case to arrange the vaccination of P, the court has to consider that question in line with public law principles.

This conclusion is supported by the decision of the Court of Appeal in Coventry City Council v PGO [2011] EWCA Civ 729, [2012] Fam 210, albeit that case concerned interim relief. In that case, the Court of Appeal (Lord Neuberger of Abbotsbury MR, Lord Wilson JSC and Dame Janet Smith) held, in the context of the first instance court having granted an injunction impacting on the local authority’s statutory powers under sections 21(1) and 38 of the Adoption and Children Act 2002, that a challenge to the exercise of those statutory powers conferred on the local authority by Parliament ought to be determined by reference to public law principles of irrationality and proportionality. On the facts of Coventry City Council v PGO, the Court of Appeal determined that in deciding whether to grant an interim injunction prohibiting the local authority from exercising its statutory powers under sections 21(1) and 38 of the 2002 Act the court had to be satisfied that there is a real prospect that the applicants would establish that the local authority’s decision was, by reference to public law principles, irrational, disproportionate or otherwise unlawful, or was otherwise in breach of their rights, or those of the adopters or of the children, under Art 8 of the ECHR.

By parity of reasoning, and the court having already determined that it is in P’s best interests for the local authority to share parental responsibility with the mother under an interim care order, which in turn confers on the local authority the statutory powers set out in s.33 of the 1989 Act, I am satisfied that before preventing the local authority from implementing the decision it has taken under the statutory power conferred on it by s.33, the court must be satisfied that the mother has demonstrated that the local authority’s decision to arrange vaccinations for P is, by reference to public law principles, unreasonable, irrational or otherwise unlawful or is otherwise in breach of her rights, or those of P, under Art 8 of the ECHR.

A number of matters will inform that decision. They will include the best interests of the subject child (which will not, in this context, be paramount), including the balance of risk and benefit of vaccination for that child, the fact of the NHS childhood vaccination programme and the specific immunisations recommended for children in this jurisdiction as set out in the Green Book: Immunisation against infectious disease, published in 2013 and updated thereafter, the absence of any cogent scientific evidence linking childhood vaccinations under the NHS programme with conditions such as ASD and ADHD, the risks to children of being unvaccinated against childhood diseases, the views of the parents and the competing ECHR rights of the parent and child that are engaged. This is not an exhaustive list.

Where it cannot be said that the local authority’s decision to exercise the powers conferred on it by Parliament by s.33 of the 1989 Act to arrange the vaccination of P is, by reference to public law principles, unreasonable, irrational or otherwise unlawful or is otherwise in breach of her rights, or those of P, under Article 8 of the ECHR, then the decision will fall against the court preventing the local authority from giving effect to its decision.

The NHS programme provides for a number of vaccinations to be given to babies who are under 1 year old:

As I have recounted, the local authority currently has an interim care order and must act in P’s best interests. Under s. 33 of the 1989 Act, the local authority has the power to determine the extent to which the mother may exercise her parental responsibility, in this instance by deciding to have P vaccinated in order to safeguard or promote her welfare, and has chosen to exercise that power. I am not satisfied that it can be said that that decision on the part of the local authority was unreasonable, irrational, disproportionate or otherwise unlawful or is otherwise in breach of her rights, or those of P, under Article 8 of the ECHR.

As observed in Re H (A Child) (Parental Responsibility: Vaccination), the current established medical view is that the routine vaccination of infants is in the best interests of those children and for the public good. The specific immunisations which are recommended for children in this country are set out in the routine immunisation schedule which is found in the Green Book: Immunisation against infectious disease, published in 2013 and updated since. That position has not changed and there remains in place an established NHS Childhood Vaccination programme.

The mother has not placed before the court cogent, objective medical and/or welfare evidence demonstrating a genuine contra-indication to the administration of one or all of the routine vaccinations for P. There is no evidence of such conditions or contraindications in the LAC medical review. The views expressed by the mother as to the dangers of vaccination for P derive, I am satisfied, from her own assessment of material she has heard and accessed online. In this regard, it is important to repeat the observations of King LJ in Re H regarding the asserted link between autism and vaccination, a purported link that the mother leans heavily on in support of her application:

“ 48. It has subsequently been confirmed that there is no link between autism and the MMR vaccine. The NHS England website states that

"…there has not been a single credible study that has shown a risk of MMR causing autism, despite tens of millions of children around the world receiving the vaccine. On the contrary, numerous high-quality research studies support the safety of MMR".

49.

A paper in May 2014 (Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies, Taylor and others, Vaccine 32(29)) analysed cohort studies involving over 1.2 million children and showed no link between vaccination and autism, and no relationship between autism and MMR, or thiomersal, or mercury.

50.

A major study in March 2019 (Measles, Mumps, Rubella Vaccination and Autism, Hviid and others, Annals of Internal Medicine 170(8)) again found no link between MMR and autism. This study, conducted by researchers from Statens Serum Institut and the University of Copenhagen in Denmark, and Stanford University School of Medicine in the United States, involved 657,461 Danish children, born between 1999 and 2010, who were monitored until they were 8 years old. Of the children, 95% had received the MMR vaccine, and only around 1% of them (6,517) developed autism. Critically, there was no difference in the rates of autism between those who had, and had not, been vaccinated. Further, there was also no link found between the MMR vaccine and those children who may be at higher risk of developing autism, such as those who had an autistic sibling. The researchers thus concluded:

"The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. It adds to previous studies through additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases."

51.

Most recently, on 20 April 2020, an updated Cochrane review (Does the measles, mumps, rubella and varicella (MMRV) vaccine protect children, and does it cause harmful effects? Di Pietrantonj and others, Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD004407) considered 138 studies with more than 23 million children. It concluded that MMR vaccines are effective in preventing the infection of children by measles, mumps, rubella and chickenpox, with no evidence of an increased risk of autism or encephalitis and a small risk of febrile seizure.”

This court has been provided with no evidence to gainsay these observations and, as I have already observed, the NHS childhood vaccination programme continues.

The risks to P of not being vaccinated are also well established, with this court being satisfied that her health and wellbeing would be seriously impacted were she to suffer from a preventable childhood illness by reason of the failure to vaccinate her. The court has listened to the mother’s concerns but the potential consequences of P contracting a disease which these vaccines protect against are much greater than the low level side effects, which are usually mild and transient and cannot outweigh the benefits of vaccination when balanced against the manifest advantages of protection against the risk of serious infection or illness conferred by vaccination.

I acknowledge that the applicant is the mother of P, and that as such she has an Art 8 right to family life with P. However, the right to respect to private and family life set out in Art 8(1) is qualified by Art 8(2).

In this context, the court must take account of the fact that the is a pressing social need to vaccinate infant children to achieve the legitimate objectives both of protecting the vaccinated child and of securing the health and safety of the wider population through herd immunity. Whilst the law must allow for exceptions where vaccination is contraindicated on health or welfare grounds, and meet the requirements of foreseeability and accessibility and contain adequate safeguards, these requirements are met by the legal framework established by s. 33(3) of the 1989 Act, which gives the local authority a power, not a duty, to determine the extent to which the mother may exercise her parental responsibility by refusing to have P vaccinated, and the authority will not exercise that power where there is objective evidence to contraindicate it. In the circumstances, the local authority’s decision does not constitute an unnecessary or disproportionate interference in the mother’s Art 8 right to respect for family life.

Finally, I am not satisfied that it would be appropriate to wait until the conclusion of these proceedings before a decision on the mother’s application is made. To do so would leave P exposed to the risks attendant on childhood diseases, and would leave her exposed to those diseases at a very young age when she remains vulnerable. Further, there is at present no indication as to when the proceedings will conclude and no guarantee currently that they will conclude with a supervision order. In the circumstances, the court would be adjourning the issue for an indeterminate period. I accept Mr Coutts’ submission that if the court acceded to the mother’s submission that the court should wait to determine issues vaccination until the final outcome of proceedings is known, there would never be a case where the issue was determined under an ICO because the court us always ignorant at that stage of the final outcome.

For all these reasons, there is no basis for concluding that the decision of the local authority to exercise the powers conferred on it by s.33 of the Children Act 1989 by arranging for P to be vaccinated is unreasonable, irrational, or otherwise unlawful or is otherwise in breach of her rights, or those of P, under Art 8 of the ECHR. In the circumstances, the decision falls firmly in favour of refusing the mother’s application for an order prohibiting the local authority from taking that course of action.

Accordingly, the mother’s application is dismissed and I will make no order as to costs.