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Double check before you double jab

01 May 2007

Mrs B received a letter from the Child Health Department addressed to the Parents or Guardians of Jemima B. The letter said: “Jemima B born in … is due for her pre-school immunisation; please telephone your GP surgery and arrange an appointment with them.”

Mrs B attended with Jemima on the arranged date. She brought her daughter’s Personal Child Health Record. The practice nurse, Mrs K, saw Jemima and noticed that, according to her records, she was up to date with her immunisations. She confirmed with Mrs B that Jemima was well and not suffering from any coincidental infections at the time.

Mrs K then gave Jemima two injections to conform with the UK’s routine childhood immunisations: one for diphtheria, tetanus, pertussis and polio (DtaP/IPV), and another one for measles, mumps and rubella (MMR). Mrs K prepared the syringes out of Jemima’s sight to avoid scaring her and then gave both injections in immediate sequence, one in each thigh.

At this point Mrs B asked why she needed to have two needles and the practice nurse explained about the different vaccines. Mrs B became distressed. She said that she had not given her consent for Jemima to have the MMR. She told Mrs K that her next door neighbour’s little boy was autistic and his mother was convinced that it was due to the second MMR. Mrs B was crying inconsolably and left the surgery without wanting any more explanations.

A few days later Mrs B’s GP, Dr C, received a written complaint from Mr and Mrs B stating that they had not consented to their daughter having the MMR vaccination and demanded an explanation. Dr C contacted MPS for advice.

He was told that consent is always needed for any procedure and the best response was to write an apology and to organise a meeting with the parents. The medicolegal adviser gave Dr C some guidelines on how to write the letter and how to conduct the meeting.

Dr C met Jemima’s parents at the surgery. He apologised again and they had a long discussion about their concerns about the safety of the MMR. Mr and Mrs B were satisfied with the apologies and the reassurance and did not take the complaint any further.

Learning points

  • Consent must be obtained before starting any treatment or physical investigation or before providing personal care for a patient. This includes the administration of all vaccines.
  • There is no legal requirement for consent for immunisations to be in writing, but it is good practice to record in the patient’s notes that consent has been obtained.
  • A healthcare professional with appropriate training must ensure that the parents are aware of what vaccinations their children are having, the possible side effects and how to treat them.
  • Written or verbal information should be available in a form that can be easily understood.
  • Consent should be sought on each immunisation visit. Just because they attend does not mean they have given their consent.
  • A recent report from the Healthcare Commission in the UK found that 11% of complaints relating to children involved immunisation.
  • Further information