Public Health England (PHE) has issued a guidance to support immunisation of children in school settings when there are outbreaks in schools. Schools are a very suitable setting for deploying immunisation programmes targeting children ≥4 years of age. The uptake of vaccination in schools remains higher than in other settings owing to the convenience and acceptance by both parents and students. School-based programmes also seem to reduce inequalities in vaccine delivery, for example by reaching children not registered with a GP practice.
An outbreak such as measles in a school setting calls for urgent immunisation of partially immunised or unimmunised children. Introducing immunisation in the school setting is an ideal way to achieve high uptake in a short time, to protect individual children, and also counteract transmission in the school.
Written consent from parents is the most common approach in routine school-based immunisation programmes. Consent forms should not, however, be a barrier to immunisation and must be simple to complete. The consent process may be expedited using email or electronic forms of consent. If written consent is unavailable on the day of the immunisation session, the immunisation teams should try to seek parental consent over the phone. This approach is beneficial in maximising uptake and enables inclusion of individuals with language or literacy issue unable to provide written consent.
Some young individuals are capable of self-consent. Self-consent could be used, where appropriate, when a parent is not reachable through phone at the time of the immunisation session. Young individuals aged 16 and 17 years by law are able to provide self-consent. Younger children if considered ‘Gillick competent’, i.e. able to completely understand the proposed procedure, can also give consent but it is ideal for their parents to be involved. The positive consent of 16 or 17-year-olds or a Gillick competent child cannot be overridden by a parent. In case they refuse, an individual with parental responsibility cannot usually overrule such a refusal. Self-consent is beneficial in improving inclusion when parents have language or literacy issues.
When it is uncertain if a young person has been previously immunised, it is advisable to proceed with immunisation owing to its high benefit and lack of harm from additional doses.
