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New Rapid Ethics Review from the UK Pandemic Ethics Accelerator investigates the question of whether or not children should be offered vaccination against COVID-19, a question which has raised significant ethical challenges.

Syringe with COVID-19 vaccine label held in gloved hand

Dr Alex McKeown from the Neuroscience, Ethics and Society (NEUROSEC) group in the Department of Psychiatry and Deputy Director of the UK Pandemic Ethics Accelerator, a collaborative of four major UK universities and the Nuffield Council on Bioethics, has co-authored a Rapid Ethics Review with fellow Ethics Accelerator researcher Jonathan Pugh from the Oxford Uehiro Centre for Practical Ethics.

Now that the vaccination for children policy has been implemented, the Review looks retrospectively at the ethical challenges:

  • Taking into account best interests
  • Capacity to consent
  • Vaccine mandates
  • Data governance issues.

Whether children should be vaccinated against COVID-19 turns on a range of factors, including capacity, age, the balance between vaccine safety and COVID-related harm, and data security. As is the case with adults, there is a need to ensure an ethical balance between individual freedom, public health, and vaccine safety; as such, questions about whether vaccination should be a condition of certain kinds of activity – for example, school attendance - are of particular ethical significance in children. Given the widespread need for collection of personal information to help control the pandemic, there are notable uncertainties about current and future data security, sharing, and reuse, which also affects the balance of ethical benefits and risks in vaccinating children.

These questions are particularly challenging because the term 'child' covers an age range where capacity is developing and can vary extensively from one individual to another. In particular, it overlaps with adolescence, so while all individuals under age 18 may be regarded in law as children, the inability to give informed consent cannot be inferred from this fact alone. The Review outlines some of the key ethical and legal considerations at stake in questions about informed consent for childhood vaccination in the context of COVID-19.

The collaborative’s Principal Investigator, Ilina Singh, Professor of Neuroscience & Society in the Department of Psychiatry and Co-Director of the Wellcome Centre for Ethics & Humanities at the University of Oxford, said:


'The issue of vaccination of school-age children for COVID-19 will continue to come up as a key ethical and policy challenge. In the short term, we should assess capacity to consent in young people. However, in the long term we need a review of UK standards for consent in this population, based more thoroughly in evidence of developing consent capacities across age groups. It's important that the values and preferences of young people are taken into account when making these policy decisions.'

Alex McKeown, said:

'This review is an example of how the collaborative approach of the Ethics Accelerator, both across Oxford and with partner institutions, can make a vital contribution to public discussion of and engagement with the numerous ethical challenges raised by the COVID-19 pandemic.'

Read the full Rapid Ethics Review.

For more information about the UK Pandemic Ethics Accelerator.