An 11-year-old girl was given a vaccination at school even though her mother ticked a box on a form refusing consent for this to happen.

Health NZ Te Whatu Ora says it has apologised to the family, and public health nurses who administered the jab have been given extra training.

The Health and Disability Commissioner (HDC) received a complaint in 2024 after the girl received a Boostrix vaccination at her school, against her mother’s wishes.

The mother wanted the girl to have the shot - containing a booster dose of tetanus, diphtheria and whooping cough vaccine - at her doctor’s office, not at the school, in case of a reaction.

The names of the family and school have been redacted from the HDC report, released today.

The HDC said that although the free immunisation programme is provided at schools across the country, it is carried out by Health NZ, the Government health agency which was the subject of its investigation.

Deputy Health and Disability Commissioner Vanessa Caldwell said she noted the principal of the school “did what he could” in following up after the incident, and had since stopped hosting the immunisation programme.

Caldwell found that Health NZ breached the Code of Health and Disability Services Consumers’ Rights in vaccinating the girl without consent.

Ticked box denying consent

The girl’s mother said before the immunisations, she completed a consent form.

She ticked a box on the form showing she did not consent to her daughter receiving the Boostrix jab at the school, preferring to have it administered by her GP.

Deputy Health and Disability Commissioner Dr Vanessa Caldwell. Photo / James Gilberd Photography

On June 17, 2024, the students were called for their immunisations, but the 11-year-old initially stayed in class as she was aware her mother had not consented.

However, a teacher told her to go with her classmates.

On arriving at the school hall, the girl gave the form with the withdrawn consent to the first nurse she saw.

This nurse acknowledged that she shouldn’t be getting the jab and asked another nurse to phone her mother to check. This call was never made.

Girl ‘confused and stressed’ by questions

The girl said she was “confused and stressed” by a lot of questions from the second nurse that she did not understand or know the answers to, including whether she had a “concussion or stuff”.

The second nurse told the girl “you look old enough to have this” and sent her to a third nurse, who gave her the injection.

The second nurse later told the HDC that she saw the tick on the form and took it as consent, even though it was in the box denying consent.

She said a medical history section under the heading “complete if your child is receiving the Boostrix immunisation” had been completed.

A section under the heading “complete if you do not want your child to receive the Boostrix immunisation at school” had not been filled in.

Caldwell said that Health NZ had breached the code of patient rights.

“(The girl) was administered the Boostrix immunisation vaccine, despite the box on the consent form having been ticked clearly to state that (her mother) did not consent for (her daughter) to have this, and at least one of the nurses having been aware of the non-consent,” Caldwell said.

Caldwell was also critical of the nurses for contacting the girl’s grandmother to tell her about the error, and disclosing the information about it to her, before the mother.

Although the grandmother had been listed on the form as an emergency contact, the mother’s number was also clearly visible.

Health NZ also failed to contact and update the girl’s mother after she had complained to the HDC, despite saying that they would.

Health NZ told the HDC that it took the errors “very seriously”.

It provided the Public Health Nursing Service team with extra training a week after the event, and asked its staff to complete training modules and “put in place triple-checking of consent forms”.

Caldwell recommended that the nurse who misread the forms should write an apology to the girl and her mother, and complete a learning module about informed consent.

Ric Stevens spent many years working for the former New Zealand Press Association news agency, including as a political reporter at Parliament, before holding senior positions at various daily newspapers. He joined NZME’s Open Justice team in 2022 and is based in Hawke’s Bay.