A nurse has been found to have breached the rights of a 12-year-old girl who received the second dose of the HPV vaccine at school without her mother's consent.
According to an investigation, the nurse believed the student had confused the HPV jab for the Covid-19 vaccine prior to administering the vaccine.
The incident occurred in November 2021.
The student’s mother had previously provided written consent for the HPV vaccine but later withdrew permission. The 12-year-old told the administering nurse that her mother no longer consented to the vaccination.
Deputy Health and Disability Commissioner Dr Vanessa Caldwell said the nurse misunderstood the girl’s concerns as instead relating to a different vaccine and did not contact her mother to confirm the consent.
In Caldwell's report, Te Whatu Ora has also been criticised for not providing enough information about withdrawing consent in an information leaflet provided to parents.
"I do not consider that this was an assertion of the nurse’s views or beliefs over those of the student or her mother," the deputy commissioner said in a media release.
"But I do consider that the nurse was on notice that the student’s mother had withdrawn consent for her daughter to receive HPV2."
In statements provided to the commissioner, the nurse who administered the vaccine said they recollected the 12-year-old student objected to receiving the Covid-19 vaccine — which was not being administered at the time.
"I accept that the nurse appears to have believed that Miss A thought the vaccine was for Covid-19," the report read.
The nurse reassured the student about their concerns and called her father to reassure him that the vaccine was for HPV, not Covid-19. However, she did not contact the 12-year-old's mother, which the deputy commissioner was critical of.
"When uncertainty about the mother’s consent was raised, this cast doubt on the validity of the consent that was held," Dr Caldwell said.
"As the registered nurse administering the vaccine, it was her responsibility to ensure she had appropriate consent before doing so.
"Given the student’s vulnerability as a young consumer and the fact that her consenting parent was not present, [I] considered the threshold for questioning whether the parental consent was still valid needed to be low."
The incident occurred during a school-based vaccination on November 15, 2021. Free HPV vaccinations are offered to all girls in schools from around Year 8.
The mother complained that her daughter suffered long-term symptoms after the vaccination, including poor mental health and other side effects.
Vaccines against HPV infection have been offered in New Zealand since 2008. International studies and research involving millions of people have unanimously agreed that the vaccine is both safe and effective.
The deputy commissioner found that the nurse in the 2021 case was in breach of two rights. One stipulated that services can only be provided if an informed choice is made and consent obtained. The second right breached was the right to withdraw consent.
Dr Caldwell recommended that the nurse undertake an online training module on informed consent and provide a written apology to the student and her family.
She was also critical of Te Whatu Ora after a process for informing parents and caregivers when a student misses the initial vaccination clinic was not followed.
The deputy commissioner also recommended that Health New Zealand use an anonymised version of the case for wider education of vaccination nurses and to review the manual for confirming parental consent and arranging "catch-up" clinics.
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