Should vulnerable people who lack the mental capacity to make important decisions for themselves be vaccinated against COVID-19 even in the face of objections from their loved ones? The High Court confronted that uniquely difficult issue in the case of an 80-year-old care home resident who was suffering from dementia.

The woman's son did not object to vaccination in principle but was deeply sceptical about the efficacy of COVID-19 vaccines and the speed at which they had been authorised for use. In opposing her vaccination, he argued that her wishes and feelings had not been adequately canvassed. In those circumstances, the local authority that bore responsibility for her care sought judicial guidance.

Ruling on the matter, the Court found that, by reason of her dementia, the woman lacked the capacity to decide for herself whether she should receive a COVID-19 vaccine. She was unable to understand information concerning the existence of the virus and the potential danger it posed to her health. She could not retain information for long enough to enable her to weigh up the advantages and disadvantages of vaccination.

In seeking to ascertain what her wishes and feelings might be, the Court noted that she had willingly received the influenza vaccine in the past. She had been generally compliant with public health advice and had exhibited trust in the medical profession. When asked by a GP whether she wanted to be vaccinated, she responded that he should take whatever course was best for her.

The Court emphasised that her right to autonomy was not eclipsed by her dementia. Whilst respecting the son's right to his own views, it found that they were a facet of his own temperament and personality and did not reflect his mother's more placid and sociable character. It was her approach to life, rather than that of her son, on which the Court was required to focus.

Authorising the woman's vaccination, the Court noted that the UK has one of the highest death rates per capita due to COVID-19 in the world. There had been a recent outbreak of the virus at the care home where the woman lived. COVID-19 posed a grave threat to her health and ultimately her life, and such risks decisively outweighed the unidentified possibility of her suffering an adverse reaction to the vaccine.