These laws usually relate to the age of consent for medical and surgical treatment, and have implications for sexual and reproductive health and the provision of STI vaccines. In some countries,

however, national laws, regulate the access of children and adolescents to health services in accordance with international and regional human rights standards. South Africa, for example, requires consent of the parent or care-giver for children up to 12 years, and for this age group also requires that the providers give proper medical advice to the child together with the parent/care this website giver [40]. Children over 12 have the right to seek health care (including preventive health care) without parental consent. In other countries, for example the

United Kingdom, laws allow health care providers to give confidential advice and services (for example on contraception or HIV and STIs) to minors without parental consent, provided certain criteria are met [41]. These criteria include whether the health professional is satisfied that the young person will understand the professional’s advice, and that it is in her best interest that she be given advice or treatment with or without parental consent [42] and [43]. In summary, young people have the right to full and comprehensive sexual health care interventions – which include both vaccines and sexuality education. The law recognizes that young people (under the age of 18) have an evolving capacity for making decisions about access to health care, and there are a number of national precedents which have reaffirmed the Lenvatinib chemical structure rights of young people to access effective sexual

health care. Such laws could be used to support young people’s guaranteed access to STI vaccines in the future. The introduction of HPV vaccine in some countries over (or individual states in federal systems) has been mandated on the grounds of “common good” – i.e. protection of the entire population through widespread vaccine coverage. In these instances, countries may use legal measures to enforce mandatory vaccine policies (against any type of infection). For example, mandated vaccine uptake can act as a prerequisite for accessing other public services as in the case of school entry requirements. Mandatory vaccine uptake, is, however, only used by a small number of countries – historically both England and Wales mandated vaccination against smallpox during the mid-nineteenth century, and currently some states in the United States of America and some Canadian Provinces have mandated school-entry vaccination policies [44]. In the case of mandated vaccines for pre-school children, the rationale for their use is based on a balance of factors including safety, efficacy, disease burden, and considerations of herd immunity [45]. When these principles were applied in the case of HPV vaccine, concerns about the concept of mandatory vaccination arose from many sides.