Public health records for Ottawa and Toronto schools show that among the cohorts assessed this year, more than half of the students did not have up-to-date immunization records, which experts say exposes an antiquated system that’s unhelpful in the race to boost vaccination rates.
Toronto Public Health said it sent 60,000 letters over the summer to students in Grades 2 to 5 who hadn’t submitted records. The Immunization of School Pupils Act requires students to be vaccinated against nine diseases in order to attend school.
The public health unit said earlier this month about 54 per cent, or 50,000, students were still non-compliant, and would get suspension notices if their records aren’t updated in the coming months.
Similarly in Ottawa, the city’s public health unit said as of Oct. 12, about 16,000 students’ immunization records were not up to date in Grades 2 and 12. That’s more than 66 per cent of children in those age groups.
In Ontario, it’s up to parents to submit immunization records to public health units, which also send letters to households that haven’t done so or applied for exemption. Each year, local public health units select cohorts to assess for compliance.
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Toronto Public Health said that in some grades, as few as 25 per cent of students have up-to-date vaccination records. It’s a particular problem among elementary school students.
Public health experts say the magnitude of students receiving these letters reflects that the cumbersome multi-step process, which often involves tracking down yellow cards or printouts from doctors’ offices, means public health officials have incomplete data.
“It’s not the ideal process and it is not what we would like to see happen,” Toronto’s Medical Officer of Health Dr. Michelle Murti said in an October interview at Metro Hall.
This comes at a particularly critical time for Canada, which is seeing vaccination rates slide as health experts tackle misinformation online. Canada is also poised to lose its status as a measles-free country due to an ongoing yearlong outbreak that has infected more than 5,000 people over the past year.
If it does lose the status — which would happen later this year after meetings by the Pan American Health Organization — Canada would need to prove vaccination rates have improved to 95 per cent or higher and that it has robust surveillance to identify and contain cases in order to get its elimination status back.
Murti said the ideal scenario would be that health providers input vaccination records straight into a central provincial or national registry, a system doctors have been calling on the province to establish for decades.
Ontario’s top doctor Kieran Moore joined this chorus of calls last month, but acknowledged that the challenge is integrating data from various health-care providers stored in different systems. The Ministry of Health has said it is working on a digital tool to give people access to their vaccine records and other personal health information, but an estimated timeline was not available.
“We’ve been screaming from the rooftops for years on this issue,” Murti said.
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Dr. Milena Forte is familiar with the perils of the vaccine reporting system, both as a family physician and a parent in Toronto.
Earlier this month, Forte said a mother brought her kids in for an appointment after receiving a letter from Toronto Public Health stating her children were missing vaccines. But when Forte checked her records, she saw the kids were up to date.
“You can imagine all the paperwork and all the people involved,” Forte said. “In a stressed system, we’re using resources to duplicate tasks — that doesn’t make a lot of sense.”
Forte received one of these letters a couple years ago stating that her own child was missing vaccines and would get a suspension notice if records were not provided.
She was confident her kid was immunized and even recorded the date, but she still had to go through the process of calling her doctor and asking them to pull up the information in their system, and forward her documentation to the school and public health.
“It’s creating extra work and we could be using this time to counsel on other preventative health issues including things like vaccination,” Forte said.
Last year, Hamilton’s public health unit sent almost 22,000 letters to parents of students in Grades 8 to 12 and 1 to 3 about incomplete vaccination records, representing about 38 per cent of the pupils in those cohorts. About 6,400 were eventually suspended.
Toronto Public Health says in the 2024-25 school year, 6,090 students were suspended for one day or more. More than 4,400 students were still suspended by the second day.
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Joe Crampton, a father of two kids in Hamilton, said it’s “ludicrous” that there is not one consolidated record of all of this information.
“The way you’d expect this to work in a financial institution is that you would just grant access from one entity to look at the other entity. But you don’t do that. You type into a system from a handwritten yellow card, but if you can’t find a card, you’re in trouble,” said Crampton, who works in financial institution software.
Ottawa-based Dr. Kumanan Wilson has been advocating for a vaccine registry for close to two decades.
The challenge at hand has stayed the same, except he said one element has changed that could make a difference: the resurgence of vaccine-preventable diseases like measles.
“It’s something we never expected to see,” he said. “There may be perhaps a bit more of an urgency to approach this.”
