Public health data from Ottawa and Toronto schools shows that among groups assessed this year, more than half of students did not have updated vaccination records, which experts say demonstrates an outdated system that is useless in the race to raise vaccination rates.
Toronto Public Health said it sent 60,000 letters over the summer to students in grades 2 to 5 who did not provide records. The School Immunization Act requires students to be vaccinated against nine diseases in order to attend school.
Earlier this month, the public health department said about 54 percent, or 50,000 students, were still not in compliance and would receive notices of suspension if their records were not updated in the coming months.
Similarly, in Ottawa, the city's public health unit reported that as of Oct. 12, about 16,000 students in grades 2 and 12 had not been updated. This is more than 66 percent of children in these age groups.
In Ontario, parents must provide immunization records to public health authorities, who also send letters to families who have not done so or have not applied for an exemption. Each year, local public health departments select cohorts to assess compliance.
Toronto Public Health said in some classes, as few as 25 per cent of students have up-to-date vaccination records. This is a particular problem among elementary school students.
Public health experts say the number of students receiving these letters reflects that a cumbersome, multi-step process that often involves tracking down yellow cards or printouts from doctors' offices means public health officials have incomplete data.
“It’s not a perfect process and it’s not what we would like to see,” Toronto’s medical officer of health, Dr. Michelle Murthy, said in an October interview at Metro Hall.
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It comes at a particularly critical time for Canada, which has seen declining vaccination rates as health experts battle online misinformation. Canada is also at risk of losing its measles-free status as the year-long outbreak continues. Over the past year, more than 5,000 people have been infected.
If it does lose status – which will happen later this year after meetings of the Pan American Health Organization – Canada will have to prove that vaccination rates have increased to 95 per cent or higher, and that it has robust surveillance to detect and contain cases to return exception status.
Murthy said the ideal scenario would be for health-care providers to enter vaccination records directly into a central provincial or national registry, a system doctors have been urging the province to create for decades.
Ontario's Chief Medical Officer Kieran Moore joined this chorus of calls last month: but acknowledged that the challenge lies in integrating data from different healthcare providers stored in different systems. The Department of Health said it is working on a digital tool that would give people access to vaccine records and other personal health information, but an estimated timeline was not known.
“We've been shouting from the rooftops about this for years,” Murthy said.
Dr. Milena Forte knows the dangers a vaccine reporting system for both the family physician and the parent in Toronto.
Earlier this month, Forte said a mother brought her children to an appointment after receiving a letter from Toronto Public Health saying her children had not been vaccinated. But when Forte checked her notes, she saw that the children were aware of the events.
“You can imagine all that paperwork and all the people involved,” Forte said. “In a stressed system, we use resources to duplicate tasks—that doesn’t make much sense.”
A couple of years ago, Forte received one of those letters, saying her own child had not received her immunizations and would receive notice of suspension if records were not provided.
She was sure her child had been vaccinated and even wrote down the date, but she still had to call her doctor and ask him to pull the information into their system and forward her documentation to the school and health authorities.
“This creates additional work, and we could use this time to advise on other preventive health issues, including things like vaccinations,” Forte said.
Last year, Hamilton Public Health sent out nearly 22,000 letters to parents of students in grades 8-12 and 1-3 about incomplete vaccination records, accounting for about 38 per cent of students in those groups. Ultimately, about 6,400 people were suspended.
Toronto Public Health reports that in the 24-25 school year, 6,090 students were suspended for one day or more. On the second day, more than 4,400 students were still suspended.
Joe Crampton, a father of two from Hamilton, said: It is “ridiculous” that there is no single summary report of all this information.
“In a financial institution, you would expect that you would just give one entity access to view another entity. But you don't do that. You enter data into the system with a handwritten yellow card, but if you can't find the card, you're in trouble,” said Crampton, who works in financial institution software.
Dr. Kumanan Wilson of Ottawa has been advocating for a vaccine registry for nearly two decades.
The challenge remains the same, except that he said one element that could make a difference has changed: the resurgence of vaccine-preventable diseases such as measles.
“This is something we never expected to see,” he said. “Perhaps there needs to be more urgency in approaching this issue.”
© 2025 The Canadian Press
