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this year, more than half of students did not have updated vaccination records, which experts say demonstrates an outdated system that is useless in the race to raise vaccination rates.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.
Ontario schools are beginning to suspend some of the thousands of students who have not been fully vaccinated as the spread of measles continues.
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.
Vaccination rates are declining
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 due to a year-long outbreak that has infected more than 5,000 people over the past year.
If it does lose status – which will happen later this year after meetings of the Pan American Health Organization – Canada will need to prove that its vaccination rate has increased to 95 per cent or higher and that it has robust surveillance to detect and contain cases to regain elimination 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 the chorus of calls last month, but acknowledged the challenge is integrating data from different health care 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.
A new study published in the medical journal Lancet suggests childhood vaccination rates have stagnated or declined since 2010. The authors say geopolitical instability is contributing to the recession in some countries, but misinformation contributes significantly to the decline in high-income countries.
Dr. Milena Forte knows the dangers of the vaccine reporting system as a family physician and 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 this documentation and all the people involved,” Forte said. “In a stressed system, we use resources to duplicate tasks—that doesn’t make much sense.”
Some students are suspended
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 6,090 students were suspended for one day or more during the 2024-25 school year. On the second day, more than 4,400 students were still suspended.
With cold weather expected to hit the region soon, Region of Waterloo Public Health has released its fall vaccination plan. David Aoki, director of infectious diseases and chief nursing officer at Region of Waterloo Public Health, explains what you need to know.
Joe Crampton, a father of two from Hamilton, said it was “ridiculous” that there wasn't one consolidated account of all this information.
“In a financial institution, your expectation is that you will simply grant access to one entity to view another entity. But you don't. You enter the 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 software for financial institutions.
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.”
