Vaccine records not up to date for more than half of Ottawa, Toronto students assessed: Public Health

Public health records from Ottawa and Toronto schools show that among the groups assessed this year, more than half of the students did not have up-to-date vaccination records, which experts say highlights an outdated system that is unhelpful in the race to boost vaccination rates.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 had not submitted records. Under the School Pupils Immunization Act, students are required to be vaccinated against nine diseases to go to school.

The public health unit said earlier this month that about 54 percent, or 50,000 students, were still not in compliance, and would receive suspension notices if their records were not updated in the coming months.

Similarly in Ottawa, the city’s public health unit said that as of Oct. 12, vaccination records for about 16,000 students in grades 2 and 12 were not up to date. That’s more than 66 percent of children in those age groups.

In Ontario, it is up to parents to submit vaccination records to public health units, who also send letters to families who have not done so or applied for an exemption. Each year, local public health units select groups to assess compliance.

Toronto Public Health said that in some grades, at least 25 per cent of students have updated vaccination records. This is a particular problem among primary school students.

Public health experts say the number of students receiving these letters shows 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.

“This is not the ideal process and it’s not what we want to see happen,” Dr. Michelle Murthy, Toronto’s medical officer of health, said in an interview at Metro Hall in October.

Decline in vaccination rates

This is a particularly important time for Canada, which is seeing a decline in vaccination rates as health experts tackle online misinformation. Canada is also poised to lose its status as a measles-free country after a year-long outbreak infected more than 5,000 people in the past year.

If it loses the status — which will happen after the Pan American Health Organization meetings later this year — Canada will need to prove that vaccination rates have improved to 95 per cent or more and that it has strong surveillance to identify and control cases to get back to elimination status.

Murthy said the ideal scenario would be for health providers to input vaccination records directly into a central provincial or national registry, a system that doctors have been calling on the province to set up for decades.

Ontario’s top doctor Kieran Moore joined this group of calls last month, but he acknowledged the challenge is integrating data from different health-care providers stored in different systems. The health ministry 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 have been shouting from the rooftops on this issue for years,” Murthy said.

Dr. Milena Forte is familiar with the dangers of the vaccine reporting system, both as a family physician in Toronto and as a parent.

Earlier this month, Forte said a mother brought her children for an appointment after receiving a letter from Toronto Public Health saying her children were not vaccinated. But when Forte checked her records, she saw that the children were up to date.

“You can imagine all the paperwork and all the people involved,” Forte said. “In a stressed system, we are using resources to mimic functions – it doesn’t make much sense.”

some students were suspended

Forte received one of these letters a few years ago stating that her own child had not been vaccinated and that if the records were not provided she would receive a suspension notice.

She was confident her child was vaccinated and had the date recorded, but she still had to go through the process of calling her doctor and asking them to pull the information into their system, and forwarding her documentation to the school and public health.

“This is creating additional work and we could use this time to provide consultation on other preventive health issues, including things like vaccinations,” Forte said.

Last year, Hamilton’s public health unit sent nearly 22,000 letters about incomplete vaccination records to parents of students in grades 8 to 12 and 1 to 3, representing about 38 per cent of students in those groups. Ultimately about 6,400 were suspended.

Toronto Public Health says that in the 2024-25 school year, 6,090 students were suspended for a day or more. By the second day, more than 4,400 students were suspended.

Joe Crampton, a father of two from Hamilton, said it was “ridiculous” that there is not a single consolidated record of all this information.

Crampton, who works in financial institution software, said, “The way you expect it to work in a financial institution is that you would just grant viewing access from one entity to another. But you don’t do that. You type into the system with a handwritten yellow card, but if you don’t get a card, you’re in trouble.”

Ottawa-based Dr. Kumanan Wilson has been advocating for a vaccine registry for nearly two decades.

The current challenge remains the same, except he said one element has changed that could make a difference: the resurgence of vaccine-preventable diseases like measles.

“This is something we never expected,” he said. “There maybe a little more urgency to thinking about it.”