About three to five per cent of students attending school in Simcoe and Muskoka are not vaccinated.
“There is a misconception that it’s illegal in Ontario for someone to send their kids to school if they aren’t vaccinated,” said Mary Ann Holmes, manager of the immunization program for the Simcoe Muskoka District Health Unit (SMDHU).
It's true you can be suspended for not having up-to-date immunization records, though.
The Immunization of School Pupils Act (ISPA) states a child must have vaccinations against nine diseases to attend a school unless they are medically exempt or their parents have signed an affidavit of conscious or religious beliefs.
Without meeting one of the three requirements and filing the proper paperwork with the health unit, a child can be suspended. And those suspensions still happen within local Catholic, French, and public school boards.
“People think we don’t do that [suspension], but we do … it’s the last resort,” said Holmes. “Ultimately, and unfortunately, that’s what it takes to get the record.”
The suspension day for local Catholic, French and Trillium Lakelands School Boards is Thursday, said Holmes.
The public school suspension notices will be mailed out in the coming weeks and will be effective March 21.
In many cases where a suspension is issued, it’s not because the student isn’t vaccinated, it’s because the records haven’t been submitted by the parents, Holmes noted.
“The health unit doesn’t automatically get information from health-care providers,” said Holmes. “That’s the biggest piece we find when we do these suspension activities. It’s really important for parents to realize it’s their responsibility to report those to us.”
There’s an online form available 24/7 to submit information about an individual’s vaccination record to the health unit.
The role of local health units, as set out in the ISPA, is to have a record of the immunization history of students attending schools in the district.
“Our job is to make sure we know which kids are vaccinated versus which kids can’t be or aren’t vaccinated,” said Holmes. “We can use that information … if a [vaccine preventable] disease continues to spread we may look at doing what we call exclusions.
"We may decide kids who are not vaccinated and are not protected are not allowed at school. That’s for two reasons, one to prevent further spread, and two, to protect them from the disease.”
A decision to enact an exclusion lies with the Medical Officer of Health in a given health unit.
Last week, letters went home to parents of students at two Collingwood schools informing them a student at their school had mumps.
The SMDHU says there are currently five cases of the mumps in unvaccinated children aged 10 and under in Collingwood.
In cases where a parent chooses not to vaccinate a child, they are still required, under the ISPA, to let the health unit know.
As of 2017, they must also attend a 30-minute education session at their local health unit that covers basic information about immunization, vaccine safety, community health, and immunization law in Ontario.
“It was never really the intent to change people’s minds,” said Holmes of the added legislation in the ISPA. “People who have made the decision firmly, this isn’t going to change people’s minds … it was just to make sure people understood the consequences of what they were doing and to make sure they knew what their responsibilities are.”
The parent or guardian must then submit the vaccine education certificate they receive in that session as well as a notarized statement of conscience or religious beliefs (an affidavit) to the health unit.
For more on the responsibilities of parents who choose not to vaccinate their children, visit the SMDHU website here.
A medical exemption can be added to an individual’s record on the recommendation of a nurse practitioner or physician.
Medical exemptions usually apply to individuals who are immunosuppressed whether by disease or treatment. In those cases, they would be exempt from live vaccines such as the Measles, Mumps, and Rubella vaccine. In other cases, severe allergies prevent an individual from receiving a vaccine.
When a parent or guardian enrols a student in a school, they are required to include an immunization record with the application. That information is sent to the health unit by the school administration and/or school boards.
The health unit does not review every student’s immunization record each year. Instead, staff target certain age groups where the Ontario immunization schedule suggests a booster or other immunization.
“We don’t have the capacity to review every child’s record every year, though we would like to do that,” said Holmes.
Instead, staff will focus on students in Grade 2, who would have received booster shots for some of the vaccines they received as toddlers.
There’s another focus on Grade 8 students who would have received a meningitis vaccine around Grade 7. A booster scheduled for youth aged 14-16 means the health unit also focuses on high school students’ records.
Health unit staff will compare the records they’ve received from parents to the school’s enrollment list and send letters home in cases where the information is incomplete or where there is no record of vaccinations.
If the records are not updated, the health unit will send out a suspension notice.
Holmes has been part of the SMDHU immunization program for 11 years. She said she hasn’t seen any significant increase in unvaccinated children during her time with the program.
“Locally, we’ve always had pockets of people who have been anti-vaccination,” said Holmes.
“It is challenging because, I think, often times we’re trying to pass along information they may not want to hear,” she said. “It’s important for me to recognize when somebody’s already made their decision, and whatever information I give isn’t going to change their mind and I need to be respectful of that.”
She said most parents are in favour of having their kids vaccinated.
“The majority of parents are pro-vaccination, and they want their kids protected.”
What has changed, according to Holmes, is the number of questions the health unit receives from people who want to know more about vaccines, or are what she calls “vaccine-hesitant.”
“I think it’s fair to say there’s more information now available to people than ever before,” said Holmes. “What I’ve seen is people have more questions, and that’s good … we’re just trying to make sure they’re getting the information they need to make an informed decision.”
She said she and the staff in the immunization program get a lot of phone calls, and one of the most-asked questions is “why do kids get so many vaccines and why are we adding more?”
Holmes said having a list of available vaccines and seeing that list grow is a success.
“We’ve got access to vaccines in our publicly-funded schedule in Ontario that many other places don’t have access to, and have to pay for,” said Holmes. “I think we need to be proud of that and embrace that.”
Ontario’s funded vaccine schedule is the result of both national and provincial committee work and research.
According to Holmes, the National Advisory Committee on Immunization meets to review information on vaccines, and the diseases they are meant to prevent, and comes up with recommendations for each province to consider.
At a provincial level, the ministry of health will determine how to spend the dollars the province has been allocated and what vaccines will be covered for residents of Ontario.
“The people who are making decisions around what vaccines go in our vaccination schedule are not ‘big pharma,’” said Holmes. “It’s not just one person arbitrarily making up the schedule.”
For a complete list of the Ontario Routine Immunization Schedule, click here.
The ISPA requires vaccination records for nine diseases including diphtheria, tetanus, polio, pertussis, measles, mumps, rubella, meningitis, and varicella (Chicken Pox). The Chicken Pox vaccine is only required for children born in or after 2010.
The five cases of the mumps in Collingwood represent the third highest case rate in the health unit over the last 19 years. In the past, the region has also seen outbreaks of pertussis.
“It does happen, that’s the nature of [infectious diseases],” said Holmes.
For more on the SMDHU immunization program, Ontario’s publicly funded immunization schedule, to update yours or your child’s immunization records, or to get information on immunization clinics, click here.
