Ontario schools begin suspending students who aren't fully vaccinated

Ontario schools are starting to issue suspensions to some of the thousands of students who aren't fully vaccinated, as the spread of measles continues, giving new urgency to calls for the province to digitize its immunization record system.

Toronto Public Health says about 10,000 students are not up to date on their vaccinations, and an initial group of 173 students in Grade 11 will be suspended Tuesday.

A total of 574 students were sent suspension orders, which will continue to roll out across Toronto high schools until May.

TPH says students can avoid suspension and return to school by showing proof of vaccination or completing a valid exemption.

Dr. Vinita Dubey, Toronto's associate medical officer of health, expects "compliance will exceed 90 per cent" after all the notices are sent out.

"Toronto Public Health's goal is to help students catch up on their vaccinations and avoid missing school, and it continues to offer support to improve immunization coverage across the city," Dubey said in a statement on Tuesday.

Ottawa Public Health says approximately 15,000 notices of incomplete immunization records were handed out to students in mid-January, and suspensions are taking place from March to May. In Waterloo, more than 1,600 students were suspended last week.

Ontario urged to set up electronic registry

Under the Immunization of School Pupils Act, students must be vaccinated against various diseases including measles, whooping cough and tetanus.

However, most people in the province still track their shots on paper, which the Ontario Immunization Advisory Committee is encouraging the Ministry of Health to change.

The committee said in a position statement that it "strongly urges" the province to develop an electronic immunization registry, which would replace the current method of keeping track of shots on yellow paper.

That statement was published in September, says Dr. Jeffrey Pernica, co-chair of the committee. Yet it's only getting major attention now because of measles.

"It took a measles outbreak to really highlight why it's good for individuals to be able to know what vaccines they've received," says Pernica, adding that there would be far fewer suspensions if an electronic immunization registry existed.

Ottawa-based Dr. Kumanan Wilson has been advocating for the change since 2011, when he launched an app to track vaccinations. He's hopeful measles might be the push that the provinces needs to pivot to a digital system.

The outbreak has infected 661 people in Ontario, primarily unvaccinated children.

Because it is one of the most contagious diseases in the world, it requires vaccination coverage of about 95 per cent.

"Small gaps in knowledge on vaccination coverage can result in outbreaks," Wilson said. 

At the moment, the immunization data the province has collected is mostly limited to school-aged children. Wilson says that means data on infants to six-year-olds is not comprehensive, of particular significance with measles, which has resulted in the hospitalization of 42 children.

Wilson says lack of appropriate record-keeping might also be leading to the student suspensions.

"It may not even be anti-vaccination attitudes. It may just be that people don't know."

Ontario's measles outbreak has drawn international attention with health officials in New York issuing a travel advisory last week that noted the province's spread.

The April 2 advisory stated, "Measles is only a car ride away!"

Toronto Public Health in 'catch-up phase' after pandemic

Dubey said Toronto Public Health used to assess the immunization records of every student every year, but the pandemic disrupted that practice. Last fall, TPH assessed the records of students born in 2008, who are in Grade 11 now and who number about 24,000 students in Toronto in all four boards.

Letters were sent home to about 18,000 of those students and their families in January because their immunizations were not up to date. By February, the number was down to about 10,000. TPH has since begun issuing suspension orders for the 10,000. 

Dubey said the suspensions, which began on Tuesday, will roll out across Toronto high schools until May. On Tuesday, 21 secondary schools in Toronto began suspensions. Of the 1,355 students at these schools born in 2008, 957 were initially not up-to-date and received a first letter. A month later, over half the students were up to date. 

A total of 574 students were sent a suspension order. On Tuesday, 173 students will be suspended.

Dubey said students born in 2008 have the lowest rates of vaccination because they were in Grade 7 during the pandemic and TPH did not have school-based vaccinations for them. She said TPH is now in a "catchup phase."

She said the act doesn't force students to be vaccinated but they need to get an exemption if they do not get vaccinated.

"There is no forced vaccination here," Dubey said.

"We really want to get the message out. If you received a letter from Toronto Public Health, if you have not acted on it, report your vaccinations. No one reports them to us. A doctor doesn't report it to us. Get your vaccine and then report it to us."