The yellow school buses were just returning to Toronto streets when Aisha Rahman received the letter from Toronto Public Health. Her son Zayn, starting Grade 7 at Thorncliffe Park Public School, was among nearly 3,000 students at risk of suspension over incomplete vaccination records.
“I thought we were up to date,” Aisha tells me as we sit in the family’s apartment near Don Mills Road. “Between moving twice during the pandemic and his regular doctor retiring, somehow we missed his 4-6 year boosters.”
The Rahman family’s experience mirrors what thousands of Toronto families are facing this September as Toronto Public Health implements what some are calling the most rigorous vaccination enforcement in years. After pandemic-era relaxation of vaccination requirements, health officials have resumed strict enforcement of the Immunization of School Pupils Act.
Dr. Eileen de Villa, Toronto’s Medical Officer of Health, points to concerning trends. “We’ve observed a 23% decrease in childhood vaccination rates since 2019. With a confirmed measles case in Toronto last month and increasing cases across North America, we need to rebuild our community immunity quickly.”
The enforcement affects students lacking proof of immunization against diphtheria, tetanus, polio, measles, mumps, rubella, meningococcal disease, whooping cough, and chickenpox (for children born in 2010 or later). What makes this year’s push notable is the scale – Toronto Public Health data shows approximately 2,900 students received suspension notices in August alone.
When I visited one of the overflow immunization clinics at Flemingdon Health Centre, the line stretched around the building. Inside, public health nurses were administering vaccines while clerical staff helped families update their records through the provincial ICON database.
“We’re seeing families who are fully vaccinated but never reported it, and others who genuinely fell behind during COVID,” explains Saida Mohamed, a public health nurse who’s been working extended hours. “The good news is most just need documentation help, not the actual vaccines.”
At Thorncliffe Park Public School, where the Rahman family’s son attends, the impact is particularly pronounced. Principal Aatif Choudhry estimates nearly 140 students received suspension warnings. “Our community was hit hard by COVID. Many families lost income, housing stability, and regular access to healthcare. Now they’re scrambling to catch up.”
The school has responded by hosting on-site vaccination clinics and hiring temporary administrative support to help families navigate the documentation process. “We’re trying to keep kids in school while meeting public health requirements,” Choudhry says.
The enforcement comes as Toronto faces growing concerns about vaccine hesitancy. Data from Public Health Ontario shows MMR (measles, mumps, rubella) vaccination rates in some Toronto neighborhoods have dropped below 85% – well short of the 95% needed for optimal community protection.
Dr. Anna Banerji, pediatric infectious disease specialist at the University of Toronto, supports the enforcement but acknowledges the timing challenges. “Ideally, we would have gradually rebuilt vaccination rates before implementing suspensions, but recent measles outbreaks in Montreal and Vancouver have created urgency.”
Toronto Public Health’s approach reflects a broader provincial trend. Ontario’s Ministry of Health announced in April 2023 that it would phase back in vaccination requirements after the pandemic pause. However, Toronto’s implementation has been among the most stringent.
For families like the Rahmans, the enforcement has created anxiety but also action. Aisha was able to get Zayn caught up at an evening clinic. “The staff were amazing – they helped us get everything sorted in one visit. But I worry about families who don’t speak English well or work multiple jobs.”
Community health workers share these concerns. Razia Shaheen, a settlement worker supporting newcomer families in Thorncliffe Park, has been fielding panicked calls. “Many parents don’t understand why this is happening now. Some arrived during COVID and never received proper orientation to Canada’s vaccination system.”
To address equity concerns, Toronto Public Health has expanded clinic hours to include evenings and weekends, deployed mobile vaccination teams to priority neighborhoods, and hired additional multilingual staff. They’ve also partnered with school boards to ensure translation services are available.
While most medical experts support the enforcement, some parents and civil liberties advocates question the approach. The Justice Centre for Constitutional Freedoms has raised concerns about the impact on education access, particularly for vulnerable students. However, Ontario courts have consistently upheld vaccination requirements for school attendance, provided religious and medical exemptions remain available.
As of this week, Toronto Public Health reports that vaccination compliance has increased by 17% since notices went out, suggesting the policy is achieving its intended effect. Suspension notices give families 20 school days to comply before enforcement begins.
For the Rahman family, the experience has been a wake-up call. “I’m grateful we got the notice and fixed things quickly,” Aisha says. “But it makes me wonder what other health services we missed during the pandemic years.”
As Toronto works to rebuild its immunization rates, the current enforcement reveals both the challenges of post-pandemic health recovery and the continued importance of vaccination programs. The coming weeks will show whether the approach successfully closes immunization gaps without creating new educational disparities.
When I reached out to Toronto Public Health for final comment, they emphasized that their ultimate goal isn’t suspensions but protection. “We want every child in school and protected against preventable diseases,” said a spokesperson. “The notices are a necessary tool to ensure both outcomes.”
