The yellow-and-blue notice arrived in Melissa Chen’s mailbox on a snowy February afternoon. Her daughter Maya, a bubbly Grade 2 student at an elementary school in Innisfil, was at risk of suspension. The reason wasn’t behavioral issues or academic concerns—it was missing immunization records.
“I thought we were up to date,” says Chen, leafing through Maya’s health booklet at her kitchen table. “We moved from Brampton last year, and somewhere in the shuffle, the records didn’t transfer properly. Now we’re racing against the clock.”
Chen’s situation isn’t unique. Across Ontario, thousands of families receive these notices annually as public health units enforce the Immunization of School Pupils Act (ISPA), provincial legislation requiring students to be vaccinated against several preventable diseases or have valid exemptions on file.
The Simcoe Muskoka District Health Unit (SMDHU) recently began its annual review process for the 2023-24 school year, sending notices to families whose children have incomplete immunization records. If not addressed, these students face potential suspension from school.
“This isn’t about punishing families,” explains Dr. Natalie Bocking, Medical Officer of Health at SMDHU. “It’s about ensuring our schools remain safe environments for learning by preventing outbreaks of serious vaccine-preventable diseases.”
According to Ontario’s Ministry of Health, students must be immunized against diphtheria, tetanus, polio, measles, mumps, rubella, meningococcal disease, pertussis (whooping cough), and varicella (chickenpox) for those born after 2010.
The enforcement process follows a predictable pattern. First, notices are sent to families with missing or incomplete records. Parents then have a limited window to either update their child’s immunization information, schedule outstanding vaccines, or file a valid exemption. If no action is taken, suspension orders follow.
For nurse practitioner Joanne Taylor, who works at a community health center in Barrie, this annual cycle brings a predictable surge in panicked phone calls.
“Many parents aren’t anti-vaccine—they’re just overwhelmed,” Taylor notes as she reviews her clinic schedule. “They’ve moved between health units, changed family doctors, or simply fallen behind during the pandemic chaos. The suspension notices actually help us catch kids who might otherwise slip through the cracks.”
Indeed, the COVID-19 pandemic created significant disruptions in routine childhood immunizations. A study published in the Canadian Medical Association Journal found that Ontario’s childhood vaccination rates dropped by as much as 35% during the early pandemic lockdowns, with only partial recovery by 2022.
These gaps create vulnerabilities in what public health officials call “herd immunity”—the protection created when enough people in a community are vaccinated, making it difficult for diseases to spread.
Walking through the waiting room of the SMDHU immunization clinic in Barrie, the impact of the suspension notices is evident. Amidst the cheerful wall murals and child-sized furniture, parents flip through smartphones searching for vaccination dates while children clutch stuffed animals for comfort.
Raj Patel arrived with his twin sons after receiving notices last week. “We actually had the shots done at a pharmacy last year, but never reported them,” he explains while completing paperwork. “I didn’t realize we needed to inform the health unit ourselves.”
This common misunderstanding highlights one of the system’s structural challenges. Unlike some provinces with centralized immunization registries, Ontario relies heavily on parents to report vaccinations to their local health unit, creating gaps when families aren’t aware of this responsibility.
For families truly opposed to vaccination, Ontario law does provide alternatives. Parents can file exemptions based on medical reasons (requiring a physician’s documentation) or conscience/religious beliefs (requiring attendance at an education session and notarized statement). However, these exempted students may be excluded from school during disease outbreaks.
The stakes of maintaining high immunization rates became starkly apparent in 2019 when measles—once considered eliminated in Canada—resurfaced in several communities. According to Health Canada data, each confirmed case required public health to track and monitor up to 100 potential contacts, straining resources and demonstrating why preventive measures remain crucial.
Back in Innisfil, Melissa Chen has managed to locate Maya’s missing records and submitted them online through the health unit portal. “Crisis averted,” she says with visible relief. “But the experience has been a wake-up call. I’ve now set calendar reminders for when her next boosters are due.”
For families still facing potential suspensions, health units emphasize that the goal isn’t to keep children out of school but to protect community health. The SMDHU offers catch-up clinics, extended hours, and online submission options to help families comply with requirements before suspension dates arrive.
As Ontario’s schools continue navigating post-pandemic challenges, maintaining these immunization safeguards represents one element of a return to normal public health vigilance—a system of checks and balances designed to protect the most vulnerable while allowing education to continue uninterrupted.
“When the system works properly, nobody notices,” reflects Dr. Bocking. “That’s the paradox of public health. Success means diseases don’t spread, outbreaks don’t happen, and children stay healthy enough to complain about homework rather than miss school due to preventable illnesses.”
For information about school immunization requirements or updating records, Ontario families can contact their local public health unit or visit the Ministry of Health website.
