More than 25,000 students across Ontario have been suspended this school year due to out-of-date vaccination records, according to data collected by The Trillium.
The suspensions reflect totals so far in areas covered by just 18 of the province’s 29 public health units. The other 11 didn’t respond to The Trillium’s request, or didn’t yet have complete data for the current school year.
While public health units say vaccination record checks are an annual occurrence, some stressed that the province’s measles outbreak underscores why high vaccination rates in schools are key.
Opposition parties and medical professionals also say the suspension numbers highlight the need for improved data collection and a provincial vaccine registry.
This comes as the Ford government faces criticism over its response to the rise in measles cases in Ontario, which has reached more than 1,200 cases since October.
‘The suspension process works’: health unit
The Trillium requested suspension data tied to outdated vaccination records from all 29 of the province’s public health units, which carry out the vaccination record checks. The figures could be higher for some of the 18 that provided data for the current school year as the suspensions process is still ongoing in some areas or data provided spanned two years.
Elementary and high school students in Ontario are required under the Immunization of School Pupils Act (ISPA) to be vaccinated against nine “designated diseases” including diphtheria, tetanus, polio and measles, unless they have a “valid exemption.”
Students can be exempt for medical reasons or through a statement of “conscious or religious belief,” with the latter requiring a parent to complete an immunization education session and have their statement witnessed by a commissioner for taking affidavits, such as a lawyer, judge or notary.
Students who aren’t vaccinated or don’t have a valid exemption can be suspended for up to 20 days.
Suspensions can be extended after the first 20-day period, but some public health units said this is rare, while others said they decide not to take this step.
Hamilton Public Health Services said students in its region returned to school after the 20-day suspension even if they hadn’t updated their vaccination record or provided a valid exemption, but would be subject to ISPA enforcement in subsequent years.
The North Bay Parry Sound District Health Unit takes a similar approach, saying that students who didn’t comply with the requirements returned to school after 20 days. Of 199 high school students suspended within the health unit’s coverage area this school year, 19 didn’t provide the updated records and didn’t attend school for the full suspension. Another 172 elementary students were also suspended.
“We know the suspension process works,” the health unit told The Trillium in a statement. “Suspension balances the need to enforce the legislation with the need to keep kids in school.”
The North Bay Parry Sound District Health Unit said this is why it decided to limit suspensions to 20 days, instead of issuing another suspension order.
The health unit also hosted vaccine clinics in secondary schools where the 1,250 high school students who received initial notices about incomplete records could get immunized. About 561 students received vaccines at these clinics.
More than 50 per cent of students are back at school within two days and most within a week, the Middlesex-London Health Unit said, adding that there’s a “high volume of work involved” in the vaccination record checks.
Middlesex-London’s health unit said it does checks in four rounds, with each taking about two to four months.
First, letters are sent to families indicating which of their child’s vaccines, or vaccination records, are missing. About six to eight weeks later, a student will get a “suspension notice” if the record is still incomplete, giving them another 30 days to update it.
Lack of vaccine registry is costing the province: doc
Dr. Allison McGeer, an infectious disease physician with Sinai Health, said the school suspension numbers show that “we need a vaccine registry.”
She said the current system that relies on yellow immunization cards and families self-reporting vaccinations is problematic because people don’t always think about keeping their cards or updating their records. Another challenge is kids who aren’t being regularly followed by a medical team.
“(It’s) hard to get vaccinated if you don't have a family physician or nurse practitioner taking care of you,” McGeer said.
Additionally, she said the need for public health units to focus on the COVID-19 pandemic created “huge gaps in collecting data on kids’ vaccination.”
McGeer also cautioned how she thinks people should interpret the suspension numbers.
“I don't think people should interpret that number as (Ontario having) a serious problem with vaccinating our children,” she said. “I think they should interpret that number as we have a serious problem with tracking” whether or not kids are vaccinated.
“We should fix that, because it’s not that hard to fix,” she said.
McGeer said the measles outbreak “makes it really obvious why we want to have a registry,” and that public health units are “spending a lot of money on this measles outbreak” as a result.
She said while the province has been “managing with what we have” when it comes to kids’ vaccinations, she’s worried about what a lack of an adequate registry will mean for aging adults in the face of numerous available vaccines.
“There are four million people over the age of 65 in Ontario, all sorts of whom are getting vaccines, and we're counting on what, their memory of which vaccine they got a decade ago?” McGeer said.
Dr. Adil Shamji, Liberal MPP for Don Valley East, echoed McGeer’s call for a registry and has been advocating for what he describes as a long-overdue move toward modernization.
“It's shocking to believe that in the year 2025, we still rely on little yellow cards to know whether our children are vaccinated or not,” he said. “A digital vaccine registry would help all of us be able to know very quickly how immunized are our communities.”
With improved data-sharing mechanisms between parents, public health and school boards, Shamji believes Ontario could respond more proactively to declining vaccination rates.
Around 70 per cent of seven-year-olds are fully immunized for measles, Public Health Ontario data from 2023-2024 shows.
Shamji said Ontario’s approach to childhood immunization remains inadequate, pointing to the Ministry of Health and local public health units as falling short in their duty to inform and support Ontarians.
“(They) still have much more to do in order to get the message out, the education, the resources out there to get everyone as close to fully vaccinated as possible,” he said.
NDP Leader Marit Stiles also called out the Ford government for its response to a rise in vaccine misinformation, saying the consequences are showing up in hospitals and classrooms across the province.
“We all know there's a misinformation campaign out there around the safety of these vaccines, and the government has a really important role to play in a public health education campaign,” she said at Queen’s Park.
Stiles accused the government of taking a hands-off approach as immunization rates fall and preventable illnesses re-emerge.
“What I see is the government taking a pretty laissez-faire attitude about it,” she said. “And this is the time, and we see it with 1,300, 1,400 people now with measles, 63 kids that were hospitalized, that's just children.”
“We have really vulnerable people living in our communities, they deserve to be protected, and we have an effective and safe vaccine,” she said. “What's missing is an actual public health campaign supported by the province.”
Green Leader Mike Schreiner said the province doesn’t have adequate data and that’s a problem.
“You can't manage what you don't measure, and the fact that the provincial government doesn't have a provincewide dashboard measuring vaccine rates and school suspensions related to it, to me tells you have a problem,” he said. “And one of the results of not measuring things properly so you can respond quickly is now the measles outbreak that we're seeing in Ontario.”
He called for information campaigns and more access to vaccines in schools, noting this is especially important with many Ontarians not having access to a family doctor.
“With my kids, we would discuss it with our family doctor and make a plan to get our children vaccinated,” he said. “If you don't have access to a family doctor, then you don't have access to that information and those resources.”
For its part, the government said it is taking steps to promote vaccinations and modernize health records.
“The best way to prevent disruptions to learning is to ensure students are up to date on their vaccinations,” said Ema Popovic, a spokesperson for Health Minister Sylvia Jones, adding that the government’s made “record investments” and taken steps to “encourage vaccine catch up and build healthier communities.”
“Last year, we wrote to healthcare providers across the province to support vaccine catch-ups for patients to receive all routine vaccinations, including measles, and to communicate with patients the effectiveness of vaccines in preventing disease transmission,” said Popovic, adding that the government has boosted funding for public health units by 25 per cent and are giving them base funding increases for three years.
When it comes to record-keeping, she said public health units use a central database called Panorama to record routine vaccinations and that through the More Convenient Care Act, the government is “modernizing the provincial electronic health record to provide Ontario residents with a digital identity tool to access their personal health information, including medical and vaccination records.”
Meanwhile, the Ontario Immunization Advisory Committee, which provides scientific and technical advice to Public Health Ontario, issued a call last fall for the province to develop a “provincial immunization registry.”
“Currently, Ontario does not have a reliable, complete or timely system to record vaccinations for all people in the province,” the committee stated in its report. “This registry should include vaccination records for everyone in Ontario and provide real-time access to individuals and their health care providers.”
Suspension numbers
Peel Public Health, which gives families two notifications before suspending a student, said that 2,712 students had been suspended this school year as of May 5 — 2,450 of those suspensions were resolved through families updating their records.
Chatham-Kent Public Health reported 267 suspensions — 152 elementary and 115 high school students — this school year after initially issuing 1,303 “suspension orders,” which would include the dates of the suspension period and what a student needs to do to avoid a suspension.
This compared to 257 suspensions during the previous school year and 1,535 suspensions in 2022-23, though the public health unit said the numbers in the latter year were “significantly higher” because it was the first year it resumed suspensions after COVID-19 pandemic disruptions.
For Hamilton Public Health Services, the 2024-25 school year was the first since the pandemic that it restarted ISPA enforcement. The health unit sent notices to families indicating out-of-date vaccination records at least two months prior to suspensions, according to Dr. Brendan Lew, associate medical officer of health.
Suspensions took place in four waves following the issuance of 16,705 suspension orders. Of three of the cohorts totalling 50,736 students, 5,592 elementary and high school students were suspended. The fourth wave of suspensions are taking place this month.
“A high level of routine vaccination in schools is critical to protecting students and preventing the spread of vaccine-preventable diseases,” Lew said in a statement to The Trillium.
Dr. Vinita Dubey, Toronto Public Health’s associate medical officer of health, said they started assessing Grade 11 students’ records in the fall and that 3,464 students born in 2008 had been suspended, “which is less than 15 per cent of all the students in that birth year.”
Through the Haliburton Kawartha Northumberland Peterborough Health Unit, 140 high school students and 112 elementary students have been suspended as of May 5. While suspensions are initially ordered for 20 days, the health unit said suspensions are rescinded earlier if students meet the requirements under the ISPA and that most only last one or two days.
Within the Middlesex-London Health Unit, 3,383 students were suspended this school year from a pool of 85,633 students, while 663 were suspended in March in the Windsor-Essex County Health Unit.
Since the province’s measles outbreak began in October, Chatham-Kent Public Health and Windsor-Essex County Health Unit have experienced the fourth and fifth-highest number — 255 and 122, respectively — of probable and confirmed cases between then and May 13, according to Public Health Ontario.
Ottawa Public Health said the vaccination record checks are important because the process “provides the best estimates of how many students attending school in Ottawa received vaccines such as MMR” (measles, mumps, and rubella).
“We continue to face the difficulty of not having real-time information about measles immunization rates in Ottawa because there is no integrated registry in the province that would enable reporting by providers at the time the vaccine is given,” the health unit said.
It added that the ISPA process also allows the public health unit to identify students who aren’t vaccinated against measles or other diseases in the event these diseases are found in a school.
Toronto Public Health’s Dubey said the “measles outbreak in Ontario, and outbreaks in other Canadian jurisdictions and around the world, underscores the importance of ensuring students are up to date with their school-based immunizations.”
Exemptions
Some health units provided The Trillium with exemption numbers — either as a percentage of student population or total number of exemptions.
Within the Renfrew County and District Health Unit, valid exemptions have been applied for 2.3 per cent of students, similar to the 2018-19 school year with 2.2 per cent of students with a valid exemption.
The Sudbury & District Health Unit said 1,179 — 4 per cent of the 29,209 students aged 4 to 17 — were exempted.
Ottawa Public Health said for students born in 2007 and 2017, preliminary "philosophical exemption" rates were less than two per cent.
As of May 5, the exemption rate among students covered by Hamilton Public Health Services was 4.7 per cent.
Around 4.9 per cent of students had a statement of conscience or religious exemption, according to Wellington-Dufferin-Guelph Public Health, which is up from 4.2 per cent in the 2023-24 year.
York Region Public Health had a total of 3,666 exemptions — 3,147 for “philosophical reasons” and 519 for medical, while the Simcoe Muskoka District Health Unit recorded 4,364 this school year. The Northwestern Health Unit indicated that 375 students have exemptions on file for this school year, 18 of which are new.
| Public Health Unit | Number of Suspensions |
| Algoma Public Health Unit | 140 |
| Chatham Kent Health Unit | 267 |
| Durham Region Health Department | Process still ongoing, final data not available |
| Eastern Ontario Health Unit | No data provided |
| Grand Erie Health Unit | No data provided |
| Grey Bruce Health Unit | Only exemption data received |
| Haliburton Kawartha Northumberland Peterborough Health Unit | 252 |
| Halton Region Health Department | 2,039 |
| Hamilton Region Health Department | 5,592 (so far) |
| Huron Perth Public Health | No data. Suspensions begin on May 23 |
| Lambton Public Health | No response |
| Middlesex London Health Unit | 3,383 |
| Niagara Region Public Health Department | No response |
| North Bay Parry Sound District Health Unit | 371 |
| Northeastern Health Unit | 79 |
| Northwestern Health Unit | 69 |
| Ottawa Public Health | Process still ongoing, final tally in June |
| Peel Public Health | 2,712 |
| Renfrew County and District Health Unit | 119 |
| Simcoe Muskoka District Health Unit | 1,296 |
| South East Health Unit | 95 |
| Southwestern Public Health | No data provided |
| Sudbury & District Health Unit | Data available in June |
| Thunder Bay District Health Unit | Process still ongoing, final data not available |
| Toronto Public Health | 3,464+ |
| Region of Waterloo Public Health | 2,544 |
| Wellington Dufferin Guelph Public Health | 1,104 |
| Windsor Essex County Health Unit | 663 |
| York Region Public Health Services | 1,633 |
This article was updated on May 21 to correct the name of Huron Perth Public Health.
