Report Student Vaccination (ISPA)

Roles & Responsibilities Under the ISPA

Toronto Public Health

Under the ISPA, TPH maintains and reviews the vaccination records and/or exemptions for students attending grade school in Toronto. If a student does not have the required vaccinations or a valid exemption on file, a suspension order can be issued to the school principal by the Medical Officer of Health.

TPH keeps vaccine records for the sole purpose of enacting ISPA and the Child Care and Early Years Act (CCEYA).

Schools

Public and private grade schools in Ontario have responsibilities outlined in the ISPA. They are required to share specific student information to the local public health unit to support the administration of the ISPA as well as enforce a suspension order issued by the Medical Officer of Health.

TPH works closely with grade schools and school boards to minimize disruptions and get students up to date on vaccinations before the start of a suspension period in a school.

Parent/Legal Guardians (or Students 16 Years of Age and Older)

Under the ISPA, the role of parents and legal guardians, or students 16 years of age and older, is to keep track of their child’s/their vaccinations and report them to TPH. Vaccine records can be reported online using Immunization Connect Ontario (ICON). Records should be updated when:

• Beginning grade school
• Transferring to grade school in another area (e.g. another public health unit’s region)

By law, students 16 years of age and older are required to give consent directly to TPH if they want their parent/legal guardian to access or update their immunization record.

Health Care Providers

Health care providers, such as doctors or nurses, are not required to report vaccines to TPH under the ISPA. It is the responsibility of parents and legal guardians (or students 16 years of age and older) to report vaccines to TPH.

About Immunization Connect Ontario (ICON)

Immunization Connect Ontario (ICON) is a secure online provincial system used to track and report a child’s immunizations to TPH. Once your child’s vaccination record is complete in ICON, you can access a copy of their vaccination record when needed. For example, ICON can generate an electronic yellow vaccination card when proof of vaccination is required.

To submit or view immunization records in ICON you will need one of the following:

• The student’s Ontario Health Card (OHCN)

OR

• The student’s Ontario immunization ID (OIID – 10 digit #) found on the letter sent from TPH

Getting an Ontario Immunization ID (OIID)

If your child does not have an Ontario Health Card, you will need to get an OIID and a PIN to submit and view immunization records in ICON. Please call 416-338-7600 (select option 2) to obtain an OIID and a PIN.

How to Submit Vaccine Records

Submitting vaccine records online using ICON is fast and secure. For help reporting, watch the video below or check out the how to enter immunizations into ICON guide (also available in French).

Notification Letters & Suspension Orders from TPH

Notification Letters

TPH sends a notification letter when we do not have your child’s up to date vaccine record or a valid exemption on file. If you already reported your child’s immunization(s) but still received a letter, additional information may be needed from you.

Vaccines should be up to date for the age of the child based on Ontario’s Immunization Schedule. For example, children between 14 to 16 years of age need a tetanus, diphtheria and pertussis vaccine (Tdap) booster.

What you need to do:

1. Check vaccination records and get any missing vaccines.
   1. Check your child’s yellow vaccine card to see whether they received the required vaccines (or age-appropriate boosters). If you are unsure, speak to a health care provider.
      1. If your child does not have a primary health care provider, visit Health Care Connect to find a family doctor or nurse practitioner in Ontario.
   2. If your child is missing one or more of the required vaccines (or age-appropriate boosters), make an appointment with a health care provider or at a TPH community vaccine clinic to get vaccinated for free.
   3. If your child already received the required vaccines (or age-appropriate boosters), report your child’s vaccination record to TPH.
2. Report vaccination record to TPH.
   1. Parents/legal guardians or students 16 years of age and older are responsible for reporting student immunizations to TPH. Health care providers do not have this responsibility.
3. Obtain a valid exemption.
   1. TPH strongly encourages all children attending school to get vaccinated. Maintaining high immunization rates is essential to prevent vaccine-preventable diseases. Parents may have medical, religious, or philosophical reasons not to immunize their child. To ensure the exemption is valid, a Medical Exemption form or a Statement of Conscience or Religious Belief form along with an education session certificate must be provided to TPH.

TPH sends at least one notification letter with a minimum of 4 weeks to respond, before sending a suspension order.

Suspension Orders

Under the ISPA, all students must have a record of vaccination against nine diseases (based on their age) or a valid exemption to attend school in Ontario. It is the responsibility of parents/legal guardians to ensure these requirements are met. If a student receives a suspension order and the requirements of the ISPA have not been met, the student can be suspended from school for up to 20 school days.

If a student receives a suspension order from TPH, it means we have not received one of the following for the student:

• Document(s) showing the student has received vaccines/age-appropriate boosters for the following diseases (according to Ontario’s Immunization Schedule): Diphtheria, Measles, Meningococcal disease, Mumps, Pertussis, Poliomyelitis, Rubella, Tetanus, Polio or, for students born in 2010 or later, Varicella; or
• An unexpired Statement of Medical Exemption; or
• A Statement of Conscience or Religious Belief and confirmation that the parent completed the required education session. The Statement of Conscience or Religious Belief form must be sworn or affirmed by a Commissioner for Taking Affidavits.

Suspension periods begin a minimum of 4 weeks after the suspension order is sent. The dates that the suspension will start are listed on the suspension order. If the student is up to date with immunizations or a valid exemption before the suspension starts, the student will not be suspended.

If vaccination records have been submitted and a suspension order is still received, please call 416-338-7600 (select option 2) for more information.

Information in the suspension order

A suspension order will show:

• Name of student to be suspended;
• Dates for the suspension period (up to 20 school days);
• Immunization information required;
• Information on how to update the student’s immunization record;
• Information on how to submit a valid exemption; and
• Information on how to appeal the order.

Note: if the student’s immunization records are updated with TPH and meet the requirements of the ISPA, the student can return to school when the order is lifted by TPH. The student does not have to complete the full 20-day suspension period.

What you need to do:

To avoid suspension, parents/legal guardians or students 16 years of age and older need to report student immunizations to TPH or submit a valid exemption.

1. Check the student’s yellow vaccine card to see if they received the required vaccines (or age-appropriate boosters).
   1. If the student has not received the required vaccines (or age-appropriate boosters), make an appointment with a health care provider to get vaccinated. Then, report the student’s vaccination record directly to TPH.
   2. If the student already received the required vaccines, report the student’s vaccination record to TPH.
2. If you have already sent in student records to TPH and are still receiving notification letters, please call 416-338-7600 (select option 2).

When a suspension order can be lifted

If a student receives a suspension order and comes into compliance before the suspension period begins, the suspension order will be lifted and the student will not be suspended.

Once a suspension period has begun, a student can return to school when:

• The requested vaccination information is submitted to TPH and the student is now in compliance with the ISPA (up to date). TPH will confirm the student can return to school; or
• A valid exemption is provided to TPH and the student is in compliance with the ISPA. TPH will confirm the student can return to school; or
• The suspension period has ended (20 school days or as otherwise specified in the suspension order).

Appealing a suspension order

Parents/legal guardians and students 16 years of age and older have the right to appeal a suspension order and request a hearing with the Health Services Appeal Review Board (HSARB) within 15 days after the date the order is served. The HSARB is an independent adjudicative body established by provincial legislation to handle ISPA appeals.

To appeal a suspension order, the parent or student must notify the following parties of the intention to appeal in writing within 15 days of receiving the suspension order:

• Medical Officer of Health (email immunization@toronto.ca)
• HSARB (currently recommends all requests for appeal be sent via email to hsarb@ontario.ca or faxed to 416-327-8524)
• Principal of the student’s school

Do not send your immunization records to the HSARB. Contact them if you are appealing the suspension order and are requesting a hearing. TPH may not receive records that are sent to the HSARB, resulting in delays.

Student’s education record

Suspensions under the ISPA do not go on a student’s education record. The goal of the ISPA is to protect the health of children and school communities against the designated diseases in the ISPA.

Where to Get Vaccinated

Book an appointment with your health care provider, or students can catch up on their school-based vaccines by booking an appointment at a TPH community clinic.

All vaccines needed for school are free (publicly funded). If your child does not have OHIP or health insurance, contact a clinic that provides free health care to uninsured people.

Valid Exemptions

A student may be exempted from immunization under the ISPA for medical reasons or due to conscious or religious belief. To apply a valid exemption on your child’s immunization record for:

Medical Exemptions

1. Download and print the Statement of Medical Exemption form.
2. Have a health care practitioner complete the form. Your health care practitioner will submit the necessary documentation back to TPH.

Non-Medical Exemptions

1. Attend an Immunization Education Session required by the ISPA and receive a Vaccine Education Certificate.
   1. The education session must be completed by a parent/legal guardian and should be the same person completing the Statement of Conscience or Religious Belief form. To receive a Vaccine Education Certificate, your child(ren) must either live and/or attend school within the City of Toronto.
2. Complete the Statement of Conscience or Religious Belief form. Have the form signed before a Commissioner for Taking Affidavits. (Note: you may be charged a fee for this service).
   1. TPH currently requires original signatures on a Statement of Conscience or Religious Belief form. At this time, we do not accept forms with e-signatures, such as DocuSign.
   2. A Commissioner for Taking Affidavits is a person who can sign and swear or affirm. This form can be signed by:
      • Lawyer, judge, justices of the peace – who practice in Ontario
      • Notary public service
      • Members of a municipal council (City Councillor)
      • Members of the Provincial Parliament
      • Call 211 for a list of legal clinics
3. Mail both the original notarized form and a copy of the certificate back to:

Toronto Public Health
Vaccine Preventable Diseases
5100 Yonge Street, 2^nd Floor
Toronto, ON, M2N 5V7

For more information on immunization exemptions, call 416-338-7600 (select option 2).

Note: if a student has a valid exemption on file with TPH and there is a vaccine preventable disease case or outbreak at your child’s school, your child may be excluded from school to keep them and their school safe.

Child Care Centres

For parents/legal guardians with a child/children in a licensed child care centre (if the child/children are not in grade school), there is a different form and process for an exemption. See Immunization Exemptions for Children for more information.

Childhood Vaccines – Quick Reference Guide

Learn more about what vaccines are needed for children to attend school and child care and get tips to improve your child’s immunization experience.