Ontario schools are starting to issue suspensions to some of the thousands of students who aren't fully vaccinated, as measles continues to spread, giving new urgency to calls for the province to digitize its immunization record system. Toronto Public Health (TPH) reports that approximately 10,000 students are not up to date on their vaccinations, and an initial group of 173 students in Grade 11 will be suspended on Tuesday, April 8, 2025. A total of 574 students have received suspension orders, which will continue to roll out across Toronto high schools until May 2025.
TPH states that students can avoid suspension and return to school by providing proof of vaccination or completing a valid exemption. Ottawa Public Health has also been active in this initiative, distributing around 15,000 notices of incomplete immunization records to students in mid-January 2025. Suspensions are occurring from March to May 2025, with over 1,600 students suspended in Waterloo last week alone.
Under the Immunization of School Pupils Act, students are required to be vaccinated against various diseases, including measles, whooping cough, and tetanus. However, many residents in Ontario still track their vaccinations on paper, which the Ontario Immunization Advisory Committee is urging the Ministry of Health to change. In a position statement published in September 2024, the committee strongly advised the development of an electronic immunization registry to replace the outdated method of tracking vaccinations on yellow paper.
Dr. Jeffrey Pernica, co-chair of the committee, emphasized that the current measles outbreak has spotlighted the importance of having accessible vaccination records. "It took a measles outbreak to really highlight why it's good for individuals to be able to know what vaccines they've received," he said. Pernica added that there would likely be far fewer suspensions if an electronic immunization registry were in place.
Dr. Kumanan Wilson, based in Ottawa, has been advocating for a digital vaccination tracking system since 2011, when he launched an app designed for this purpose. He remains optimistic that the ongoing measles outbreak might finally compel the province to transition to a digital system. The outbreak has already infected 661 individuals in Ontario, primarily unvaccinated children, and has resulted in the hospitalization of 42 children. Wilson noted that measles is one of the most contagious diseases globally, requiring vaccination coverage of approximately 95 percent to prevent outbreaks.
"Small gaps in knowledge on vaccination coverage can result in outbreaks," Wilson stated, highlighting the need for better record-keeping. Currently, the immunization data collected by the province mainly pertains to school-aged children, leaving data on infants to six-year-olds incomplete—an issue of particular significance given the current outbreak.
Dr. Vinita Dubey, Toronto's associate medical officer of health, expects that compliance with vaccination requirements will exceed 90 percent after all notices are sent out. She pointed out that current Grade 11 students missed school-based vaccinations in Grade 7 due to the COVID-19 pandemic, contributing to the current situation.
Ontario's measles outbreak has not only affected local communities but has also drawn international attention. Health officials in New York issued a travel advisory last week, around April 2, 2025, warning that measles is "only a car ride away!" This advisory underscores the potential risks posed by the outbreak, particularly for those traveling from Ontario.
Dubey explained that Toronto Public Health previously assessed the immunization records of every student annually, but the pandemic disrupted this practice. Last fall, TPH focused on students born in 2008, who are now in Grade 11, totaling about 24,000 students across all four school boards. In January, letters were sent home to approximately 18,000 students and their families, notifying them that their immunizations were not up to date. By February, this number had decreased to around 10,000.
As of April 8, 2025, 21 secondary schools in Toronto began implementing suspensions. Of the 1,355 students at these schools born in 2008, 957 were initially not up-to-date and received a first letter about their vaccination status. A month later, over half of these students had caught up on their vaccinations. However, a total of 574 students received suspension orders, with 173 being suspended on the first day of enforcement.
Dubey clarified that while the act does not force students to be vaccinated, they must obtain an exemption if they choose not to vaccinate. "There is no forced vaccination here," she stated, emphasizing the importance of reporting vaccination status. "If you received a letter from Toronto Public Health and 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."
As Ontario grapples with this public health crisis, the call for an electronic immunization registry grows louder. Experts argue that such a system could prevent future outbreaks and ensure that parents and guardians have easy access to their children's vaccination records. The current situation serves as a stark reminder of the importance of vaccination and the need for efficient tracking systems that can keep communities safe.
