May 2025 Board of Health Meeting - ISPA Enforcement Outcome Update 2024-2025 School Year Information Report

PREPARED BY: Immunization

DATE: 2025-05-15

The Immunization of School Pupils Act (ISPA) R.S.O. 1990 requires all Ontario students to be immunized against nine diseases. Public health units are required under the ISPA to routinely review student immunization records for students in their jurisdiction to ensure compliance. Students may be exempt from immunizations due to medical or non-medical reasons. These students, although not up to date on their immunizations, will have satisfied the ISPA requirements.

The Windsor-Essex County Health Unit (WECHU) assesses compliance with the ISPA and takes a collaborative enforcement approach; working closely with our partners in education. Parent(s)/guardian(s) of students not in compliance with the ISPA are notified in advance and provided information on actions to avoid a school suspension. A suspension order is issued only if proof of immunization or an exemption is not provided to the WECHU by the date specified. Students with incomplete immunization records or without a valid exemption by the deadline are suspended from school for up to 20 days or until the required immunization information is reported to the WECHU. 

DISCUSSION

In the fall of 2024, immunization records were reviewed for all elementary students (45,139) and secondary students (20,496) attending school in Windsor and Essex County (65,635 total). Notices were issued to 7,076 elementary students and 4,785 secondary students indicating that their immunization records were not up to date with the WECHU. These notices provided information on the ISPA requirements, next steps, and deadlines to avoid suspension from school. Notices were mailed via Canada Post in November 2024, but due to work interruptions at that time, the WECHU delivered additional notices directly to the schools to be distributed in December 2024. This ensured that all affected families received the notices and had ample opportunity to address them.

Prior to enforcing the ISPA through the suspension process, the WECHU engaged in activities to help families avoid suspension including:

• Collaborated with health care providers to assess/update student immunization records, arranged for increased vaccine supply, and provided education on provincially funded immunization schedules.
• Provided frequent updates and met routinely with School Board Liaisons.
• Developed a webpage of resources for school administrators, including suspension preparation documents, standardized process outlines, FAQ, and more.
• Hosted in-house immunization clinics with flexible hours (including evening and weekends) for students to get missing vaccines and update records with the WECHU.
• Collaborated with school boards and school administrators to offer onsite school immunization clinics for two secondary schools with above average pending suspensions.
  • Promotional flyers were shared through the schools.
  • School staff made targeted phone calls to affected families to help arrange appointments.
  • Settlement Workers in Schools (SWIS) assisted those with language barriers.
• Launched a targeted communication campaign promoting key messages through diverse channels such as radio, Google ads, and social media outlets.
• Provided schools with promotional graphics to be displayed on televisions in lobbies, classrooms, etc.
• Translated resources for schools in French, Arabic, and Spanish.
• Engaged settlement workers in schools (e.g. SWIS, TÉÉ) to help reach newcomer families.
• Used RIO (a remote live interpretive language service) to service families in their preferred language.
• Provided several options for reporting immunization records (online, phone, fax, in person at the WECHU) along with information on where to get immunized (health care provider, walk-in clinic, or WECHU clinic).
• Tailored support to families and schools provided by public health nurses over the phone and in person.
• Shared news releases/media statements to keep the public informed. 

After the suspension deadline, the WECHU engaged in key activities to help get suspended children back to school:

• Daily calls to affected families to help troubleshoot.
• Daily communications with school administrators who have students remaining on their suspension list.
• Hosting daily walk-in immunization clinics for students to get missing vaccines and/or update records.
• Media statements to keep the public aware of enforcement progress.

After the suspension periods ended, the WECHU reviewed each outstanding non-compliant case to determine next steps based on factors such as whether the student was attending school and provide individualized support wherever possible to achieve compliance (e.g., arranged for transportation to get immunized, arranged with family and school for the WECHU to immunize the child at school). 

As of April 22, 2025, 99.9% of elementary and secondary students in Windsor and Essex County are compliant with the ISPA for the 2024-2025 school year. Compliance means that they are either immunized for the nine vaccine preventable diseases as required by the ISPA, or they have a valid medical or non-medical exemption.