October 2022 Board of Health Meeting - Immunization of School Pupils Act (ISPA) Enforcement in Secondary Schools and Grade 7 In-School Immunizations Information Report

Meeting Document Type
Information Report
Immunization of School Pupils Act (ISPA) Enforcement in Secondary Schools and Grade 7 In-School Immunizations


Healthy Schools Department – Immunization


October 20, 2022


Immunization of School Pupils Act (ISPA) Enforcement in Secondary Schools and Grade 7 In-School Immunizations


In Ontario, the Immunization of School Pupils Act (ISPA) R.S.O. 1990, requires children and adolescents attending primary or secondary school to be immunized against mumps, rubella, diphtheria, tetanus, meningococcal, varicella and polio, or have a valid Medical, Conscience or Religious Belief exemption on file at the Health Unit. As outlined in the Ontario Public Health Standards (OPHS), health units in Ontario are required to have a complete immunization record, or a valid exemption on file, for every student attending school in their area.


ISPA Enforcement in Secondary Schools

Beginning in the spring, the WECHU reviewed immunization records for students attending secondary school in Windsor and Essex County, as mandated by the ISPA. In June 2022, 13,254 secondary school students had incomplete immunization records and were either overdue for one or more vaccines or had not submitted their updated records to the WECHU. These students received an immunization notice in June, informing them of their missing vaccines along with information on how and where to receive any missing vaccinations and/or how to update their records. A suspension order was then mailed in early August to any secondary student who had not yet submitted the required immunization information to the WECHU.

Throughout the summer, the WECHU hosted catch-up immunization clinics in all municipalities in Windsor and Essex County, to ensure that these students had the opportunity to complete their vaccine series prior to the 2022/2023 school year and to avoid suspension. The WECHU also worked with local health care providers to provide them with the necessary vaccines and ensure their patients’ records were updated.

In addition to the secondary school student immunization record review, an immunization record review was also conducted for children in kindergarten to grade 3 in early 2022. 8,687 immunization notices were sent to parents informing them of the student’s missing vaccines and encouraging them to get their child vaccinated. The enforcement process (i.e., issuing suspension notices and suspension) for elementary students will begin in 2023.

Prior to enforcing the ISPA through the suspension process, the WECHU worked with local school boards to host onsite immunization clinics in local secondary schools, in addition to the clinics in each municipality and WECHU offices. As part of the strategy to promote these clinics, the WECHU developed a detailed communications plan that included news releases, social media posts, paid Facebook and SnapChat ads, a 211 email blast, and radio ads. From June 1st to August 31st, 54 organic Facebook, Twitter, Instagram messages were posted ranging from general messaging about the benefits of vaccination, to where to find an immunization clinic and how to update a student’s immunization clinics.

In August, 7,554 secondary students still had incomplete immunization records and were mailed suspension orders. As of the suspension deadline on Monday, September 12th, there were 1,519 secondary students who had not provided updated records to the WECHU. These students were suspended on September 14th, 2022. The WECHU has continued to provide walk in clinics and updated records with information received by health care providers and online submissions through ICON.

In order for a student to return to school after being suspended, the student or parent/guardian must provide the WECHU with an updated immunization record. Clinics for students who were suspended have been operational at both WECHU locations with evening and weekend appointment availability to ensure every student has the opportunity to receive their vaccine. Additionally, WECHU nurses have been contacting every student on the suspension list and reviewing their immunization records with them to ensure they are complete. Once the student’s immunization record is up-to-date with the WECHU, the school principal is informed that the student can return to school. This process involves sending a daily up-dated suspension list to every secondary school in Windsor and Essex County. As of October 3rd, 49 students are still suspended for incomplete immunization records.

Grade 7 School Immunization Clinics

Due to the ongoing COVID-19 pandemic and the disruption of regular public health and education services, the WECHU was unable to fully implement in-school immunization programs over the last two years, in particular to students in grades 7 for Hepatitis B, Human Papillomavirus (HPV), and Meningococcal Disease. These vaccines were made available to local health care providers to administer free of charge to eligible patients. However, some families have not been able to visit their health care providers to update their child’s vaccinations due to the pandemic or other external factors.

School-based immunization clinics for Grade 7 students will return to the normal pre-pandemic schedule in the 2022-2023 school year. In-school clinics are being offered starting October 20th to all local schools. As of September 28th, there are 4,455 students eligible for the HPV vaccine, 3,941 students eligible for the Hep-B vaccine, and 4,308 students eligible for the Men-C-ACYW-135 vaccine. Given the student’s previous vaccination history, they may be eligible for one or more of these vaccines. These clinics will be offered this fall and a second round of clinics will be scheduled next spring. These publicly-funded vaccines are free of charge, to eligible Grade 7 students. Parents of Grade 7 students will receive a letter informing them of the date for their school’s clinic. Parents will complete an online consent for the vaccines they want their child to receive and will be informed that the meningococcal vaccine is a required vaccine under the ISPA.