PREPARED BY: Immunization

DATE: 2026-05-14

SUBJECT: ISPA Enforcement Outcome 2025-2026 School Year

BACKGROUND/PURPOSE

The Immunization of School Pupils Act (ISPA), R.S.O. 1990, requires all primary and secondary students in Ontario to be immunized against nine diseases. Under the ISPA, public health units must routinely review immunization records for students within their jurisdiction to ensure compliance. Parents and legal guardians are responsible for reporting their child’s immunizations directly to their local public health unit. Students may be exempt from immunization requirements for medical or non‑medical reasons. While these students may not be up to date on their vaccines, they are still considered compliant with ISPA once the required exemption documentation is submitted.

The Windsor-Essex County Health Unit (WECHU) assesses compliance with ISPA using a progressive and collaborative enforcement approach. In the fall, families of students enrolled in Windsor Essex County (WEC) schools who are not compliant are sent a letter, or “Immunization Notice”, that provides information on ISPA requirements, instructions for next steps, and deadlines for avoiding suspension. A suspension order is issued only if the required immunization records or exemption documentation are not submitted by the deadline specified on the Immunization Notice. Students who do not have complete immunization records or a valid exemption by the due date are suspended from school until the necessary information is provided to WECHU.

DISCUSSION

During the beginning of the 2025-2026 school year, immunization records were reviewed for all elementary students (46,163) and secondary students (20,359) enrolled in WEC schools. Immunization Notices were issued to elementary and secondary school students whose immunization records were not up to date with the WECHU. Immunization Notices were sent directly to the schools to be distributed to students to avoid delays due to potential Canada Post services interruption. 

Prior to ISPA Enforcement

Upstream interventions were implemented by the WECHU to help families avoid suspension: 

• Targeted assessment and outreach to WEC students missing MMR and Tdap vaccines, as well as those students with no immunization records with the WECHU. Outreach activities included phone calls, mailed written notices, and social media posts.
• Communicated key information to local vaccine providers regarding vaccine supply updates and ISPA requirements. 
• Encouraged local health care providers to assess student immunization status, provide missing immunizations and update student immunization records with the WECHU.
• Engaged School Board Liaisons in program planning and incorporated feedback to inform student interventions and ISPA timelines. 
• Updated resources available on the WECHU School Administrators’ webpage. This included materials such as process outlines, FAQs, and information to support educators in providing consistent messaging and support to families. Many resources were made available in French, Arabic, and Spanish.
• Shared a communication guide with an established School Board Communication Working Groups that included key information, timelines, and sample communication messaging.
• Hosted in-house immunization clinics with flexible hours. This included offering evening and weekend appointment for students facing barriers to updating immunization records with the WECHU or missing vaccine.
• Launched a targeted communication campaign promoting key ISPA messages through news releases, radio, and social media. 
• Collaborated with school administration to host onsite immunization clinics at three high risk WEC secondary schools identified as having a higher number of students with incomplete immunization records.
  • The WECHU provided promotional materials translated into requested languages identified by the schools (Arabic, Spanish, Dari, Pashto, and Kinyarwanda)
  • Targeted phone calls were made by the WECHU staff and school administrators to affected families to help arrange appointments. 
  • Engaged Settlement Workers in Schools (SWIS) to assist those with language barriers. 
• Engaged settlement workers in schools (e.g. SWIS, TÉÉ) to help reach newcomer families and provide information to meet ISPA requirements. 
• Collaborated with the New Canadians’ Centre of Excellence to host in person presentations for newcomer parents. These provided an opportunity to hear from a public health nurse about the importance of vaccination and vaccine requirements in Ontario. Nurses also answered questions, assessed and updated immunization records and helped book immunization appointments.

ISPA Enforcement

After suspension deadlines, the WECHU:

• Made phone calls to affected families and schools to provide support and help overcome barriers.
• Provided school administrators a daily updated lists of students who continued to have incomplete immunization records with the WECHU. 
• Hosted daily walk-in immunization clinics for students to receive vaccines and update records.
• Provided media updates to keep the public aware of ISPA enforcement progress.

*In 2023-2024 no suspensions were enforced with secondary school students.

Summary

ISPA focused efforts during the 2025–2026 school year were successful, as demonstrated by a measurable decline in the number of students with incomplete immunization records at every milestone. Year over year, gains are being made through strategic interventions based on continuous quality improvement. Equity targeted upstream approaches, collective efforts with School Board partners, and community health care providers further contributed to positive outcomes. 

Key strategies included increasing outreach to families and students with incomplete immunization records prior to the start of the school year; providing services and communications in diverse languages to better meet community needs; and offering more opportunities for assessment and immunization through an expanded number of in house and community clinics.