Message from Toronto Public Health

February 6, 2015

To: Parent/Guardian:

Re: Ensure Your Child is Vaccinated Against Measles

Toronto Public Health is investigating a measles outbreak in the City of Toronto. Vaccination is the best defense against measles infection; and two doses of measles-containing vaccine (MMR or MMRV) are required for full protection.

Most Toronto schools have high vaccination rates. However, if a measles exposure occurs in a school, students with incomplete vaccination, or an exemption from receiving the vaccine, will not be allowed to attend school until the outbreak is over.

If you are unsure of your child's immunization status, please check your child's yellow immunization card, or speak with your health care provider. Once children are completely vaccinated they can return to school.

If your child is in kindergarten, please make sure they received their 4-to-6 year old booster. Parents with children who have completed their MMR/MMRV immunization (two doses), please ensure you have updated your child's record with Toronto Public Health. If you have not updated your child's record with Toronto Public Health, your child will be considered as having incomplete vaccination. To make reporting easier and faster, we offer online reporting at: www.toronto.ca/immunization or by fax at 416-338-2487.

If you have travel plans, please be aware that the United States is experiencing a multi-state measles outbreak, linked to Disneyland in California. Before you travel, make sure you and your children are protected. Those born in 1970 or later require two doses of measles-containing vaccine.

Sincerely,

Dr. Barbara Yaffe
Director, Communicable Disease Control
and Associate Medical Officer of Health

Public Health
277 Victoria Street
5th Floor
Toronto, Ontario M5B 1W2

Dr. David McKeown, Medical Officer of Health
Tel: 416-392-7405 Fax: 416-392-0713
byaffe@toronto.ca
toronto.ca/health

Immunization

Background

 The Immunization of School Pupils Act (IPSA) requires that children
attending school in Ontario must be immunized against diphtheria,
tetanus, polio, measles, mumps and rubella.

 To attend school in Toronto, children must be immunized according to the
IPSA

 The IPSA requires that all public health units in Ontario keep a file of
immunization records on all students attending school between the ages
of 4-18 or a valid exemption for students who for are not immunized.

 It is parents' responsibility to report their child's immunization record to the
public health department. Toronto Public Health provides various reporting
options.

 Children are required to have a number of vaccinations through their
school years or to have a valid exemption on file.

 If the record is not complete, two warning letters are sent to the family at the most recent address on file at the child's school. The letter is in English.

 If the family does not provide proof of vaccination, the child is suspended from school until proof is provided. Many students are suspended each year. A majority of the suspensions last less than five
days.

 Some doctors may report vaccinations but it appears that most don't.

Research:

 Unreported research has shown that suspensions are highest in schools with the greatest percentages of newcomer students.

 In 85% of the cases where the record is incomplete, students have received the vaccination but it hasn't been reported to Toronto Public Health.

Typical Immunization Issues

 Child has been immunized in first country but the immunization schedule in Ontario is different
and the child has to be immunized again
o Parent is concerned about health impact. Call the immunization line.

 To start school, child needs to be immunized but the family isn't eligible for a health card
o TPH runs free immunization clinics, call the Immunization Line

 Parent gave the record to the school but the parent is getting letters from TPH
o Call the immunization line to determine what is missing

 Child is suspended without notice. Parent didn't receive any letters.
o Letters are sent to the last address on file at the school. Parent may have moved and
not updated the school. Call the Immunization Line.

Advocacy Hints:

 As soon as you become involved, call the Immunization Line and let them know that you are helping the family. Ask if they can extend the time limits so that you can help the family comply with the requirements.

TPH Services

 Free immunization clinics are offered, health card not needed, see toronto.ca/health

 Free translation of vaccination records from other countries, for more information call 416-392-1250

 Multi-lingual information line 416 392 1250

 Three ways to report the information: online toronto.ca/health, fax416-338-2487 and mail to Toronto Public Health Immunization, 850 Coxwell Avenue, Toronto, Ontario M4C 5R1

 Exemption process, call the immunization line