School and Child Care Vaccinations

Elementary school students
March 27 was suspension day for elementary students whose vaccination records are not up to date with Public Health. If your child was suspended, please review the options below.

• If your child is suspended and requires a vaccination, you are uncertain if they need a vaccination, or you need an immediate                          resolution of the suspension, you must book an in-person appointment with Public Health.
• Appointments are held at 99 Regina St. South, Waterloo and 30 Christopher Dr., Cambridge from 9 a.m. to 4 p.m.
          •  Additional appointment booking will open at 8 a.m. and 4:30 p.m. each day.
          •  If capacity allows, walk-ins are welcome from 9 a.m. to 11 a.m. or 1 p.m. to 3 p.m.
Book an in-person appointment 
 
• If your child is suspended and you need to update their vaccine record, you can submit an update online through                                              the Vaccine reporting form*.
Vaccine reporting form 
*Given the high number of suspensions, it may take one to two days to review information submitted through our online forms. For immediate resolution, please book an in-person appointment
For further questions call 519-883-2020.

   

Secondary students
If your child has received the missing vaccines listed on the Immunization Notice, please report them to Public Health. Due to a high volume of vaccine records being submitted, it will take 5 to 7 business days to update records in our system.
Please only submit your child’s record once, we will follow up directly if your child’s record is not up-to-date.
Report your child’s vaccinations

If your child has received an Immunization Notice and is missing a vaccine, you have the following options:
       • Book an appointment with your primary health care provider and report your record to Public Health after vaccination
       • Book an appointment with Public Health 
Book a vaccine appointment with Public Health 
Please note that Public Health is unable to release health information, to parents/caregivers, for students over the age 16 years without their consent.

Vaccination protects children from many serious diseases that are easily spread in schools and child care settings. Each vaccine is given at a specific age, and some require multiple doses. View the complete vaccine schedule for more information.

On this page:


Required vaccines

The Immunization of School Pupils Act (ISPA) requires all elementary and secondary school students to have proof of immunization against:

  • Diphtheria
  • Tetanus
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Meningococcal Disease
  • Pertussis (whooping cough)
  • Varicella (chickenpox)
    • Required for children born in 2010 or later
Public Health also recommends the following vaccines, that can be received during Grade 7 school clinics:
  • Hepatitis B
  • HPV

View the complete vaccine schedule for more information.


Vaccination records and reporting

The Immunization of School Pupils Act requires Public Health to maintain vaccination records for all private, public and Catholic school students in Waterloo Region. 

Parents/guardians must report their child's vaccine records or valid exemptions to Public Health before their child starts school. See vaccine reporting for kindergarten for details. 

Every time your child gets a vaccine from their health care provider, you need to notify Public Health. Your health care provider does not report these records for you.

Report, view or request immunization records


Vaccine exemptions

Children who are not vaccinated are at increased risk of getting infections and spreading diseases to others. If your child has a vaccine exemption, and a vaccine preventable disease appears in your child’s school or daycare, your child may have to stay out of school, daycare, playgroups or sports until the disease is no longer present. You will be informed when it is safe for your child to return. Be prepared to keep your child home for several days, or up to several weeks depending on the disease.

Kindergarten to Grade 12 students
Under the Immunization of School Pupils Act (ISPA), a child attending school (Kindergarten-Grade 12) must either have proof of vaccination, or have a valid medical or non-medical exemption. A parent/guardian who wishes to submit an exemption must complete an appropriate exemption form and submit it to Public Health.

Medical exemption

A medical exemption can be submitted if a child has a medical condition that prevents them from receiving a vaccine or there is evidence of immunity to the disease making further immunization unnecessary.

Submit your vaccine exemption

Non-medical exemption

The Ontario Ministry of Health requires all parents/guardians of students wishing to obtain a non-medical exemption to watch a vaccine education video online and complete a Statement of Conscience or Religious Belief form.

  • Complete the mandatory Immunization Education Session
  • Once the education session is complete you will receive communication from Public Health with a Statement of Conscience or Religious Belief form that will need to be completed and taken to a Commissioner for taking affidavits to have it notarized.
    • Note: Photo ID with a signature is needed (e.g., driver’s license, picture health card). Some offices require an appointment and some may charge a fee.
    • Once this form is complete and notarized you will be able to submit it online with a webform link provided by Public Health.
Please contact Public Health at 519-575-4400 ext. 5001 if you have questions about this process or are unable to complete the education session online. 


Licensed child care centres

The Child Care and Early Years Act requires children attending child care to have proof of vaccination or a valid medical or non-medical exemption. A parent/guardian who wishes to submit an exemption must complete the appropriate exemption form and submit it to Public Health.

Ministry of Education exemption forms

Medical:

Non-medical: 

  • Complete the mandatory Immunization Education Session
  • Once the education session is complete you will receive communication from Public Health with a Statement of Conscience or Religious Belief form that will need to be completed and taken to a Commissioner for taking affidavits to have it notarized.
    • Note: Photo ID with a signature is needed (e.g., driver’s license, picture health card). Some offices require an appointment and some may charge a fee.
    • Once this form is complete and notarized you will be able to submit it online with a webform link provided by Public Health.

Please contact Public Health at 519-575-4400 ext. 5001 if you have questions about this process or are unable to complete the education session online. 

Note: The Ministry of Education, Child Care and Early Years Act exemption form will expire once a child enrolls in school and a new Ministry of Health and Long-Term Care exemption form under the Immunization of School Pupils Act will be required.


Grade 7 school clinics

Public Health provides the hepatitis B, human papillomavirus (HPV) and meningococcal vaccines at no cost to Grade 7 students through the school-based vaccination program.

Grade 7 students will receive paper consent forms on or close to the first day of school. Parents must sign and return these forms to provide vaccination consent. If you do not have a paper consent form, you can request another form through your child's school. 

2023-2024 School Vaccination Schedule

If your child did not receive these vaccines in school during Grade 7, and is currently in Grade 8-12, they may receive them from their health care provider.

Who gives the vaccines in school clinics? 
Our Public Health Nurses receive specific vaccination training. All our nursing staff are licensed with the College of Nurses of Ontario. They administer thousands of vaccines annually and have great knowledge and experience at putting anxious children at ease. 
How will the school clinics run? 

Students will be called down by class to the school clinic to receive their vaccines.

Students will be supervised for at least 15 minutes post-vaccine.

Severe reactions are rare and most occur within 15 minutes of getting the vaccine. The nurses will stay at the school for at least 15 minutes after the last vaccine is given. 

What will happen if my child has a reaction after the nurses have left? 

Most reactions occur within the first 15 minutes after receiving the vaccine. Public Health Nurses are always available at the school for at least 15 minutes after the last vaccine is given. Before leaving, the nurse provides the school with first aid instructions should a reaction occur. This may include referring the student to their family physician or emergency
services (if indicated).

Report any reactions that occur after nurses have left, to Public Health at 519-575-4400 ext. 5003 

Who can I contact if I have questions or if I did not get a consent form?  
Consent forms can be obtained by calling our Vaccine Information Line at 519-575-4400 ext. 5003. 
My grade 7 child missed a school clinic. Where can he/she get the vaccines and when? 

At your child's next school vaccination clinic (if available).

Public Health has school clinics twice a year, in the fall and then again in the spring.

  • A signed consent form or verbal consent is needed for your child to receive the vaccines at school
  • Your child will bring the consent form home the first week of school
  • Send the signed consent form with your child on the day of the school clinic
  • You may call in your verbal consent to Public Health if unable to send the signed form with your child

At a Public Health clinic.

Your child can come to a Public Health clinic all year, including the summer.

  • If your child missed both school clinics in Grade 7 or
  • If your school does not have a vaccination clinic (e.g. small private school) or
  • If your child is homeschooled

Book an appointment online here. Or call 519-575-4400 ext. 5003 to make an appointment by phone.

At your doctor's office

School program vaccines are also available through local health care providers.

Parents/students can access immunization records and submit immunization information via Immunization Connect Ontario (ICON).

Students without a health card or those needing assistance can call Public Health at 519-575-4400 ext. 5001.

I have questions about Hepatitis B vaccine 

My child received three doses of Hepatitis B vaccine as an infant. How do I sign the consent form? 

The three doses of Hepatitis B your child received as a baby should provide lifetime immunity. The National Advisory Committee for Immunization (NACI) does not recommend a booster dose for healthy individuals. Check off “no” on the consent form and sign. Check off the vaccine given and list dates (if known) on the consent form. 
Is Twinrix a Hepatitis B vaccine? 
Twinrix® or Twinrix®Junior is a vaccine that contains both Hepatitis B and Hepatitis A vaccine. Some people purchase these vaccines when they are planning to travel to countries where Hepatitis B and/or Hepatitis A are common. 
My child received two doses of Twinrix Junior when he/she was small. Should I sign consent for my
child to receive Hepatitis B vaccine in Grade 7 at school? 

It is recommended that you discuss with your doctor (or the office where you received your vaccine) to see if your child needs another dose of the vaccine. Public Health recommends that you complete the third dose of Twinrix® Junior at your doctor's office if needed. There will be a charge for Twinrix® Junior at your doctor's office because it is not publicly funded in Ontario.

If you prefer to have your child receive publicly funded Hepatitis B vaccine, they will then be complete for their Hepatitis B vaccines, but may require a final dose of Hepatitis A vaccine from the doctor's office to be completely protected against both Hepatitis B and Hepatitis A. Please ensure that your child's record is updated with the correct dates of the vaccines. 

My child received two doses of Twinrix® vaccine in Quebec when he/she was in Grade 4. Does he/she still need more Hepatitis B vaccine? 
No. Research has recently shown that students who received two doses of adult Twinrix® vaccine, six months apart have shown an equivalent antibody response to those who received all three doses of Twinrix® Junior. For this reason, they are considered to have completed their Hepatitis B and Hepatitis A series so they don't need to receive another Hepatitis B vaccination. Please ensure that your child's record is updated with the correct dates of the vaccines. 
My child was born in another province and received three doses of DTaP-IPV-HB-Hib vaccine (Diphtheria, Tetanus, Pertussis, Polio, Hepatitis B and Haemophilus influenzae type B) as an infant. Does he/she need another dose of Hepatitis B for a booster dose? 

No, another dose of Hepatitis B vaccination is not needed. The three doses of DTaP-IPV-HB-Hib that your child received as a baby should provide lifetime immunity. The National Advisory Committee for Immunization (NACI) does not recommend a booster dose for healthy individuals. 

I have questions about Meningococcal C-ACWY135 
My child received a Meningococcal vaccine after age one. Why is another one needed in Grade 7?  

The Meningococcal vaccine that your child most likely received after one year of age was a vaccine that covers one Meningococcal disease strain - the C strain. The protection from that vaccine decreases over time and a booster dose is needed. Studies show that youth and young people from ages 14 to 25 are at an increased risk for Meningococcal disease.

Meningococcal conjugate - ACWY-135 (Menactra®, Menveo®, or Niminrix®) protects against four of the dangerous strains of Meningococcal disease so it is recommended that youth and young adults receive at least one dose during the teen-age years. In Ontario, it is provided during Grade 7. 

My child received meningococcal conjugate-ACWY-135 before age 11. Is another dose needed in Grade 7? 

It is recommended that you consult with your doctor to see if waiting might be the best option for your child. Public Health knows that Meningococcal conjugate-ACWY-135 can offer protection for approximately five years so your child may still be getting protection from the dose given before age 11. Your child will remain eligible to receive one dose of the publicly funded vaccine from Grade 7 until the end of Grade 12.

It is important to note that if your child received one dose of Meningococcal C-ACYW135 after the age of nine months, they are considered up-to-date under the Immunization of School Pupils Act (ISPA).

I have questions about the HPV vaccine 

Through the School Immunization Program, all students attending Grade 7 in Ontario are eligible to receive publicly-funded doses of HPV9 until the end of Grade 12 for female clients and until the end of Grade 10 for male students. 

Is it true that HPV is also publicly funded for young men age 26 or under? 
Yes. As part of the High Risk HPV Immunization Program HPV9 is publicly funded for men who have sex with men (MSM) who are 26 years of age or younger, who identify as gay, bisexual, as well as some individuals who identify as trans, and who have not started their HPV vaccine series before September 5, 2017. 
My child received HPV4 (Gardasil®) last year but needs one more dose to complete the series. Can my child receive HPV9? 
Yes. Your child can complete their HPV series with HPV9. This is aligned with the National Advisory Committee on Immunization (NACI) recommendations and guidance, which allows for the use of HPV9 vaccine to complete an HPV4 series, if it is not possible to complete the series with the HPV4 vaccine. 

If my child needs to complete their Grade 7 vaccines in Grade 8, do I need to sign a new consent form? 

If you signed a consent, or called in a verbal consent to Public Health in Grade 7, you will not need to sign a new consent form. That consent, whether written or verbal, is good for 12 months or until the series is complete.

My child has an exemption on file for a vaccination, how can I be sure that he/she won't receive the vaccine at a school clinic? 

Exemptions are in place according to the Immunization of School Pupil’s Act, which is not part of the Grade 7 school program. To be sure that your son or daughter is not immunized, check off “No” on the consent and return with your signature.

It is a good idea to speak with your child ahead of time to let them know that they should not be receiving a vaccine at the school clinic. 

My child is on special medications for an underlying health condition. Is it safe for him/her to receive the school immunization program vaccines? 

Very few underlying health conditions would prevent a child from receiving vaccines. Consult with your doctor and/or contact Public Health at 519-575-4400 ext. 5003 to speak with a nurse about your child's specific situation. The nurse can answer your questions and provide you with information about what options are available for your child to receive the publicly funded vaccinations. 

My child has a serious needle phobia. What are my options to ensure that publicly funded vaccines are received? 

Needle anxiety is common in teens. Our nurses in the school clinics have dealt with many anxious children and have developed several techniques to make the process as anxiety-free as possible, for example:
  • Distracting the student
  • Allowing the student to listen to music
  • Using ice or a local anesthetic like EMLA® or Ametop® to numb the injection site (this must be provided by the parent and applied by the student 30 minutes before the vaccination)

Tips for you:

  • Ensure you send your child to school well fed
  • Pack an extra drink or snack to avoid fainting

If your child knows ahead of time that they are prone to fainting, please have them notify the nurse prior to getting their needle. 

Do I need to report all immunizations my child receives to Public Health?

Only immunizations required under the Immunization of School Pupils Act must be reported to Public Health, including:

  • Diphtheria
  • Tetanus
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Meningococcal Disease
  • Pertussis (whooping cough)
  • Varicella (chickenpox)
    • Required for children born in 2010 or later

Any immunization your child receives from Public Health (e.g. though a school or Region of Waterloo Public Health clinic) will be automatically reported.


Frequently Asked Questions

Why did I receive a letter from Public Health about my child's vaccine record?

Under the Immunization of School Pupils Act (ISPA) and the Child Care and Early Years Act, a child attending school or licensed child care must have proof of vaccination or a valid medical or non-medical exemption. Parents are required to report their child's vaccination information to Public Health on an ongoing basis. 

Why did my child receive a suspension letter from Public Health?

There are several common reasons for receiving a suspension letter:

  • Your child’s vaccine information has not been reported to Public Health. Parents/guardians are responsible for updating Region of Waterloo Public Health every time their child receives a required vaccine.
  • The vaccination information you provided was after suspension orders were automatically generated.  Information submitted online can take up to five business days for the information to be processed.
  • If your child is not being vaccinated for medical or non-medical reasons, you are required to submit a valid exemption. Learn more at Vaccine Exemptions.
Where can I have my child vaccinated?

If your child has received an Immunization Notice and has not received the missing vaccines listed, you may book an appointment at a Public Health clinic. 

Book your vaccine appointment here

You child can receive their vaccines at:

  • Your family doctor or health care provider
  • Walk-in clinic

Is it safe to receive multiple vaccinations at the same time?

Yes. The immune system can safely and effectively handle more than one immunization at a time. Most common side effects are mild (such as low grade fever and tenderness on the injection site) and will last for only a day or two.

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