School and Child Care Vaccinations

As a result of school closures during the COVID-19 pandemic, many students missed out on important vaccines. If you wish to have the vaccines administered at your family doctor’s office, the vaccines are available for your doctor to order from Public Health.

If you do not have a family doctor, students can also book an appointment at a Public Health Routine Vaccination Clinic. For more information, including eligibility or to book an appointment, visit Routine Vaccination Clinics.

On this page:

Required and recommended vaccines

Vaccination protects children from many serious diseases that are easily spread in schools and child care. Each vaccine is given at a specific age, and some require multiple doses.

Under the Immunization of School Pupils Act (ISPA) all primary and secondary students need 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 recommends receiving the following vaccines during our Grade 7 School Clinics:
  • Hepatitis B
  • HPV
  • Meningococcal (required by ISPA)

View the complete vaccine schedule for more information.

Grade 7 school clinics

Public Health provides the Hepatitis B, Human Papillomavirus (HPV) and Meningococcal vaccines at no cost to Grade 7 students annually through the school-based vaccination program. If your child is in Grade 7 this school year, they are eligible to receive these vaccines or complete their vaccines series if it has already begun. 

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 vaccines in Grade 7 and is currently in Grade 8-12, they may receive them with their health care provider or at a Public Health Routine Vaccination clinic.

Book your catch-up vaccine appointment here

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. 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

School aged children
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.

  • Print the Statement of Medical Exemption, Immunization School Pupils Act
  • Have your child’s medical doctor or nurse practitioner complete the form (you may be charged a fee)
  • Submit the original completed exemption form to Region of Waterloo Public Health by:
    • Mail: Vaccine Preventable Diseases, 99 Regina Street South, Waterloo ON N2J 4V3
    • In person: 99 Regina Street South, Waterloo, 2nd floor clinic reception or 150 Main Street, Cambridge, main floor reception
  • Keep a copy for your own records
Non-medical exemption

As of September 1, 2017, the Ontario Ministry of Health has made it a requirement for all parents/guardians of students wishing to obtain a non-medical exemption to watch a vaccine education video online. You will receive a certificate of completion after watching the video. Both the certificate of completion and a notarized Statement of Conscience or Religious Belief form must be returned to Public Health before the exemption can be applied to your child’s record.

  • Print and complete the Statement of Conscience or Religious Belief form for school-aged children and take the completed form to a Commissioner of Oaths to have it notarized. A Commissioner of Oaths can be one of the following: 
    • Municipal Clerks or Deputy Clerks for your local municipality
    • Members of the Provincial Government (MPPs)
    • Provincial Judges
    • Justices of the Peace
    • Barristers or Solicitors licensed to practice law in Ontario
    • Licensed Paralegals
    • A notary Public

Please 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.

  • Click here to complete the mandatory Immunization Education Session
  • Submit the notarized exemption form and the certificate of completion to Region of Waterloo Public Health by:
    • Mail: Vaccine Preventable Diseases, 99 Regina Street South, Waterloo ON N2J 4V3
    • In person: 99 Regina Street South, Waterloo, 2nd floor clinic reception or 150 Main Street, Cambridge, main floor reception
  • Keep a copy for your own records

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. 


Children in licensed child care centres
According to the Child Care and Early Years Act, a child attending child care 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. 

Children who do not get immunized are at an increased risk of getting some infections and spreading these diseases to others. If 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.

Ministry of Education exemption forms

The Child Care and Early Years Act requires children attending licensed child care seeking exemptions from vaccination for religious or conscientious reasons, or for medical reasons, must submit one of the Ministry of Education exemption forms found below:

Child care centres should submit exemption forms to Public Health along with a completed Immunization Information Form for Licensed Child Care Settings (PDF, 2 pages, 160 KB) form at the time of enrolment. A copy of both forms is to be kept on file at the child care centre for review by a Ministry of Education licensing officer. Please note that the Ministry of Education, Child Care and Early Years Act 2014 exemption form will expire once a child enrols in school and a new Ministry of Health and Long-Term Care exemption form under the Immunization of School Pupils Act will be required.

Frequently Asked Questions

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.

Contact Us