UPDATE: Immunization School Pupils Act (ISPA) – Orders of Suspension

Starting in early November, the City of Hamilton Public Health Services has initiated the Immunization of School Pupils Act (ISPA) Screening and Suspension Process. Letters are being sent to families of students who are not up to date on vaccines required under the ISPA, which includes tetanus, diphtheria, pertussis, poliomyelitis, measles, mumps, rubella, varicella, and meningococcal disease (Men C-C and Men-ACYW135). For this reason, you might notice an increase in the number of individuals seeking vaccinations. Individuals who have received notification letters are required to either update their vaccine records or get the necessary vaccinations or exemptions. They must also ensure that these vaccinations or exemptions are reported to public health. This step is essential to avoid any potential suspension from school, as during the 2024/2025 school year, Hamilton Public Health Services will be enforcing the Immunization of School Pupils Act including suspension from school of select age cohorts who do not have up to date vaccine records or appropriate exemptions. We greatly appreciate all of your work and support to ensure that children in Hamilton are up to date on their routine vaccinations, as a critical measure to reduce spread of vaccine preventable diseases.

In the 2024-2025 school year, Hamilton Public Health Services will be sending screening letters to students who are born in 2007-2019 and are overdue for missing vaccinations. Enforcement of the ISPA legislation by way of suspension will occur for those born in 2007-2012, and 2017-2019.

Public Health Services continues to appreciate and ask for your support as local health care providers in providing routine vaccination for youths. Due to the impacts of COVID-19 there are many students being provided notice of out of date vaccine records and possible suspension. This may result in increased requests from your patients to access vaccination, or receive vaccine records. We greatly appreciate all you can do to provide access to routine vaccinations for your patients including:

• Providing appointment availability to help students catch-up on missed immunizations.
• Providing  reminders during patient appointments of the need for parents/students to report their immunizations to public health and provide written documentation of the vaccines they have received.
• Checking immunization status and need for routine vaccines when you are seeing a student for any reason and, offering vaccination if needed.

Vaccine Orders 
To order all publicly funded vaccines including those required under ISPA, and in accordance with the Publicly Funded Immunization Schedules for Ontario, complete and submit the provided order form via fax at 905-546-3472.  

School Catch-up Clinics
Hamilton Public Health is responding to the high demand for student vaccinations by organizing catch-up clinics at local high schools in January and February 2025. These clinics will offer mandatory ISPA vaccines as well as optional Hep B and HPV vaccines for secondary school students. 

For Hamilton residents and students attending a school in Hamilton without a health card, routine vaccines including ISPA mandated and optional vaccines are available at Hamilton Public Health’s community vaccine clinics. If you are unable to immunize a student because they do not have a health card, please advise them to book an appointment at www.hamilton.ca/schoolclinics. 

Screening and Suspension Letters
The screening letter that parents/guardians receive will specify which of the child’s vaccinations have not been reported to Public Health. We advise parents/guardians to book an appointment with their health care provider and bring the screening letter to their appointment. We ask that you please check the patient’s records to determine whether they have received the listed vaccines in the past. If they have, please advise them of the product and date of vaccination to report to public health. If their vaccinations are not up to date, or you do not have a record of their previous vaccinations, please consider administering the vaccinations as per the Ontario Publicly Funded Vaccine Schedule.

The screening letter will have a 'report by date,' which is the deadline for updating their child’s vaccination records. Following this, if the records are not updated, a suspension order may be issued. This order will include a 'suspension date,' which gives them additional time post-screening to update the vaccination records and avoid suspension. 

Ontario Publicly Funded Vaccine Schedule 
To support your ongoing efforts and to ensure compliance with the Publicly Funded Immunization Schedules for Ontario, all immunizers should  ensure they have up to date knowledge using appropriate guidelines and resources such as vaccine product monographs and the Canadian Immunization Guide (CIG).

The Publicly Funded Immunization Schedules for Ontario provides Ontario’s routine and catch-up immunization schedules, information regarding eligibility for all publicly funded vaccines as well as high risk programs and vaccine intervals for vaccine series. Catch-up schedules are available for use when individuals are ‘off-schedule’ with their recommended vaccines. If you have questions about the Publicly Funded Immunization Schedules for Ontario or records assessment, please call 905-546-2424 ext. 7556. Public Health does not provide written documentation of missing vaccine records outside of the Immunization of School Pupils Act 
(1990) process. Health care providers are responsible for recommending appropriate vaccinations as per the Publicly Funded Immunization Schedules for Ontario and discussion of the risks and benefits with the patient.

The Publicly Funded Immunization Schedules for Ontario also includes timing information on how to complete the Pneu-C-15 series, as well as the Tdap-IPV series depending on an individuals current age and previous doses received.  

Reporting Vaccines
If a student receives vaccines from you, please remind their parents or guardians to report these vaccinations to the public health unit linked to the student's school. For example, if a student attends school in Hamilton but lives in Halton, the vaccination should be reported to Hamilton Public Health.

For Hamilton residents/students attending a school in Hamilton, vaccines can be reported in the following ways:

1. Online Reporting: via URL hph.icon.ehealthontario.ca or www.hamilton.ca/reportingvaccines
2. Mail: City of Hamilton, Public Health Services, Vaccine Program; P.O. Box 897, Hamilton Ontario, L8N 3P6
3. Phone Reporting: Call Vaccine Records at 905-540-5250. Expect high call volumes and exercise patience.

Thank you for your continued partnership as we work together to protect students and the public from vaccine-preventable diseases in our community. Please feel free to contact [email protected] if you have any questions or concerns.