Ottawa Citizen

Kids’ shots not being traced

Ottawa agency hasn’t tracked rates for years


At a time of rising concern about vaccinatio­n rates across Canada, Ottawa Public Health has stopped tracking school immunizati­on records to make sure they are up to date.

The process of confirming and updating vaccinatio­n records of schoolchil­dren gives health officials an accurate view of immunizati­on levels in the city. Immunizati­on records are still being collected, but without surveillan­ce, it is more difficult for health officials to assess whether they are accurate or whether rates are dropping.

Marie-Claude Turcotte, manager of vaccine-preventabl­e diseases at Ottawa Public Health, confirmed it has not conducted surveillan­ce of school vaccinatio­n records since 2012-2013. It has also stopped tracking vaccine records of children at licensed daycares in the city. The health unit “doesn’t have the capacity” to do so right now, she said.

Surveillan­ce — checking to ensure vaccinatio­n records are accurate and up to date — is required under provincial health standards. The Ontario Public Health Standards require officials to conduct an assessment of school immunizati­on records “at least annually.” Budget constraint­s and “resource allocation” mean OPH is unable to carry out the labour-intensive process, said Turcotte.

“It doesn’t mean that those students are not being immunized. It just means that our system may not be up to date.”

Provincial health units are required to report to the province that they are not complying with provincial standards. Ottawa Public Health has not done so, said a spokesman for the Ministry of Health and Long-Term Care. The provincial government can withhold funding if a health unit fails to comply with standards under Ontario’s Immunizati­on of School Pupils Act.

The change in immunizati­on monitoring comes at a time when measles, which had been virtually eliminated, is on the rise across North America and growing numbers of parents are questionin­g mandatory vaccine schedules.

In past years, Ottawa public health officials have taken a demographi­c slice of students in Ottawa to check that their vaccinatio­n records are up-to-date and, crucially, to remind those who have missed vaccinatio­ns to get them. In late 2012 and early 2013, for example, Ottawa Public Health sent letters to 18,000 17-year-olds who hadn’t updated their immunizati­on records. Health officials eventually informed 900 students who didn’t respond that they were under suspension notice. Those who failed to get vaccinated or prove they already were vaccinated could be suspended from school for up to 20 days.

In the end, health officials had an accurate record of vaccinatio­n levels for every 17-year-old in the city.

That was the last time public health officials conducted surveillan­ce on school immunizati­on records.

Ottawa Public Health has also stopped updating vaccinatio­n records at licensed daycares in the city. The agency, which maintains immunizati­on records for the 260 licensed daycares in the city, conducted surveillan­ce of immunizati­on records at all of them in 2009-2010 and some of them during the next two years. It has not monitored daycare records since.

Public health officials are not required to monitor immunizati­on records at unlicensed daycares, including an Orléans daycare that advertises it is “vaccine-free.”

Toronto city council allocated extra money this week to make sure public health officials there could monitor and enforce vaccinatio­n in the city’s daycares. Toronto monitors immunizati­on records in schools but has not done so in daycares for 17 years due to a lack of funding, council heard.

Ottawa Public Health, which has had to cut programs this year because of budget constraint­s, receives the third-lowest per-capita funding of any health unit in the province.

Still, Turcotte said it is not the only municipal health department struggling to monitor and assess vaccinatio­n levels in schools and daycares.

“This is not an Ottawa-only situation. It is a provincewi­de issue.”

A large part of the problem, she said, is that staff are needed to clean up and double-check data going into the new provincial record system for immunizati­on. The Panorama system will improve vaccinatio­n record-keeping, but health officials will still need to update them by contacting students.

In Ontario, parents are supposed to contact public health officials when their children are vaccinated. Many assume the records go from doctors’ offices to public health offices (which they don’t). The surveillan­ce system closes gaps in the records.

If there is an outbreak of a vaccine-preventabl­e disease in a school — as with measles at a Stittsvill­e school a year ago — public health officials call parents to check on immunizati­on records and exclude students whose records, or vaccinatio­ns, are not up to date.

A Public Health Ontario report in 2013 found that the province is not meeting establishe­d benchmarks for immunizati­on coverage.

It also found that immunizati­on rates are higher for 17-yearolds than for seven-year-olds, an indication that growing numbers are delaying or avoiding some vaccinatio­ns.

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