April 2023 Board of Health Meeting - Immunization of School Pupils Act (ISPA) Compliance Update for Windsor and Essex County Information Report

Meeting Date
April 2023 Board of Health Meeting
Meeting Document Type
Information Report
Immunization of School Pupils Act (ISPA) Compliance Update for Windsor and Essex County

PREPARED BY:

Healthy Schools Department - Immunization

DATE:

April 20, 2023

SUBJECT:

Immunization of School Pupils Act (ISPA) Compliance Update for Windsor and Essex County

BACKGROUND/PURPOSE

The Immunization of School Pupils Act (ISPA) R.S.O. 1990, requires all Ontario students to be immunized against nine diseases. Public health units are required under the ISPA to routinely review student immunization records for students in their catchment area to ensure compliance. Students may be exempt from immunizations due to medical or non-medical reasons. These students, although not up to date on their immunizations, will have satisfied the ISPA requirements.

The WECHU assesses compliance with the ISPA and takes a progressive and collaborative enforcement approach. Parent(s)/guardian(s) of students not in compliance with the ISPA are notified in advance and provided information on actions to avoid a school suspension. A suspension order is issued only if proof of immunization or an exemption is not provided to the WECHU by the date specified. Students with incomplete immunization records or without a valid exemption by the deadline are suspended from school until the required immunization information is reported to the WECHU.

DISCUSSION

ISPA Enforcement in Secondary Schools

Immunization records for secondary students in Windsor and Essex County, were reviewed in June 2022:

  • 13,254 students received immunization notices.
  • 7,554 students were mailed suspension orders.
  • 1,519 students were suspended.

Prior to enforcing the ISPA through the suspension process, the WECHU hosted onsite immunization clinics in local secondary schools, regional municipalities, and WECHU offices. Clinic promotion was largely done on social media channels and by engaging youth-serving agencies (e.g., school boards and New Canadians’ Centre of Excellence Inc.).

Implementation of ISPA in Elementary Schools

For the 2022/2023 school year, student compliance with the ISPA was assessed and enforced for elementary students starting in December 2022 (see table below). Most students issued a suspension order on March 20, 2023 have since updated their immunization records with the WECHU and have returned to school.

Table 1. Number of Number of Elementary Students Not in Compliance with ISPA by date
Date Number of Elementary Students Not in Compliance with ISPA
December 5, 2022 12,023 immunization notices were sent to parent(s)/guardian(s) of elementary students who had incomplete immunization records across Windsor and Essex County.
January 30, 2023 6,654 suspension notices were mailed out to students with incomplete immunization records. This was the final notice mailed to students.
March 20, 2023, Suspension Day 1,908 students with incomplete immunization records were suspended from school.
April 5, 2023 54 students continue to be suspended due to incomplete immunization records.

Prior to enforcing the ISPA through the suspension process, the WECHU engaged in activities to help families avoid suspension:

  • Collaborated with health care providers to assess/update student immunization records, arranged for increased vaccine supply, and provided education on provincially-funded immunization schedule.
  • Collaborated with school boards and school administrators to offer onsite school immunization record review clinics and communicated updates through school social media channels.
  • Provided frequent updates to School Board Liaisons.
  • Developed a webpage of resources for school administrators.
  • Hosted immunization clinics for students to get missing vaccines and updated records with the WECHU.
  • Launched a targeted community communication campaign promoting key messages through diverse channels such as: Arabic radio (CINA 102.3 FM) and other media outlets; 2-1-1, and Facebook.
  • Translated resources for schools in French, Arabic, and Spanish.
  • Used RIO (a phone-based language service) to service families in their preferred language.
  • Provided several options for reporting immunization records (e.g., online, phone, fax, in person at the WECHU) along with information on where to get immunized (i.e., their health care provider or via a WECHU clinic).
  • Tailored support to families and school administration provided by public health nurses over the phone and in person.

After the suspension deadline, the WECHU has been engaging in key activities to help get suspended children back to school:

  • Daily calls to affected families to help troubleshoot.
  • Daily communications with school administrators whose schools have affected families.
  • Hosting daily walk-in immunization clinics for students to get missing vaccines and update records.
  • Media advisories to keep the public aware of enforcement progress.

Immunization Compliance and Coverage Rate

As of April 5, 2023, 94% of enrolled students are in compliance with the Immunization of School Pupils Act during the school year 2022-23, meaning they are either immunized for the ISPA-designated diseases or have a recorded exemption. This percentage includes students from all grades except Grade 9 as the WECHU is currently running the compliance process for this grade.

The WECHU also plans to publish an interactive dashboard in April on local temporal trends of immunization coverage rates among 7- and 17-year-olds up until school year 2021-22 and will also compare these rates to provincial rates and national goals for coverage. The WECHU will provide a second update in August 2023 by adding data on 12- year-olds and include coverage rates for the 2022-23 school year.