Toronto Public Health has sent letters to the families of 45,000 elementary and high school students in the city, warning they could face suspension because their immunization records are not up-to-date.

Dr. Barbara Yaffe, director of communicable disease control and associate medical health officer at Toronto Public Health, says the letters went to parents and guardians of students aged 7, 16 and 17 years. 

"We are now in the process of reviewing school immunization records that have been provided to us by parents and guardians," Yaffe said in a written response to questions.

"In the vast majority of instances, the updated information is provided and suspension does not occur."

Yaffe said the process involves public health officials receiving updated immunization records, reviewing them to make sure students are up-to-date, then updating the provincial vaccination record database known as Panorama. 

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Vaccination clinics are being held in Toronto to ensure elementary and high school students can get their shots. (CBC)

After that, Toronto Public Health will determine whether a second reminder notice letter will be sent out. Parents and guardians will receive two letters before students can be suspended.

Yaffe said public health staff will work with school staff and parents and guardians to minimize the number of students suspended and to get students back to school as soon as possible if they are.

She declined to say if there is a paperwork problem but said immunization information is sent from doctors to families, then is sent by the families to Toronto Public Health. The information is reviewed by public health officials and entered into Panorama after that.

"The information is sent to us in various forms, including mail, fax, online and also by telephone. The volume of information received is thus very large," she said. 

"A comprehensive provincial immunization registry, accessible to parents and guardians, health care professionals and public health, would help make this process more efficient."

According to Toronto Public Health, parents are responsible for notifying the city about their child's immunization record or for providing a valid exemption. Exemptions may be granted on medical, religious or philosophical grounds.

Health minister says it's the law

Under the Immunization of School Pupils Act, all Ontario students must be vaccinated against measles, mumps, rubella, diptheria, tetanus, polio, pertussis (whooping cough), meningococcal disease and chicken pox (only applies to childen born on or after 2010).

Ontario Health Minister Eric Hoskins said this week immunization of children is the law.

"It's protecting them, but also those around them, so it is a requirement."

He said public health departments across the city are holding clinics to make sure that students can get their shots.

"I know that a number of public health units are making available immunization clinics for this express purpose," he said.

Parent glad to get it out of the way

Ines Garcia, a Toronto parent, received a letter from Toronto Public Health earlier this school year because her daughter's immunization record wasn't up-to-date. She said the family took care of the problem immediately.

"It was simple. We just booked an appointment at the health department and we went and she got it and it was fine." 

Garcia said she is glad she got it out of the way because it can take time for parents to arrange it.

"They're going to have book appointments, and go over there, and then there will be a long lineup."

Exemptions could get tougher to get

Noni Haynes, another Toronto parent, say she has eight children in the Toronto District School Board. She filed a Statement of Conscience — a form parents in Ontario can fill out to exempt their children from immunization — so none of them would require shots. 

"I kind of studied it a little bit when I started having children, and I didn't like what I was reading, and so I just said: 'You know what, I'm not going to bother.' "

But the exemption laws could get tougher for Ontario parents if the health minister has his way.

Haynes would have to sit down with a public health official for an education session as part of the process. She says that will not change her opinion.

"I will just continue doing what I'm doing. It's working, so why change it. right."