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Middlesex-London Health Unit

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Immunization Records and School Suspension Notices

School Immunization Programs 

Since the COVID-19 pandemic, vaccine rates and immunization record reporting for school-aged children across the Middlesex-London region are currently lower than normal. In an effort to ensure that students are protected against disease and illness, the Middlesex-London Health Unit has taken the critical step of reviewing immunization records of all students enrolled in elementary and secondary schools in London and Middlesex County. As part of this process, the Health Unit notifies the families of children whose immunization records are incomplete. Letters are sent out requesting immunization record information. Families are asked to send in the vaccine information prior to the date listed on the letter, through the options listed. 


Have you received a school suspension notice because your child’s immunization record is incomplete?

In Ontario, Public Health Units retain student immunization records according to regulations included in the Immunization of School Pupil's Act (R.R.O. 1990).

Public health nurses screen all records and send letters to those who are missing information or require updated vaccines. For some families, this will mean sending their child’s immunization record to the Health Unit; for others, it will mean taking the child to a health care provider to receive any overdue vaccines and then to report that those vaccines have been given to the Health Unit.

PLEASE NOTE: Depending on the information that is being communicated, the letters the Middlesex-London Health Unit sends to families about their child’s immunization records are printed on different coloured paper.

You may receive initial and follow-up letters requesting information about your child’s immunization records. If these letters are not followed up on, or updated immunization records are not received, the Health Unit then sends suspension notices printed on yellow paper. These suspension letters include the date a potential suspension from school would come into effect. If the required information is not received by the suspension date, the student will not be able to attend school until the Health Unit receives updated vaccination information.

Parents and caregivers must report their child’s provincially mandated immunizations to the Middlesex-London Health Unit. Health care providers do not report the immunizations they have administered to the Health Unit.

We recognize that this can be a challenge because many parents do not realize that, depending on where their child received their vaccines, immunization records are not automatically reported. When a child is vaccinated at a health care provider’s office, parents and guardians need to request a record of the vaccines provided, and then report that information to the Middlesex-London Health Unit. Vaccination records from a different country would also need to be submitted to the Health Unit.

Immunization of School Pupils Act

The Immunization of School Pupils Act requires that all students in Ontario must be immunized against diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, and meningococcal disease. For children born in 2010 or later, two doses of chickenpox (varicella) vaccine are also required.

If the Health Unit does not receive the required information about a child’s vaccination status, or the child has not been immunized by the dates set by the Health Unit, it can result in the student being suspended from school. As soon as the required vaccination information is received and processed by the Health Unit, the student would no longer be at risk of being suspended from school.

How to submit your immunization record

In many cases, the child may have already received the required vaccines, however the dates they were administered were not reported to the Health Unit. For many parents, the first step is to find their child’s immunization record.

Once you have the record, you can submit it to the Health Unit, either online or in-person, at 355 Wellington St. (inside Citi Plaza - at the southeast corner of Clarence St. and King St.), Monday to Friday between 8:30 a.m. and 4:30 p.m. Learn more →

Submit your record online

NOTE: When submitting records online, please upload a picture of your child’s immunization record and enter your child’s school name. This will allow for quicker review by Health Unit staff and will ensure the information is entered correctly.

Do you need help submitting your immunization record online?

We’re here to help. If you’re experiencing difficulties, please call the Health Unit at 519-663-5317, Monday to Friday between 8:30AM and 4:30PM for support with:

  • Submitting your record online;
  • Answering your questions;
  • Setting up a phone call with an interpreter to help families who speak Arabic, Spanish, Mandarin, French, Ukrainian, etc.

NOTE: The Health Unit’s phone line can get very busy. If you’re not able to connect with a Customer Service Representative, please try again at another time. We appreciate your patience and understanding.

What should I do if my child is missing some of the vaccinations they require?

The first step is to review the Health Unit’s letter to see what vaccine doses are required and currently missing from the record on file.

Common reasons for receiving a letter:

  • Families send in records when the student starts school, but don’t always remember to update these records when their child receives additional vaccines as they grow older.
  • Young children’s vaccination records are often missing the dates on which the two 4 to 6-year-old immunizations, Tdap-IPV (tetanus, diphtheria, pertussis, polio) and MMRV (measles, mumps, rubella, varicella), were administered.
  • Children in grade 8 or higher may have missed their grade 7 vaccinations. This includes the vaccine for meningococcal ACYW-135, which is required under the Immunization of School Pupils Act.
  • Older children may have missed their 14 to 16 year old booster dose of Tdap (tetanus, diphtheria, and pertussis) vaccine. This vaccination is due 10 years after the previous booster was given between the ages of 4 to 6 years, so some students become overdue for this booster before they turn 16.
  • Children who were immunized in another country may not have received all the doses or vaccines that are required in Ontario.

Students can receive the necessary vaccines from their healthcare provider or a walk-in clinic. Please take the letter you received from the Health Unit with you, in order to ensure the healthcare provider is aware of what vaccines your child requires.


Vaccination is the best way to protect children from serious diseases like measles, polio, diphtheria and tetanus in Canada and across the world. Vaccines are safe and effective – and they help the immune system learn how to protect itself against disease. However, some children are not immunized because of serious illness or allergy, or due to their family’s beliefs.

To exempt your child for medical or non-medical reasons, please read the vaccine exemption information from our website.


Date of creation: June 21, 2016
Last modified on: February 25, 2024