Immunization for School-Age Children

Immunizations provide students with the protection they need against viruses and diseases that can spread at school. An up-to-date immunization record provides important information should a disease outbreak happen in a school.

Questions?

If you have questions, please call 519-663-5317 to speak with a Public Health Nurse on the Vaccine Preventable Disease Team.

Keep your Kids on Schedule with their Immunizations

An “immunization schedule” is a list of vaccine your child needs and the ages that they should happen. The immunizations on the Ontario schedule are free for those who live here. Learn more about vaccines for children at school.

Immunization Record Review and School Suspension Notices

The Health Unit reviews immunization records for all elementary and secondary school students who go to school in London and Middlesex County. This is done to make sure their immunization records meet the requirements under the law (Immunization of School Pupils Act).

Students may be suspended from school if they do not update their records with the missing vaccines within the required timeframe provided.

Immunization of School Pupils Act

The Immunization of School Pupils Act (ISPA) R.S.O. 1990 is a law in Ontario that requires elementary and secondary school students to be immunized against the following diseases:

  • Diphtheria
  • Pertussis
  • Tetanus
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Meningococcal
  • Varicella (chickenpox) - for children born in 2010 or later

If the Health Unit does not have a record that a student is immunized according to their age against the above diseases, it may result in the student being suspended from school.

Immunization Record Review

The Immunization of School Pupils Act (ISPA) R.S.O. 1990 law states that Public Health Units in Ontario are required to keep a copy of student immunization records, and ensure that they are up to date. Public health nurses review all immunization records and send notices to families with students who are missing a record of required immunizations.

Common reasons for receiving a letter:
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  • Families submit records when the student starts school but do not provide updates when the student gets more immunizations.
  • Families submit the student’s 4–6-year booster vaccines when they start school, but do not include the immunizations the student received when they were a baby and toddler.
  • Students in Grade 8-12 may have missed their Grade 7 immunizations. This includes the required meningococcal ACYW-135 vaccine.
  • Older students may have missed their 10-year booster dose of Tdap (tetanus, diphtheria, and pertussis). This booster dose is often due between 14-16 years old, with the exact age being 10 years from the age the student received their 4–6-year booster dose of Tdap-IPV (tetanus, diphtheria, pertussis, and polio).
  • Children who were immunized in another country may not have received all the immunizations that are required for students their age to attend school in Ontario.

Types of letters and notices:

The Health Unit sends information to families with students who are at risk for suspension from school due to missing immunizations or missing information.

  • Letter – Lets families know which immunizations the student is missing within their record. This includes a due date by which to submit a record update to the Health Unit to avoid suspension from school.
  • Order of Suspension Notice – Students who are still missing immunizations after the due date provided within the first letter are given an order of suspension. This includes the date that suspension from school will begin if the record of the missing immunizations has not been submitted to the Health Unit.

What to do if your student receives a letter or notice:

Check your student’s record at home and with their healthcare provider:

  • If the student has already received the immunizations that the Health Unit is missing records of, submit a record update to the Health Unit.
  • If the student has not had the missing immunizations, they need to receive the vaccines and then submit a record update to the Health Unit.

Where can students receive missing immunizations?

Your Primary Care Provider’s Office
Walk-in Clinics
Health Unit Immunization Clinic
• Students can schedule an appointment with their family doctor or nurse practitioner if they have one.
• When you call to schedule an appointment, let them know which immunizations the notice says the student is missing. Bring the notice to the appointment.
• If the appointment date is after the date on the order of suspension notice, call the Health Unit at 519-663-5317 to discuss.
• Students with an Ontario Health Card can receive immunizations at a walk-in clinic. Call ahead to make sure they have the vaccines the student is missing and bring the notice when you go.
Immunization Clinic

Exemptions

Families may fill out an exemption form, which allows students to attend school without the required immunization records on file. The required form must be on file at the health unit, not at the school.

Grade 7 Immunization Program

Immunization clinics are held twice per school year within elementary schools in London and Middlesex County. Students in grade 7 are eligible to receive Hepatitis B, Human Papillomavirus (HPV), and Meningococcal ACYW-135 immunizations at no cost. The immunizations are provided at school by the Health Unit to students with parent/legal guardian consent. All of these vaccines provide optimal protection against diseases and are highly recommended. The Meningococcal ACYW-135 vaccine dose is required under the Immunization of School Pupils Act (1990). Options are available for students who are unable or prefer not to receive vaccines at school.

School Clinics

Public Health Nurses visit elementary schools in London and Middlesex-County to provide Grade 7 students the opportunity to receive Hepatitis B, Meningococcal-ACYW-135 and HPV vaccines at school. Immunizations are only administered to students whose legal guardians provided consent. The Health Unit asks parents / guardians to:

  1. Read the Grade 7 Vaccine Information for Grade 7 School Clinics: English (PDF)  |  French (PDF) |  Spanish (PDF) |  Arabic (PDF)
  2. Read the Grade 7 Parent Letter: English (PDF)  |  French (PDF) |  Spanish (PDF) |  Arabic (PDF)
  3. Sign the consent form: English (PDF)  |  French (PDF) |  Spanish (PDF) |  Arabic (PDF)
  4. Indicate which vaccine(s) you are consenting for.
  5. Print the form and return it to school before the first clinic date.

When a student is immunized at school, a note from the nurse will be sent home so their parent/guardian has a record.

Grade 8 Students

Grade 8 students who missed an opportunity to receive their vaccines at school when they were in grade 7 will be able to receive doses if there is a consent form on file. Grade 8 students will be immunized in the fall and/or spring depending on the recommended spacing between vaccine doses that are still required.

If your student received doses at their primary care provider's office (e.g., family doctor, pediatrician, walk-in clinic, nurse practitioner), please report these to the Health Unit to avoid additional doses being administered and to ensure that school suspension for the mandatory Meningococcal ACYW-135 vaccine does not occur if it has been received.

Students Not Receiving Vaccines at School

Students not receiving doses at school have other options:

  1. Book an appointment at a Health Unit immunization clinic.
  2. Grade 7 students may also receive these vaccines with their healthcare provider (e.g., family doctor, pediatrician, nurse practitioner). Please note:
    • Healthcare providers may not have these vaccines. Please ask when booking an appointment.
    • Parents/guardians are asked to report all doses given at healthcare provider offices to the Health Unit.

Preparing Your Child for Clinic Day

Your child may be feeling anxious about getting immunizations at school. The Public Health Nurses work to minimize anxiety and help students through the vaccination process.

Ways to help your child prepare for the clinic day:
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  • Ensure they eat breakfast and lunch, and stay hydrated.
  • Have them wear a short sleeve shirt so that it is easy to get at the upper arm where the needle will be given.
  • Talk to your child about using the following techniques to reduce possible pain and anxiety:
    • wiggle their toes during immunization
    • fully relax their arm during immunization
    • take slow deep breaths
    • close their eyes and count
    • talk to the nurse for distraction
    • hold and squeeze something in their hand

Occasionally, students in this age group, especially females, may faint due to anxiety about medical procedures, not because of the immunization itself.

After leaving the clinic, students should:

  • stay with others and be cautious on stairs
    • remain at school for at least 15 minutes
    • return to the clinic with someone if they feel unwell
Frequently Asked Questions
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What if I cannot receive the immunizations on the day of the school clinic?

  • If you miss vaccines, the Public Health Nurses will call the student down during the next clinic held at the school. Consent forms are valid until all doses are given, including in grade 8.
  • Alternatively, the student can come to the Middlesex-London Health Unit's Immunization Clinic to be immunized.

Can a student go to their doctor or nurse practitioner to receive the immunizations?

  • All three types of vaccines may be available at your healthcare provider’s office. Call ahead to make sure they have them in stock. The healthcare provider can order doses from the Health Unit for students who miss the vaccines at school.
  • Students are eligible for all three vaccines as soon as they begin grade 7. Meningococcal ACYW-135 vaccine should be administered during this school year, as it is a required vaccine. Students remain eligible for free Hepatitis B and HPV vaccines until the end of high school if not received at the same time as Meningococcal.

What if my student had one of these immunizations previously?

  • Write down the dates that any previous doses were given on the consent form. Once the consent form is, handed in, the nurse will check if more doses are required for proper scheduling of the vaccines. These doses can be given at the school clinic with a signed consent form.

Can a Grade 7 student consent for immunizations on their own?

  • In Ontario, a person does not have to be a certain age to be considered capable of providing consent. Parents are encouraged to discuss the information with their child. In most cases an adolescent can consent to the vaccine on their own. However, the Health Unit requires a parent’s consent when working in elementary schools.
  • There may be times when a parent wants a student to be immunized but the student does not want to be. Health Unit staff will help with distraction and encouragement but will not hold children down in a school clinic. In some cases, it may be easier for the student to go to a healthcare provider with a parent to receive the vaccines.

Are these immunizations mandatory?

  • Under the Immunization of School Pupil’s Act, the only grade 7 immunization that is mandatory is the Meningococcal ACYW-135 dose. Your student needs to have one dose of this vaccine, or have an exemption completed and filed at the Health Unit, to avoid suspension from school in the future. Other Meningococcal vaccines do not count towards this vaccine requirement.
  • Hepatitis B and HPV vaccines are not mandatory, but are highly recommended for this age group.

Where is the needle given?

  • These vaccines are given in the deltoid muscle (upper arm area). When three vaccines are given on the same day, one deltoid will be the site for one vaccine, and the other deltoid will be the site for two vaccines.

Should I get the Meningococcal ACYW-135 vaccine if I was vaccinated with meningococcal vaccine as a baby?

  • Yes. Children receive a Meningococcal-C vaccine at age one, and also require this different Meningococcal vaccine in grade 7.
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