Immunization Information for Child Care Licensees

Up-to-date immunization records or a valid exemption is required by law for staff working in and children attending licensed child care in Niagara.

Recent cases of measles and pertussis (whooping cough) in Ontario emphasize the importance of the Child Care and Early Years Act. Cases of pertussis continue to rise in Niagara.

If there's an outbreak of a vaccine-preventable disease at the child care centre, staff and children who are unvaccinated or not fully vaccinated will be considered at risk. They may not be allowed at the child care centre until Public Health declares the outbreak is over. Excluding them from child care is for their protection. They are excluded until the risk of developing infection is over.

Immunization status (including health assessment) of staff, volunteers and students

Under the Child Care and Early Years Act, the Medical Officer of Health determines what health assessments and immunizations are needed for staff, volunteers and students. It’s the licensee's responsibility to ensure these requirements are met (Child Care Licensing Manual, page 233).

Directed vaccinations by the Medical Officer of Health

All staff (child care employees and contracted home child care providers) are directed to get vaccinations for:

• Hepatitis B

  Hepatitis B is a virus that affects the liver and can cause permanent damage. People with hepatitis B may not show symptoms but can spread the virus through blood and body fluids, leading to liver damage, cirrhosis and liver cancer.

  Vaccination for hepatitis B is not publicly funded unless high-risk. High-risk groups include household members, people with risk factors for sexually transmitted infections (multiple sexual partners, previous STI), injection drug users, men who have sex with men and those with chronic liver or kidney disease. Talk to your health care provider for more information.

  Direction

  • Previously completed series*, or
  • One dose of hepatitis B-containing vaccine at the start of employment and the entire vaccine series completed within one year, or
  • Hepatitis B vaccine can be given alone or as part of combined hepatitis A and B vaccine (Twinrix), or
  • Laboratory evidence of immunity

  *Individuals may have received a two-dose series of hepatitis B vaccine as part of a voluntary immunization program in school in Ontario.

• Measles, Mumps, Rubella (MMR)

  Measles is very contagious and can spread through the air even after the infectious person has left the room.

  Learn about mumps and rubella (German measles).

  Direction

  • Adults born in or after 1970 are required to receive one dose of measles-containing vaccine. Adults born before 1970 are considered to be immune. Refer to the recommended vaccinations section for more information.
  • Laboratory evidence of immunity
• Tetanus, Diphtheria, Pertussis (Tdap)

  Tetanus (lockjaw) is naturally occurring in the soil. Diphtheria is a bacterial infection of the nose, throat and skin that can be life-threatening. Pertussis (whooping cough), also called the "100 day cough" is very dangerous to young infants.

  Direction

  • One dose of Tdap as an adult (18 years of age or older)
  • Booster of Td (Tetanus, Diphtheria) vaccine every 10 years thereafter
• Varicella (chickenpox)

  Chickenpox can spread through the air, days before the rash is present. It can lead to severe complications.

  Varicella is not publicly funded if born before 2000.

  Direction

  • Previously completed series, or
  • Self-report previous infection of chickenpox, or
  • Laboratory evidence of immunity, or
  • Two doses of varicella-containing vaccine for those who do not meet any of the above criteria. One dose given at the start of employment and the second dose completed within six months.

Licensees who need clarification or consultation about immunization requirements for their staff can contact the vaccine team at 905-688-8248 or 1-888-505-6074 ext. 7425.

More information

• Recommended vaccinations by the Medical Officer of Health

  In addition to the directed vaccines, the Medical Officer of Health recommends that staff:

  • Receive their annual flu shot
  • Follow the Ontario Ministry of Health recommendations for COVID-19 vaccination
  • Receive two doses of measles-containing vaccine (one dose is required) if born in or after 1970
  • Receive one dose of measles-containing vaccine if born before 1970 and can't recall having a measles infection
• Documentation requirements for staff including health assessment

  Providing an immunization record and / or the reasons for exemption from immunization fulfills the Child Care and Early Years Act requirement for a health assessment for staff.

  Niagara Region Public Health does not collect or routinely review staff immunization records.

  Licensees must have easy access to current and up-to-date vaccination information onsite, including:

  • A copy of an immunization record (yellow card or a printout from Immunization Connect), and
  • Completed Employment Immunization Status for Child Care form, or
  • A valid exemption form (Statement of Medical Exemption or Statement of Conscience or Religious Belief)
• Immunizations status of volunteers and students

  Immunization status, including the health assessment, does not need to be submitted to the licensee. The Medical Officer of Health recommends that all volunteers and students receive the same vaccinations as staff.

• Immunization status of other persons in a home child care premise

  The vaccine directions apply to partners, spouses, frequent visitors and adult children who live in or often visit a home child care premise unless they are not involved in child care.

  Children 17 and under who live in a home child care premise are recommended to be immunized according to the Ministry of Health's publicly funded schedule.

• Getting vaccinated

  Staying up to date with vaccinations helps protect and keep children in child care healthy. It also helps prevent closures caused by vaccine preventable disease outbreaks. When kids stay healthy, they can focus on growing, learning and enjoying their activities.

  Being up to date with vaccinations can also help everyone:

  • Stay healthy
  • Care for those who depend on them
  • Avoid missing work

  Learn where to get vaccinated.

Annual immunization record review for children attending child care

In the event of an outbreak, complete immunization records are needed to quickly identify who is at risk. That’s why the Child Care and Early Years Act requires licensees to:

• Collect and keep either an immunization record (yellow card or Immunization Connect printout) or a valid exemption (Statement of Medical Exemption or Statement of Conscience and Religious Belief) in a child's record. This documentation should be on file by the time the child starts attending the licensed program.
• Provide up-to-date enrollment information and immunization records to Public Health on request (Ontario Regulation 137/15, Section 72 subsection 6 under the Child Care and Early Years Act)

Public Health uses this information to review the immunization records of children in child care. Each year, parents / guardians of children without an up-to-date immunization record or valid exemption on file with Public Health are sent a reminder notice.

Licensees can support the immunization record review process by:

• Sending enrollment and immunization records to Public Health using the MOVEit platform. Public Health follows up with the Ministry of Education with licensees that do not comply with data requests.
• Sharing immunization information during enrollment to new families
• Reminding families whose child(ren) have already enrolled to report each vaccination their child receives while attending child care to their child care operator and Public Health

• Using the MOVEit platorm

  Although Public Health will continue to accept information by fax, mail or email, the preferred method for returning confidential documents is through MOVEit.

  MOVEit functions like Dropbox and allows you to easily upload documents to Public Health with no risk of a data breech. If you have any technical issues or questions about the platform, call 905-688-8248 ext. 7438.

• Reporting new enrollments to Public Health

  The Child Care and Early Years Act, 2014 requires licensees ensure that a child enrolling in a child care program for the first time is current with their vaccinations:

  1. Have the child's parent or legal guardian complete the Child Care Immunization Form during registration. If you don't have a copy of the form, call 905-688-8248 or 1-888-505-6074 ext. 7438.
  2. Make two copies of the child's original immunization record. Keep one for your files.
  3. Send the completed Child Care Immunization Form and copy of the child's original immunization record to Public Health

  You don't need to report records for children who are also attending a publicly funded school or private school to Public Health. Their record retention falls under the Immunization of School Pupils Act.

  Parents are required to report their child's vaccinations to public health.

• Monthly enrollment reporting to Public Health
  • The Child Care / Nursery School Monthly Report Form by the tenth of each month
  • Report whether you have any changes or not. If there are no changes to report, put "No" beside the "Any changes / updates" section on the form
  • Attach each child's immunization record (yellow card or Immunization Connect printout) to the Child Care Immunization Form

Public Health

Child Vaccinations

• Report Vaccinations or Request Records
• Where to Get Vaccinated
• Common Respiratory Illnesses
• Baby, Children and Youth Vaccinations
• Grade 7 Vaccinations
• Child Care Providers
• Measles