Amid howls of outrage and cries of “shame,” from the public gallery, Toronto’s board of health voted Monday to ask the province to consider preventing parents from exempting their children from vaccines on philosophical or religious grounds.

“We’re not going to wait for an outbreak,” board of health chair Joe Cressy said in support of the recommendation, one of many in a report from Toronto’s medical officer of health, Dr. Eileen de Villa, that looked at ways to address the growing issue of vaccine hesitancy.

“Vaccine hesitancy” is a term used to describe the growing number of people who are unsure about the safety and effectiveness of vaccines. In Canada, an estimated 20 per cent of parents are vaccine hesitant, according to the report.

And the number of parents claiming vaccine exemptions for their children for philosophical and religious reasons is on the rise, from .8 per cent for the measles, mumps and rubella (MMR) vaccine in 2006 to 1.72 per cent this year, according to the report.

The vaccination issue drew a standing-room-only crowd to the committee room on the second floor of city hall where the meeting took place, and in the atrium on the ground floor, where a crowd cheered each time a speaker criticized the safety of vaccines.

Dozens of people told the board of health that they or their children had been injured by vaccines and vaccine side-effects, while health professionals vouched for the safety and efficacy of vaccines.

“Our faith in what happened to our children is unshakable,” said Alexandra Harrison, who spoke at the meeting and identified herself as the mother of a vaccine-injured child.

They also argued that removing the exemptions would be a violation of charter rights because children would have to submit to vaccinations if they are to remain in school.

De Villa’s report recommends maintaining exemptions based on medical concerns only, provided the concerns are backed by a certified medical professional.

Dr. Allison McGeer, an infectious diseases specialist at Mount Sinai Hospital, told the board that vaccines have been second only to safe food and water in extending human lifespans.

“Vaccines work, vaccines are safe,” said Dr. Samantha Hill, president-elect of the Ontario Medical Association representing 31,500 doctors in the province.

“They are vital to our communities’ well-being,” she said, adding that complications from the measles can include pneumonia and swelling of the brain (encephalitis).

De Villa said that if the number of unvaccinated schoolchildren is allowed to grow, it could threaten the herd immunity that mass immunization provides.

Herd immunity occurs when enough people are vaccinated that even the unvaccinated are unlikely to get sick, which means that those who can’t get vaccines — infants and people with other illnesses — are also protected.

Jill Promoli lost a son to the flu in 2016 after it swept through his kindergarten classroom because not all the children had been immunized. She pointed out that the decision not to immunize affects more than just one child.

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“It’s not just a personal choice, it’s a public one,” said Promoli.

“Many parents are concerned that vaccines are not safe because of false or misleading information about the link between diseases of childhood such as autism and vaccination administration,” according to the report to the board of health.

California has already outlawed non-medical exemptions.

The report is aimed at bringing policy in line with recommendations from the premier’s council on improving health care and ending hallway medicine, which asked for more accountability and monitoring of vaccination rates at the local level.

The board of health will now reach out to the provincial minister of health to relay its concerns to her.

While Ontario Health Minister Christine Elliott has expressed concern with public misinformation on medical subjects, she has also said she has no plans to review the exemption system.

The city report also calls on the province to consider developing a provincial vaccine injury compensation program to strengthen vaccine safety and support those who may have a serious side effect from a vaccine.

An anti-vaccine group has threatened a court challenge against any attempt to remove their right to keep their children unvaccinated for philosophical or religious reasons.

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