Thousands of students across the GTA could be suspended from school this spring for not having their immunizations up to date, according to regional public health units.

Halton Region’s public health department says it will be issuing notices to more than 1,300 students on Monday who don’t have their records in order.

Peel has already suspended nearly 2,900 high school students this school year — with elementary school suspensions looming in March.

Toronto is in the process of sending out warning notices for missing vaccination information to more than 45,000 students, while Durham says it sent out notices to more than 14,000 students last fall.

York Region’s health unit reported this month that a whopping 61 per cent of 7-year-olds have out-of-date immunization records and “could be suspended” if they aren’t updated.

For most local health departments, this is the first time they will be enforcing suspensions since the province introduced three new vaccines into the immunization schedule in 2014 and implemented a new centralized immunization record database called Panorama. They all stress that suspensions, while mandated by law, are the last resort after months of notification through letters.

“Three notices are sent over three to four months to the child's parent or guardian requesting they update the student's immunization record or provide a valid exemption before suspensions are enforced,” said Dr. Kate Bingham, associate medical officer of health for Peel Public Health, which has already enforced 2,892 suspensions this school year among high school students.

Exemptions based on conscience or religious grounds are permitted, but parents have to fill out paperwork to officially opt out.

In February, York Region’s public health unit released a staff report that explained that the provincial medical officer of health strongly encourages local health units to “use their legislative authority under the (Immunization of School Pupils) Act by suspending students who were not up to date on their vaccinations.”

The York unit said it looked at only two age cohorts this year. It found that 42 per cent of 17-year-olds and 61 per cent of 7-year-olds in the region’s public, French and Catholic schools have incomplete records and “could be suspended” if they aren’t updated, according to the staff report.

“We wanted to ensure we could provide enough resources to meet the needs of these two groups. And to look at all the students who would be eligible for suspension would be a much larger number,” said Andrea Main, supervisor of vaccination clinics for York Region Public Health, who added that many students have already updated their information since the first letters went out, and all of the region’s immunization clinics had been booked up since.

Local health departments are responsible for ensuring that students are immunized against diphtheria, tetanus, poliomyelitis, measles, mumps and rubella. In 2014, meningococcal disease, pertussis (whooping cough) and varicella (for kids born in 2010 or after) were added.

Many public health officers say the high number of suspensions speaks not to an issue of compliance but more of reporting.

“While the majority of families in Halton immunize their children to protect their health, many are unaware that they need to notify the Halton Region Health Department about any immunizations their children have or do not have,” said Dr. Hamidah Meghani, Halton’s medical officer of health, in a release published in January.

Once they have the information, local health units have to manually input the information into the Panaroma database. In 2014, the provincial auditor general’s report program found that the current reporting practice with Panaroma “continues to result in problems with data accuracy and completeness” because it doesn’t allow for direct input from health care providers.

In December 2015, the province released a long-term vaccination plan called Immunization 2020, and said it would look at ways to streamline the reporting process to possibly it open it up to physicians, or parents themselves.

In the meantime, there is hope for students who may have gotten a suspension notice in the mail. Information can be found online, for each region, on free clinics where students can get the shots they need as soon as possible. Halton has even been offering immunization clinics in schools.

“Once suspended, the majority of records are updated within a few days and the students can return to school,” said a Peel public health spokesman. “Most of the records were updated on the first day.”

Immunization numbers

5,000 of 190,000 students in York Region asked for exemptions in the 2013/2014 school year.

3,947 high school students in Toronto were suspended in 2012/13 for incomplete immunizations.

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6,626 students in elementary schools in Toronto were suspended in 2013/2014 for incomplete immunizations.

7,754 students were suspended over two school years (2010/2011 and 2013/2014) in York Region for incomplete vaccinations