The city of Hamilton has a message for parents as their kids head back to school: Make sure they're vaccinated.

In a news release Tuesday, the city said parents should review what vaccines their child has with their doctor, and then report those records to its public health division.

"The law requires that all children in Ontario attending school or daycare get vaccines to protect against meningococcal infection, measles, mumps, rubella, chickenpox (for children born in 2010 or later), tetanus, poliomyelitis, pertussis (whooping cough) and diphtheria," the news release reads.

"These vaccines are available free of charge from your primary health care provider."

The city says it plans to review over 54,000 vaccine records for students age 7 and up, with a goal of screening all local students by 2017-2018.

"If you choose not to vaccinate your child, you increase their risk of getting disease," a post on the city's website reads.

Providing these records to the city is mandatory — Hamilton's school boards suspended 70 students from 20 schools last December for not providing updated immunization records in the first wave of checks to be done by the city.

That first wave captured just 20 of the 180 total public, Catholic and private elementary, secondary and French-speaking schools in Hamilton.

The maximum a student can be suspended over incomplete records is 20 days, then the medical officer must decide if the student can return to school.

Exemptions still exist

Though a child's immunization records might be up to date, their public health records might not be, the city warns.

"Students may be at risk of suspension from school if their vaccine record is not up to date," the news release reads. "Letters warning of incomplete records will be mailed out throughout the school year beginning in October."

But anti-vaxxing parents do have an out — the city says kids who are "unable to be vaccinated" need a valid exemption form. That form has to be notarized by a commissioner or a notary public.

Between two and three per cent of students in Hamilton schools have used these exemption forms and aren't vaccinated against certain illnesses, city spokesperson Aisling Higgins told CBC News. "This level is stable and similar to other cities in Ontario," she said.

One such form is on the basis of "conscience or religious beliefs." These forms are based on provincial legislation.

It reads, "The requirements of the Immunization of School Pupils Act conflict with my sincerely held convictions based on my religion or conscience."

However, the same form says that the Immunization of Students Act allows the medical officer of health to order a child with that exemption to be excluded from school if there is an outbreak or "immediate risk of an outbreak" of a disease where there are no immunization records.

Higgins said that means if there was a measles outbreak at a local school, a child who had an exemption form for that immunization would be removed from the school.

"So that is a good reason to be vaccinated," she said.

Children with compromised immune systems can also be exempt

Higgins said that the "immediate risk of an outbreak" clause could relate to epidemiological trends, in which staff would monitor risks for a specific population, area, or age bracket.

"It would really depend on the situation," she said.

Under a provincial strategy proposed last year called Immunization 2020, Ontario parents who want a non-medical exemption for their kids at school would have to take a course at their local public health unit on the benefits of vaccines and the "very real risks" their children face if they are not immunized before they can get an exemption.

The other option for vaccine exemption is if a child can't get a vaccine for medical reasons such as immunocompromisation — like someone undergoing chemotherapy.

Higgins pointed to this as an example for why it's important for everyone else around those children to be vaccinated in order to protect them.

That goes for babies who are too young to be vaccinated, too. In June, a B.C. mother made a public plea for all parents to vaccinate their kids after her 10-week-old girl Isabelle contracted whooping cough.

"What you do with your kids is your choice, but do not tell me that not vaccinating your kids isn't hurting anyone but your own kids," mother Annie Mae Braiden wrote in a Facebook post that has since been shared thousands of times.

"Isabelle is proof that it harms the other little babes who aren't old enough to get their vaccines yet," she wrote.

Here's how to report vaccine records:

When reporting student vaccine records, you will need your child's yellow immunization card or a record from their doctor that includes the following information:

Your child's health card number

Dates your child received vaccines

Vaccine names

You can report your vaccines to Public Health by:

Calling: 905-540-5250 from Monday to Friday from 8:30 to 4:30 PM

Fax: 905-546-4841

Mail: City of Hamilton, Public Health Services, Vaccine Program, P.O. Box 897, Hamilton, Ontario, L8N 3P6

adam.carter@cbc.ca