Tensions flared at Toronto city hall on Monday as a large group of anti-vaccination parents protested against the city's decision to adopt a new vaccination strategy.

The recommendation by Dr. Eileen de Villa, Toronto's medical officer of health, calls for a new public health strategy to address "vaccine hesitancy." It includes a proposal that would prevent students from skipping vaccines for non-medical reasons.

The growing movement against vaccines includes the reluctance or refusal to vaccinate due to concerns about possible side effects, including serious injuries and death. The City of Toronto estimates that some 20 per cent of parents in the city are vaccine hesitant.

However, Health Canada, the World Health Organization and a vast majority of health experts consider vaccinations a safe and effective tool at preventing the spread of harmful illnesses.

"Vaccination is one of the world's greatest public-health achievements, along with sanitation, antibiotics and clean drinking water," according to Health Canada.

On Monday morning, the city's board of health unanimously approved the new strategy to encourage vaccinations, though most of the recommendations are subject to approval by the provincial and federal governments.

The decision came after several Toronto residents vociferously demanded that the board reject the plan due to concerns that vaccinations are dangerous.

A look at the large crowd of anti-vaccine backers gathered in the city hall rotunda, cheering on speakers in the board of health meeting who are challenging <a href="https://twitter.com/TOPublicHealth?ref_src=twsrc%5Etfw">@TOPublicHealth</a> recommendations to end non-medical exemptions for Ontario schoolchildren. <a href="https://twitter.com/hashtag/cdnhealth?src=hash&ref_src=twsrc%5Etfw">#cdnhealth</a> <a href="https://twitter.com/hashtag/topoli?src=hash&ref_src=twsrc%5Etfw">#topoli</a> <a href="https://t.co/rxmBdXVj6O">pic.twitter.com/rxmBdXVj6O</a> —@LaurenPelley

'My body, my choice'

People attending the meeting shouted "shame" and "genocide" after the vote was taken.

"I do not consent to having myself nor my children force-vaccinated, drugged and medically induced in order to attend public schools in Canada," said Emanuela Caires during her deputation.

"I am not willing to subject this type of harm over benign childhood illnesses," added the mother of three unvaccinated children.

Catherine Condinho, an unvaccinated student, said the plan would take away her freedom of conscience and religion.

"This is my body, my choice," she said to the cheers of supporters, who filled the meeting room and city hall's atrium.

Elizabeth Kennedy, Nicolas Kaszap and their son, Sam, travelled from Ottawa to attend a rally against the proposed changes. (Evan Mitsui/CBC)

De Villa's report includes a range of recommendations to "improve vaccine acceptance," including removing exemptions, improving digital immunization records and developing a vaccine injury compensation fund.

The case for vaccinations

"Vaccines work, full stop," said Board of Health chair Joe Cressy. "There is an abundance of scientifically proven evidence demonstrating just that."

Cressy pointed to recent measles outbreaks in Canada, the United States and Europe as proof that vaccine hesitancy has potentially dangerous outcomes.

He said the plan will help Toronto prevent similar outbreaks, rather than reacting to them after they occur.

"People have the fundamental right to believe what they want, but they do not have the right to endanger others," Cressy added.

'I'm not prepared to wait for an outbreak,' said Joe Cressy, chair of Toronto's board of health. (Martin Trainor/CBC)

Last year, 1.72 per cent of Toronto students did not receive mumps and rubella vaccines due to philosophical and religious exemptions, up from 0.8 per cent in 2007.

While answering questions from board members, de Villa acknowledged that serious reactions can occur after vaccines are administered, though those instances are rare.

"That doesn't take away from the fact that [vaccines] are one of the most significant life-saving interventions that has occurred in medical history," she said.

While the recommendations were unanimously approved Monday, the provincial government previously indicated that it has no plans to update provincial regulations.

Under the Immunization of School Pupils Act, children are required to have proof of immunization for certain diseases to attend school in Ontario, unless there is a "valid medical exemption or affidavit of conscience or religious belief," said health ministry spokesperson Travis Kann.