Immunization Information for Child Care Licensees

Licensee clarifications on how the Child Care and Early Years Act is implemented in Niagara.

If there's an outbreak of a vaccine-preventable disease at the child care centre, staff and children who have not received their vaccine(s) 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.

Staff refers to child care employees and contracted home child care providers (applies to partners, spouses, frequent visitors and adult children who routinely interact with the children) working in Niagara.

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 (child care employees and contracted home child care providers):
- Receive their annual flu shot
- Receive their annual COVID-19 vaccination every fall (specific high-risk populations may be eligible for a spring dose as well)
- 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
Provision of the immunization record and / or the reasons for exemption from immunization fulfils the Child Care and Early Years Act requirement for a health assessment for child care employees and contracted home child care providers (applies to partners, spouses, frequent visitors and adult children who routinely interact with the children) working in Niagara.

Niagara Region Public Health does not collect or routinely review staff immunization records. Public Health would only request these forms or staff immunization information if the child care facility had an outbreak.

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), or
- A valid exemption form (Statement of Medical Exemption or Statement of Conscience or Religious Belief)
A completed Employment Immunization Status for Child Care form can be used by the licensee to track the above.
- The form can be used for new hires
- The form is to be kept on file by the child care licensee. Niagara Region Public Health does not collect Employment Immunization Status for Child Care forms.
Immunization status of volunteers and students (including health assessment)

While the Medical Officer of Health recommends that all volunteers and students receive the same vaccinations as staff, immunization status, including the health assessment, does not need to be submitted to the licensee.
Immunization status of other persons in a home child care premise (including health assessment)

Partners, spouses, frequent visitors and adult children who live in or often visit a home child care premise may be required to submit their immunization status depending on how much they interact with the children.

If they routinely interact with the children in the child care, the directed vaccinations apply and their immunization status, including the health assessment must be submitted to the licensee.

For those who do not routinely interact with the children, the vaccine directions are not required, they are recommended. The immunization status (including health assessment) for these individuals does not need to submitted to the licensee.

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.

Immunization status of children attending child care

Public Health requests enrolment lists and immunization records for the children attending child care as per Ontario Regulation 137/15, Section 72 subsection.

A current enrolment list from each licensee is essential for Public Health to accurately assess the immunization status and exemptions of the children attending your child care centre. This is the only way Public Health can do any kind of immunization record review.

Licensees do not need to review children's immunization records to confirm whether or not a child is up-to-date. The Child Care and Early Years Act requirement to ensure children are immunized as directed by the local Medical Officer of Health is fulfilled by licensees who:

Collect and keep immunization information for new enrolments on file, and send copies to Public Health
Support Public Health's annual immunization record review
Remind parents / guardians to continue reporting each vaccination their child receives while attending child care to both their facility and to Public Health

Partnership between Public Health and licensees for the immunization record review process

Reporting new enrolments to Public Health
1. Have the child's parent or legal guardian complete the Child Care Immunization Information 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. Send the completed Child Care Immunization Form and the child’s immunization record (copy of their yellow card or valid Ministry of Education exemption form) 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
- Include Immunization Connect (ICON) printouts as these are generated from Public Health
Public Health will review the Child Care Immunization Information Form and corresponding immunization record for each new enrolment and follow up directly with parents / guardians of children with missing immunization information.
Monthly enrolment reporting to Public Health
- Submit the completed 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
- For new enrolments, attach each child's immunization record (copy of their yellow card or valid Ministry of Education exemption form) to the Child Care Immunization Form.
Public Health will follow up directly with parents / guardians of children with missing immunization information.
Annual immunization record review - 2026 timelines and roles
- April / May - Public Health will send all licensed child care centres and licensed home child care agencies a "Request for current enrolment information under the CCEYA" email with a blank Excel template attached. Please ensure you are prepared to submit your enrolment information in this format by the deadline requested.
- May / June - Public Health will send parents / legal guardians Immunization Record Reminder Notices if we are missing immunization information for their child
- June / July - If no response is received by the deadline in the Immunization Record Reminder Notice, Public Health may contact the licensee to collaborate on efforts to work towards a completed immunization record
Reminding parents / guardians to continue reporting their child's vaccinations
The Ontario Ministry of Health requires parents and legal guardians to report all vaccines for children under 18 years of age directly to Public Health. For children attending licensed child care, the Ministry of Education requires parents / guardians to also report this information to their child care provider.
Licensees can remind parents / guardians of this by sharing information sent by Public Health or directing them to the children in child care section of our website.
Using the MOVEit platform

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.