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Immunization Information for Child Care Providers

Licensed child care centres and home child care agencies

Under the Child Care and Early Years Act, 2014:

  • Children require certain vaccines or a valid exemption to attend child care
  • Child care educators need one of the following before they can start working:
    • Vaccines directed by the medical officer of health, or
    • A valid exemption
  • Child care providers must keep current and complete files for each child and staff with vaccination information, such as original immunization record, and valid exemption forms
  • Child care providers must follow the direction of the medical officer of health, including:
    • Reporting the immunization records for children attending child care to public health
    • Providing public health with a list of children attending the child care centre or home child care agency
    • Not allowing staff and children who are unvaccinated or not fully vaccinated in the child care centre when there is an outbreak. This is to minimize the risk of spreading the disease and to protect unvaccinated staff and children.

Vaccination requirements

Children attending child care are required to have the following vaccinations or a valid exemption.

Child care providers working in Niagara are required to have either the vaccinations in the chart below or a valid exemption.

Child care educator vaccines directed by the Medical Officer of Health

Vaccine Direction

Hepatitis B (not publicly funded unless high-risk*)

Persons with hepatitis B may not show symptoms but can spread the virus through body fluids. For personal protection, all staff should be vaccinated.

  • Previously completed series**, or
  • 1 dose of hepatitis B-containing vaccine at the start of employment, and the entire vaccine series completed within 1 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

Measles, Mumps, Rubella (MMR)

Measles is very contagious and can spread through the air even after the infectious person has left the room.

  • 1 dose*** of MMR vaccine for adults born in or after 1970, or
  • Laboratory evidence of immunity
  • Adults born before 1970 are considered immune

Tetanus, Diphtheria, Pertussis (Tdap)

Tetanus (lockjaw) is naturally occurring in the soil. Pertussis, also called the "100 day cough" is very dangerous to young infants.

  • 1 dose of Tdap as an adult (18 years of age or older)
  • Booster of Td (Tetanus, Diphtheria) vaccine every 10 years thereafter

Varicella (chickenpox) - not publicly funded if born before 2000

Chickenpox can spread through the air, days before the rash is present. It can lead to severe complications.

  • Previously completed series, or
  • Self-report previous infection of chickenpox, or
  • Laboratory evidence of immunity, or
  • 2 doses of varicella-containing vaccine for those who do not meet any of the above criteria
    • 1 dose given at the start of employment, and the second dose completed within six months

*Household members, risk factors for sexually transmitted infections (STI) (multiple sexual partners, previous STI), injection drug use, men who have sex with men, chronic liver and kidney disease.

**Individuals may have received a two dose series of hepatitis B vaccine as part of a voluntary immunization program in school in Ontario

***A second dose of MMR is highly recommended if travel is planned.

Child care educator vaccines strongly encouraged by the Medical Officer of Health

Vaccine Strongly encouraged

Seasonal Influenza

Annual influenza vaccination is recommended for everyone. Children less than five years of age are at high risk of influenza-related complications. Influenza vaccine is also important for staff who have chronic health conditions.

Annual vaccination is strongly encouraged, no documentation required.

More information

  • Immunizations for students and volunteers
    • Although not a requirement for students and volunteers under The Child Care and Early Years Act, 2014 students and vaccinations should also receive the vaccinations listed in the chart above for their personal protection
    • They should see their health care provider to determine their immunization status and to get any missing vaccines
  • Immunizations for other persons in a home child care premise
    • The vaccine directions in the chart above apply to partners, spouses, frequent visitors, and adult children who reside in, or frequently visit the premise where a home child care service is operated, unless they are not responsible for child care provision
    • Any children age 17 or younger, residing in a home child care premise, are recommended to be immunized as per the Ministry of Health and Long-Term Care's publicly funded schedule
  • Vaccine costs

    Some vaccines are publicly funded (free) and others are not (fee-for-service)

    • Child care providers can find out if they are eligible for, and can access publicly funded vaccines through their doctor, walk-in clinic, or public health
    • Information on fee-for-service vaccines can be accessed through a doctor, walk-in clinic or pharmacy (many pharmacists can administer fee-for-service vaccines with a prescription as required)
  • Checking vaccination records

    For children

    The Child Care and Early Years Act, 2014 requires that child care educators ensure that a child enrolling in a child care program for the first time is current with their vaccinations:

    1. Have the child's parent or legal guardian complete the Child Care Immunization Form during registration. If you don't have a copy of the form, call 905-688-8248 or 1-888-505-6074 ext. 7425.
    2. Make two copies of the child's original immunization record. Keep one for your files.
    3. Send the completed Child Care Immunization Form and copy of the child's original immunization record to Public Health

    For staff

    Public Health doesn't collect staff immunization records or routinely review them.

    Encourage staff to call the Vaccine Preventable Disease program for any questions or concerns they may have about vaccines at 905-688-8248 or 1-888-505-6074 ext. 7425.

  • Exemptions from immunization

    Child care providers seeking exemptions from vaccination for religious, conscientious or medical reasons, must submit one of the Ministry of Education exemption forms

    • Child care providers submit their exemption form to their employer
    • Licensed home child care submit their exemption form to the licensed agency

    Name of form Requirements
    Statement of Conscience of Religious Belief Must be signed by a commissioner for taking affidavits

    Statement of Medical Exemption

    Must be signed by a health care provider and include their licence or registration number

    The child care licensee must collect and keep all exemption forms at the facility for review by a Ministry of Education licensing officer. These forms are not collected by Public Health.

  • Reporting to Public Health

    Child care providers must complete the Child Care / Nursery School Monthly Report Form by the 10th of each month whether there are changes or not. If you don't have a copy of the form, call 905-688-8248 or 1-888-505-6074 ext. 7425.

    When you have a new child enrol at your child care centre, you will need to follow the instructions under "Checking Vaccination Records" section for children.

    You don't need to report records for children who are also attending a publicly funded school or private school to Public Health. Their record retention falls under the Immunization of School Pupils Act.

    Parents are required to report their child's vaccinations to public health.

  • If there's an outbreak

    If there's an outbreak of a vaccine-preventable disease at the child care centre, unvaccinated and not fully vaccinated staff and children will be considered at risk. This means they may not be allowed to be at the child care centre until Public Health declares the outbreak is over.

  • Resources
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