Immunization Requirement for Licensed Child Care Settings

Ottawa Public Health (OPH) works with licensed child care settings operators to ensure that children under their care have up to date immunization records. According to the Child Care and Early Years Act , 2014(CCEYA), every licensee shall ensure that before a child is admitted to a licensed child care center it operates or to a premises where it oversees the provision of home child care the child is immunized as recommended by the local Medical Officer of Health. The immunization records must be kept up-to-date and available for inspection at all times. Parents should also provide a copy of the child’s immunization record to OPH.

OPH, within the guidance of immunization protocols provided by the Ministry of Health, assists the child care centre operators to assess the immunization status and maintain a record for all children enrolled in the licensed child care centres. Nurses will engage with licensed children care centres to provide information on collection and assessment of children’s immunization records, and provide ongoing support as necessary. OPH developed a tool for child care centre operators to screen immunization records upon registration. This tool will be reviewed during the nurse’s visit to the centre.

A standardized enrollment list template, also known as STIX, must be completed by all  licensed child care centres. Licensed child care centre operators are required to send the completed enrollment list by August 29. The enrollment list is sent to OPH using a secured method to ensure that personal information is kept safe (Secured File Transfer Protocol - SFTP).

The enrollment list is uploaded into the provincial database and used to create an immunization profile for each child in attendance at the licensed child care centre.  This upload  facilitates the search and assessment of existing immunization records.

It is important that the information provided in the enrollment list is correct to ensure that the profile created in the provincial database is accurate. The OPH nurse contacting the  centre will provide the necessary information on how to complete the enrollment list and how to use SFTP to send it to OPH.

It is a good practice to have written policies and procedures in place that provide guidelines related to immunization requirements for children, staff and volunteers in your centre. OPH has developed a policy template with minimum requirements related to immunizations. Licensed child care centres can adopt and/or modify the policy template to meet the more specific needs of their centre. You may download a copy of this policy template by clicking the link below:

Immunization for attendees and employees in a licensed child care centre policy template. 

Please note that Ottawa Public Health does not require children and employees, in licensed child care centres, to be screened for tuberculosis.

Ottawa Public Health's Medical Officer of Health recommends that children attending a child care centre in Ottawa be immunized as outlined in the current Publicly Funded Immunization Schedules for Ontario( or as current). Parents can refer to the Parenting in Ottawa website to learn more about the required immunizations for their child and where they can receive these immunizations. Parents should regularly review their child's immunization record with their child's health care provider to ensure that the record is up to date.

OPH has developed a tool to assist child care providers in determining if a child's immunization record is complete at the time of registration. Click the link below to download a printable version of this tool:

Immunization Assessment Tool

When reviewing the child’s immunization record, at enrollment time, if the record does not appear to be complete, the parent should be directed to consult with their child's health care provider or contact Ottawa Public Health at 613-580-6744 for an assessment and more in-depth review.

At 2 months old

Diseases, common trade name and factors to consider:

a) Diphtheria, Tetanus, Pertussis, Polio, Hib (DTaP-IPV-Hib) - 1^st dose

• Common trade names:Pentacel, Pediacel, Infanrix-IPV/Hib

b) Pneumococcal (Pneu-C-15/Pnu-C-13) - 1^st dose

•  Common trade name:  Vaxneuvance, Prevnar 13

c) Rotavirus  (Rot-1 ) – 1^st dose

• Common trade names: Rotarix (Rot-1)
• Only required for children 7 months or younger

At 4 months old

Diseases, common trade name and factors to consider:

a) Diphtheria, Tetanus, Pertussis, Polio, Hib (DTaP-IPV-Hib) - 2^nd dose

• Common trade names: Pentacel, Pediacel, Infanrix-IPV/Hib

b) Pneumococcal (Pneu-C-15/Pnu-c-13) - 2^nd dose

• Common trade name: Vaxneuvance,Prevnar 13

c) Rotavirus (Rot-1) - 2^nd dose

• Common trade names: Rotarix (Rot-1)
• Only required for children 7 months or younger

At 6 months old

Diseases, common trade name and factors to consider:

a) Diphtheria, Tetanus, Pertussis, Polio, Hib (DTaP-IPV-Hib) - 3^rd dose

• Common trade names: Pentacel, Pediacel, Infanrix-IPV/Hib

At 12 months old (must be received on or after the 1^st birthday)

Diseases, common trade name and factors to consider:

a) Measles, Mumps and Rubella  (MMR) - 1^st dose

• Common trade names: Priorix, M-M-R II

b) Meningococcal-C -C (Men-C-C) - 1^st dose

• Common trade names: Menjugate, Neisvac-C

c) Pneumococcal (Pneu-C-15, Pneu-C-13) - 3^rd dose

• Common trade name: Vaxneuvance, Prevnar 13

At 15 months old

Diseases, common trade name and factors to consider:

a) Varicella or Chickenpox (Var) – 1^st dose

• Common trade names: Varivax III, Varilrix

At 18 months old

Diseases, common trade name and factors to consider:

a) Diphtheria, Tetanus, Pertussis, Polio, Hib (DTaP-IPV-Hib) - 4^th dose

• Common trade names: Pentacel,Pediacel, Infanrix-IPV/Hib

Screening summary:

By the time a child is 18 months old, a child should have received the following:

• DTaP-IPV-Hib - 4 doses
• Pneumococcal - 3 doses
• Rotavirus – 2 (only if child is 7 months and younger)
• MMR, Varicella & Meningococcal - 1 dose

According to the Child Care and Early Years Act, 2014, “Every licensee of a child care centre shall ensure that, before commencing employment, every person employed in a child care centre it operates and every volunteer or student who is on an educational placement with the licensee has a health assessment and immunization as directed by the local medical officer of health.”

Ottawa’s Medical Officer of Health (MOH) requires all child care employees, students, and volunteers to have up-to-date immunizations as listed when they start work or an educational placement. There is no specific requirement for a health assessment in addition to these immunizations. The immunizations are to be kept on file by the childcare centre.

It is important that employees have up to date immunizations to protect themselves and the children under their care against vaccine preventable diseases. Note that, OPH does not collect and review the immunization records of employees.

All child care centre employees, students and volunteers are required to have the following up-to-date immunizations for employment:

Td/Tdap

Diseases, common trade name and factors to consider:

a) Tetanus, diphtheria/Tetanus, diphtheria, pertussis

• Common trade names: Td adsorbed (Td)Adacel (Tdap),Boostrix (Tdap)
  • 1 dose of Tdap in adulthood, then 1 dose of Td every 10 years

MMR

Diseases, common trade name and factors to consider:

a) Measles, Mumps and Rubella

• Common trade names: M-M-R II, Priorix
• If born in 1970 or later:
  • Minimum of 1 documented dose of MMR vaccine OR proof of immunity (blood test).
• If born before 1970:
  • Assumed to have natural immunity

Var

Diseases, common trade name and factors to consider:

a) Varicella or Chickenpox

• Common trade names: Varivax III, Varilrix
• History of chickenpox or shingles after 1 year of age (self-­reported), or
• 2 doses of Varicella vaccine, or
• Proof of immunity (blood test)

The following immunizations are strongly encouraged (but not required):

Influenza

Diseases, common trade name and factors to consider:

• Trade names of influenza vaccines available may vary every year
• Every year in the fall, at the start of the flu season
• Especially for employees caring for children under 5

HB

Diseases, common trade name and factors to consider:

a) Hepatitis B

• Common trade names: Engerix, Recombivax
• 2 or 3 doses depending on age
• Workers in child care centres where there is a child or worker who has acute HB or is a HB carrier should receive HB vaccine followed by immunity testing (blood test) 1 to 6 months after the last dose of HB vaccine. Because the HB status of children in child care centres is generally unknown, vaccination of all child care centre workers is strongly encouraged.

COVID-19

Annual COVID-19 vaccination plus an additional Spring dose for certain high-risk populations as outlined by the Ministry of Health.

Staff should review their immunization record regularly with their health care provider to ensure it is up-to-date.

Immunization for all employees working in child care centres - EN. An accessible format will be available shortly.

Please note that Ottawa Public Health does not require employees, in licensed child care centres, be screened for tuberculosis.

For more information, visit recommended immunizations for adults.

Reporting immunization information to OPH is the responsibility of the parent. It is important to inform parents to submit their child's immunization record and/or a copy of a medical or non-medical exemption to you and to OPH upon registration at your centre. Parents must also update OPH and their child care centre every time their child receives an immunization.

Parents can be directed to Parenting in Ottawa for more information related to immunization and the various methods that they can use to report their child's immunization to OPH, including the CANImmunize app for Apple and Android mobile devices.

OPH provides child care centres with copies of the "Report your Child's Vaccination" postcards to be given to parents. Please contact OPH at 613-580-6744 if you need additional copies. 

Children:

A parent of a child who cannot receive immunization(s) due to medical reasons, or a parent who requests an exemption due to non­-medical reasons, must complete a standardized ministry approved form and provide a copy to the child care operator and to OPH. 

Employees, students and volunteers:

Employees, students or volunteers who cannot receive immunization(s) due to medical reasons, or that request an exemption due to non-medical reasons, must complete a standardized ministry approved form and provide a copy to the child care operator. Note that, OPH does not collect and review the exemptions from employees.

Standardized forms:

Standardized medical or non-medical exemption forms, for children and employees, from the Ministry of Education can be found online at the Government of Ontario Central Forms Repository.

• Statement of Medical Exemption form
• Statement of Conscience or Religious Belief form

During an outbreak:

In the event of an outbreak related to a vaccine preventable disease, OPH may order the temporary exclusion of children and/or employees, students or volunteers who have incomplete immunization, a non-medical exemption and certain medical exemptions, until the risk related to the outbreak has ended. This is necessary in order to protect unvaccinated staff and children and to minimize the risk of spreading the disease.