Immunization of School Pupils Act - Primary Care Advisory

Primary Care Advisory – ISPA

Public Health continues to enforce the Immunization of School Pupils Act (ISPA) for the 2025–2026 school year. Updated suspension timelines, vaccination record notices, and new Quick Reference resources are now available. Health care providers are asked to continue supporting vaccination, documentation, and parent guidance.

Key Timelines

Request for Vaccination Record Notices mailed to parents/guardians of students with incomplete vaccination records:
- Secondary students (Grades 9–12): mailed December 2025
- Elementary students (JK–Grade 8): mailed January–February 2026
ISPA Suspension Orders issued as final notice to students with incomplete records:
- Secondary students: mailed early March 2026; suspensions begin April 9, 2026
- Elementary students: mailed early April 2026; suspensions begin May 7, 2026

New Resource Available

A new Quick Reference Guide (page 2) is available to support primary care providers in navigating ISPA requirements and preventing common documentation errors.

Identifying Patients Requiring ISPA Vaccines

New EMR search tools, created with Amplify Care, help identify patients aged 0–18 missing ISPA-required vaccines.
Tools and user guides available at: Amplify Care – EMR Tools
Support: EMRTools@amplifycare.com

Actions Requested from Health Care Providers

Continue providing ISPA-required immunizations, documentation, and medical exemptions as clinically appropriate.
Refer to the Publicly Funded Vaccination Schedule and the included Quick Reference Guide.
Provide families with a copy of their child’s vaccination record following immunization and remind them to report vaccinations to Public Health via regionofwaterloo.ca/vaccines.

ISPA Quick Reference – Assessing Immunization Requirements

Vaccines required under ISPA: Tetanus, Diphtheria, Polio, Measles, Mumps, Rubella, Pertussis, Meningococcal, and Varicella (for children born 2010 or later).

Important note: OPV doses given after April 1, 2016, and IPV doses given on the same day as OPV are invalid.

Vaccine	ISPA Requirement	Common Errors Impacting ISPA Requirements
Diphtheria / Tetanus / Pertussis / Polio DTaP-IPV-Hib (Pentacel, Pediacel)	4-dose primary series before age 7	Fewer than 4 valid doses; Tdap given instead of DTaP before age 7; invalid intervals.
Tdap-IPV (Adacel-Polio, Boostrix-Polio)	1 dose after age 4 (ages 4–7), at least 6–12 months after Dose #4	Missing dose after primary series; dose given before age 4; invalid interval.
Tdap (Adacel, Boostrix)	1 adolescent dose 10 years after 4-year-old Tdap-IPV (typically ages 14–17)	Missing adolescent dose; interval less than 10 years.
Meningococcal Vaccines Men-C-C (Menjugate, NeisVac)	1 dose after 1 year of age	Dose given before age 1; no documented dose after age 1.
Men-C-ACYW-135 (Menactra, Menveo, Nimenrix)	1 dose between Grades 7–12 (typically in Grade 7)	No adolescent dose after Grade 8; assumption that childhood Men-C-C meets requirement.
MMR (Priorix, MMR II)	2 doses after 1 year of age	Only 1 documented dose; dose before age 1; invalid interval (<4 weeks).
Varicella (Varivax III, Varilrix)	2 doses after 1 year of age (born 2010 or later)	Only 1 documented dose; dose before age 1; invalid interval (<4 weeks).