Ontario doesn’t have a centralized vaccination registry, making it difficult for physicians, pharmacists, and patients to track immunizations across the healthcare system.

“Ontario’s doctors have long advocated for a provincewide centralized vaccine registry, most recently in our We Won’t Give Up advocacy campaign. Ontario does not currently have a single, reliable vaccine registry, which makes it difficult for physicians, pharmacists, and patients to track immunizations across the system. This hampers proper public health record management and increases the risk of missed or duplicate vaccinations,” the Ontario Medical Association (OMA) said in a statement.

This information gap can also lead to children being suspended from school over missing or incomplete records.

“Our objective is to find ways to help people catch up with immunizations to ensure that they’re protected against vaccine preventable diseases,” Piotr Oglaza, MD, chair in the Section of Public Health Physicians at the OMA and medical officer of health and CEO of Southeast Public Health, Kingston, Ontario, told Medscape News Canada.

“Increasing people’s choices about where they can get vaccinated increases vaccine coverage. Publicly funded vaccine records typically are entered into the respective health clinic’s or hospital’s electronic medical records system, with the caveat that there is no connection between the various systems where the immunizations are recorded,” explained Oglaza.

The Immunization of School Pupils Act requires local public health units to collect information on students’ immunization status for diseases including measles, tetanus, and polio. Parents assume that these vaccination records are automatically uploaded to a public health unit registry like the Panorama Inventory Module, but that process is not mandatory and is often overlooked.

Impact on Physicians and Families

This gap in information sharing affects physicians, as well as parents and children. If a patient presents to a doctor’s office or hospital emergency department, the attending physician has no way of knowing whether he or she has been vaccinated either partially or fully or if they’re in need of a booster. In addition, the need to respond to parents’ requests for these records is an unnecessary administrative burden on family physicians. Similarly, the need to bring the records to public health agencies or upload them online constitutes an unnecessary burden for parents.

“Also, in cases of families changing immunization jurisdictions, a provincewide electronic system for sharing records would prevent parents needing to contact their previous family doctor to obtain the information. Currently, in a scenario where children are enrolled in a new school, and public health is asking them to get their shots, the parents may know that their kids’ vaccines are up to date, but they have no way of proving it,” said Oglaza.

The measles outbreak in Ontario underscores the importance of creating a centralized registry to promote the best outcomes, said Jeffrey Pernica, MD, an infectious disease physician at McMaster Children's Hospital in Hamilton, Ontario, and co-chair in the Ontario Immunization Advisory Committee (OIAC), a scientific advisory body to Public Health Ontario.

“Just under a year ago, when the measles outbreak was raging, at McMaster Children’s Hospital, we were fielding calls from panicked parents, some of whose children were immunocompromised. They didn’t know if their children’s vaccinations were up to date, because there is no quick and easy way for them to verify this information. This is a major problem when we’re dealing with one of the most infectious diseases ever known to humanity. It caused significant issues at the local public health level, as well as for provincial public health, which coordinates outbreak response, and disease prevention and control,” Pernica told Medscape News Canada.

“Doctors at McMaster Children’s Hospital can check medical records for tests being done at Grand River Hospital or Sick Kids, for example, and are able to consult all the important medical information that doctors use to provide their patients with high-quality care. Vaccination isn’t part of that, but it’s the least sensitive information. It would be very helpful for people to have a one-stop shop for vaccination records,” said Pernica.

In 2024, the OIAC published a position paper outlining its recommendations for developing and implementing a comprehensive immunization registry in Ontario. “The Ontario Ministry of Health should consult and work in partnership with key immunization interest holders locally, provincially, and nationally to ensure that all healthcare providers, local and provincial public health, and members of the public have timely and equitable access to individual-level immunization records,” according to the OIAC.

Why Not a National Vaccination Registry?

Public health advocates are focusing on developing a provincial registry rather than a national one because in Canada, health falls under provincial jurisdiction. “Even a provincial system would be a significant improvement,” said Oglaza. “It’s a necessary next step. It’s easier to connect the provincial systems than to try to influence a national one. Anyone within a patient’s circle of care should have access to vaccination records. That’s the way of the future.”

Oglaza and Pernica reported having no relevant financial relationships.

Evra Taylor is a widely published freelance medical writer and reporter with 20 years’ experience covering a broad range of therapeutic sectors, including family health, cardiology, psychiatry, ophthalmology, and dermatology.