Keeping kids healthy is a priority for parents, child care providers and communities alike, but sometimes it can be challenging. Schools and child care centres are settings where infectious diseases can be spread because children eat, play and learn close together and can easily spread germs to one another. Child care workers are also at risk for several diseases because of the close contact they have with children. Child care workers who are ill can also spread infectious diseases to young children. While not all diseases can be prevented, many can be through vaccination. Keeping vaccinations up-to-date is important for everyone.
In Ontario, the Child Care and Early Years Act (CCEYA) protects children from vaccine-preventable diseases that can be spread in child care centres. As per the Act, children in Ontario require certain vaccines to attend licensed child care centres, or they require a valid exemption for religious, conscientious or medical reasons. Likewise, prior to commencing employment, child care workers who will be working in licensed child care centres are required to be up to date with immunizations as recommended by the local medical officer of health or have a valid exemption.
Recommended immunizations for child care workers
Pre-Employment Immunization Form for Child Care Staff (PDF, 2 Pages, 971 KB)
Vaccine | Required documentation* |
---|---|
Tetanus, Diphtheria, Pertussis (Tdap) Tetanus is naturally occurring in the soil. Pertussis, also called the “100-day cough” is very dangerous to young infants. |
Documented one dose of Tdap as an adult, then Td vaccine booster every 10 years |
Measles, Mumps, Rubella (MMR) Measles is very contagious and can spread through the air even after the infectious person has left the room. |
Documented 2 doses OR Proof of immunity (if born in 1969 or earlier or a blood test) |
Varicella (chickenpox) Chickenpox can spread through the air days before the rash is present. It can lead to severe complications. |
Documented 2 doses given at least 6 weeks apart OR Proof of immunity (self-reported history of chickenpox or a blood test) |
Hepatitis B People with hepatitis B may not show symptoms but can spread the virus through body fluids. For personal protection, all staff should be vaccinated. |
Documented 2-4 dose series (as a child or adult) OR Proof of immunity Some may have received this vaccine in infancy, or as a combination hepatitis A/B vaccine for travel (e.g., Twinrix) |
*or a valid exemption (see below)
Vaccines and immunity testing strongly encouraged by the medical officer of health
Vaccine | Required documentation |
---|---|
Seasonal influenza
|
Annual vaccination, no documentation required |
Hepatitis A
|
Two or three** dose series, no documentation required. **Three-dose series if given as a combined hepatitis A/B vaccine |
Additional recommendations for women of childbearing age
Immunity testing for:
- Cytomegalovirus (CMV)
- Rubella (German measles)
- Parvovirus B19 (Fifth disease)
- Varicella (chickenpox)
Exemptions from immunization
Child care workers seeking exemptions from vaccination for religious, conscientious or medical reasons must submit to their employer one of the Ministry of Education exemption forms. The operator must collect and maintain the infomation on file at the child care centre for review by a Ministry of Education licensing officer. These forms are not collected by Public Health.
Name of Form | Requirements |
---|---|
Statement of Conscience or Religious Belief | Must be signed by a Commissioner for Taking Affidavits |
Statement of Medical Exemption | Must be signed by a healthcare provider and include their license or registration number |
Exclusion of unvaccinated staff
If there is an outbreak of a vaccine-preventable disease, Public Health may require that an employee who is not adequately immunized (including those with exemptions) be excluded from working at the child care program until the outbreak is over. It is recommended that staff who are not vaccinated (including those with exemptions) sign a document that clearly outlines the actions that your program will take in regards to employment (e.g., unpaid leave, paid time off, reassignment) in the event of an outbreak of a vaccine-preventable disease at the child care facility.
Tuberculosis screening
Tuberculosis screening is no longer required for staff working in licensed child care settings.