Keeping your immunizations (vaccinations) up-to-date is important for everyone. As a child care worker, you are at risk of exposure to communicable diseases such as varicella, measles, mumps, rubella, influenza and pertussis because of the close contact you have with children. You can also spread diseases to young children if you become ill.
Required immunizations for child care workers
- Tetanus, Diphtheria, Pertussis (Tdap) – for adults, one dose is needed, followed by Tetanus Diphtheria (Td) every ten years
- Measles, Mumps and Rubella (MMR) – for adults born in or after 1970, two doses of MMR vaccine are needed; adults born before 1970 can be considered immune
Child care centres can use this Pre-employment Immunization Form (PDF, 1 page, 430 kb) to gather immunization information from their staff.
Recommended immunizations and immunity testing
Annual influenza vaccination is recommended for everyone, but especially staff providing regular care to children less than 60 months of age. Children of this age are at high risk of influenza-related complications.
Staff with an unknown history of chickenpox disease should receive two doses of vaccine or have laboratory evidence of immunity or infection. Staff with a history of physician-diagnosed chickenpox are considered immune.
A three-dose series of hepatitis B vaccine (or laboratory evidence of immunity) is recommended for all child care staff. The vaccine is especially recommended for staff in centres where a child or worker has acute hepatitis B or is a hepatitis B carrier. However, children with hepatitis B infection are usually asymptomatic and you might not know the hepatitis B status of all children.
Staff may have received a two-dose series of hepatitis B vaccination as part of a voluntary immunization program in school in Ontario. A three-dose series of combined hepatitis A and B vaccine is also available.
Hepatitis B is a blood-borne virus.
A two-dose series of hepatitis A vaccine is recommended for all staff, including food handlers.
A three-dose series of combined hepatitis A and B vaccine is also available.
Hepatitis A is a virus that is shed in the stool. It is spread person-to-person by the fecal-oral route. Children who have hepatitis A often don’t show symptoms. Changing diapers means hepatitis A could spread to staff. Food handlers with hepatitis A infection who do not wash their hands after having a bowel movement can spread the virus to others through food preparation.
One dose is recommended for staff ages 50 years and older. Immunity is considered to be lifelong.
Recommendations for women of childbearing age
Women of childbearing age should have a blood test (titre test) done to check for immunity to the following infections:
- Varicella (chickenpox)
- Rubella (German measles)
- Parvovirus B19 (Fifth disease)
- Cytomegalovirus (CMV)
Tuberculosis screening is no longer required for staff working in licensed child care settings.
Exemptions from immunization
Amendments to the Child Care and Early Years Act, 2014, mean that as of August 29, 2016, licensed child care workers seeking exemptions from immunization for religious, conscientious or medical reasons must be submit one of the Ministry of Education exemption forms found below:
- 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
Exemptions made in writing prior to August 29, 2016 will expire on September 1, 2017 unless a new exemption using the Ministry of Education exemption form is submitted.
Submitting an exemption
If you are a licensed child care worker seeking exemption, you must submit a Ministry of Education Child Care and Early Years Act 2014 exemption form to your employer. The form will be kept on file at the child care centre for review by a Ministry of Education licensing officer.
Exemption forms from licensed child care workers are not collected by Public Health and do not need to be forwarded to us at this time.
If there is an outbreak of a vaccine-preventable disease, an employee who is not adequately immunized, or who has an exemption on file, may be excluded from working at the child care program until the outbreak is over. It is recommended that staff who are not immunized 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.