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Four-year-old Sam Ledrew of St. John's, isn't bothered as he receives his H1N1 vaccination in 2009. The Canadian Medical Association wants schools to be able to request students’ immunization records.

Paul Daly/The Globe and Mail

Every student in Canada should be required to present a "declaration of immunization" before being admitted to school, the country's top doctors' group says.

The Canadian Medical Association stopped just short of calling for mandatory vaccination, but said much more must be done to figure out who is not vaccinated against once-common childhood diseases, and that parents who do not fully vaccinate should be obliged to explain why to public-health officials.

"The goal is to know the vaccination status of every child," Yun Jen, a public-health physician from Gatineau, said at the CMA's annual meeting.

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Dr. Jen said this would make it easier to identify unvaccinated children when there are outbreaks of disease, and allow public-health officials to educate parents on the benefits of immunization.

Cindy Forbes, the president of the CMA and a Halifax family physician, said doctors are firm believers in vaccination but don't want it to be mandatory because that "inflames the conversation."

"We feel education is the way to go," she said, adding that most parents who don't fully vaccinate have concerns, but they are not dogmatically anti-vaccine.

"We think this will improve immunization rates," Dr. Forbes said.

Currently, some provinces require proof of immunization for daycare or school admission, but the rules vary by jurisdiction and adherence to the rules can vary from school to school.

It can also be difficult for parents to track down this information because, in many provinces, it is collected by family doctors up to age 5, then by schools after that age. Electronic health records, where they exist, also tend to not be connected to vaccine databases.

The CMA also called for the creation of a national vaccine registry so all information is stored centrally and securely. This is particularly important because, in recent years, there have been a growing number of outbreaks such as measles, mumps and whooping cough.

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Delegates to the CMA's annual general council meeting also engaged in a heated debate about the need for a compensation plan for people who suffer debilitating injuries due to vaccination.

Denis Yahiaoui, a medical student at McGill University, said because getting vaccinated serves the public good, the people who, on rare occasions, are harmed in the process should be compensated by the state. He said it would also encourage those who are reluctant to get vaccinated.

But Lloyd Oppel, an emergency-room physician from Vancouver, said that creating such a plan sends a message that vaccines are dangerous, and they are not.

Currently, every country in the G8 has a public insurance plan of the kind, with the exception of Russia and Canada. In this country, only Quebec has a vaccine injury compensation plan. Since its creation in 1988, the program has paid out $4.2-million.

About 400,000 children are vaccinated in Canada each year, and fewer than five suffer serious vaccine injuries, according to the Canadian Paediatric Society.

Editor's note: This is an updated version of the story with the correct spelling of Dr. Yun Gen.

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