The City of Toronto has moved toward closing a gap in monitoring immunization among its youngest residents.
As public-health officials scramble to contain a recent outbreak of measles – including at least six confirmed cases in Toronto – Medical Officer of Health David McKeown revealed on Wednesday that, despite a provincial requirement to monitor immunization in daycares, Toronto Public Health has not complied for the past 17 years due to a lack of funding.
Council unanimously approved a motion the same day for Dr. McKeown to submit an additional request in the 2015 budget to cover daycare immunization.
"We make sure that we're monitoring it in schools from JK to grade 12, but for those younger than that, we don't monitor it or enforce it," said Councillor Christin Carmichael Greb, who moved the urgent motion at council.
"I have a son who's 2 1/2. For me, I want to make sure the kids he's going to school with, that we know they're immunized." She added that the issue is particularly pressing given that daycare-aged children have often not yet received their second doses of immunization.
According to the province's guidelines, local boards of health are required to maintain a record of the immunization status of all children in daycares "to ensure that children are up-to-date with their immunizations … in order to identify children susceptible to vaccine-preventable diseases and for the prevention and control of vaccine-preventable diseases."
And while Toronto Public Health uses computer records to track and monitor the immunization status of school-aged children, Dr. McKeown said that, despite repeated funding requests in the past, the board has not been given the resources to run a similar program for daycares.
Launching such a program would cost the city about $40,000, with the remaining 75 per cent of the cost coming from the province.
"It's never been included in our budget," Dr. McKeown told reporters at City Hall. "We've tried in previous years to ask for the resources to implement the program. It's one of the few areas where we're not compliant with the Ontario public-health standards."
Dr. McKeown will bring his proposal on funding for the program to to the city's budget committee.
The debate follows a string of measles cases in Toronto – several of which involve patients who were not vaccinated against the highly infectious disease. Dr. McKeown said he does not consider the gap in oversight at daycares an "urgent problem," but the recent outbreak has raised alarms.
"The measles outbreak that we're having in this city has raised the importance of this program," he said. "None of the cases that have occurred so far with measles have been in a nursery. However, that is a population that we're concerned about. They should be as fully immunized as possible."
Mayor John Tory said he supports council's move.
"I would say in a budget of $240-million, it shouldn't be too hard to find that kind of money," he said.
However, the mayor did appear to question Dr. McKeown's comments about lack of funding, pointing to the fact that Toronto Public Health underspent its budget last year.
"But having said all that," Mr. Tory said, "let's just get on with it and get children the immunization they need against measles."