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Public health officials get a better shot at tracking immunizations


When the news came late one afternoon in February 2015 that a 14-year-old Niagara Region girl had tested positive for measles, the local public health unit was ready.

Staff in Niagara quickly reviewed the immunization records of almost 1,400 students in seven schools at risk of exposure to the disease, identifying those whose records were incomplete, who were partially immunized or unimmunized. They followed up with phone calls to the parents, saying their children needed to get their vaccinations up-to-date or be excluded from school.

By the time the bell rang the next morning, a list of such students was in the hands of all the principals. A total of 25 children were excluded until the risk subsided.

“Further spread of the disease was eliminated,” recalls Dr. Robin Williams, Ontario’s associate chief medical officer of health, noting that the timely and accurate information at the heart of the case came from a new repository that centralizes, integrates and standardizes vaccination records across the province.

The Panorama Immunization System, implemented by the Ministry of Health and Long-Term Care as of July 2014, has so far allowed public health units to collect, manage and store more than 83 million immunization records in Ontario.

Dr. Williams says the need for the system was underlined by crises such as the SARS outbreak in 2003, when she was a regional medical officer of health. Although SARS turned out not to be a vaccine-preventable disease, it led to a full review of the communicable disease system in Ontario. There were weaknesses and gaps in decades-old, paper-based vaccination records, she remembers, especially with disparate systems at each of the province’s 36 public health units. Immunizations were noted for parents on yellow cards that went missing or were forgotten in drawers. Duplicate and out-of-date records resulted in over- and under-immunization and an inability to quickly identify those at risk during outbreaks.

“We’re all speaking the same language now,” says Dr. Williams, noting that the system incorporates data such as vaccinations given at immunization clinics, recorded using mobile devices. Instead of yellow cards, parents have an electronic version of their child’s immunization status, accessible anywhere.

Work continues to expand the repository to include children earlier than school-age as well as adults, Dr. Williams adds. “We want to get all our kids – and all Ontarians – immunized with the right vaccination at the right time for the best protection. Panorama has helped us do this.”