Ontario’s top doctor is calling for a national immunization schedule and registry to address gaps exposed by the resurgence of measles in Canada — but first, he says his own province needs a centralized digital vaccine system.

Dr. Kieran Moore’s annual report, recently tabled with the provincial legislature, says a co-ordinated approach from all levels of government and the health-care system is needed to keep vaccine-preventable diseases at bay amid a rise in vaccine hesitancy.

Each province and territory has its own immunization schedule and data system but for more than 20 years, health-care providers and public health experts have been advocating for a national vaccine registry. The Canadian Paediatric Society has also called for vaccine schedules to be harmonized across the country since 1997.

In his report, Moore said Ontario is lagging behind other provinces who have modernized their vaccine records, including British Columbia, Quebec, Alberta, Manitoba and Nova Scotia.

This patchwork approach has led to confusion for parents who have become record keepers, and left public health officials in the dark when it comes to coverage gaps and inequities in access, making it difficult to respond to outbreaks.

Moore said this has also made it challenging to monitor vaccine effectiveness and safety, critical information as parental skepticism of routine immunizations doubled in Canada between 2019 and 2024. Childhood vaccination rates have also tumbled since the COVID-19 pandemic.

“Vaccine preventable diseases are an ongoing threat that can and will re-emerge if we let our guard down. A recent outbreak of measles in Ontario has unfortunately highlighted how quickly previously controlled diseases can spread,” Moore said in the report.