Toronto’s top doctor is calling on the province to consider scrapping philosophical and religious exemptions for immunizing students.

The city’s medical officer of health, Dr. Eileen de Villa, made the recommendation in a new report outlining Toronto Public Health’s strategy to address vaccine hesitancy.

Toronto Public Health offers vaccines directly to students to protect against human papillomavirus (HPV), meningitis and hepatitis B.

Public health officials estimate that in Canada, about 20 per cent of parents are “vaccine hesitant.”

“To respond to this growing threat and address the root causes of vaccine hesitancy, and maintain high vaccination rates, Toronto Public Health has developed a comprehensive strategy that involves health care providers, parents, students, educators, and government agencies at the provincial and national levels,” the report reads.

In the report, de Villa said the board of health should ask the province to consider removing philosophical and religious exemptions under the Immunization of School Pupils Act and only allow medical exemptions completed by a certified health care provider.

Toronto’s medical officer of health said another way to help combat vaccine hesitancy is to change advertising standards in the country to prevent misinformation from circulating. She said would also like to see social media organizations and major search engines develop guidelines to help filter out misinformation.

The report states that when “unscientific misinformation” circulates, it puts “vulnerable babies, cancer patients of all ages, and immune-compromised individuals at unnecessary and avoidable risk of serious complications, long-term disability, and the potential for death.”

“Messages describing the scientifically-proven benefits of vaccines need to be protected and maintained in an environment where misinformation and hoaxes can spread rapidly and unchecked, negatively influencing parents and contributing to vaccine hesitancy,” the report reads.

“Legislating restrictions on anti-vaccine information has to be balanced with the Charter right to free speech that all Canadians enjoy.”

Another recommendation put forward in the report includes asking Health Canada to consider creating a Vaccine Injury Compensation Program, which would support the few individuals who do suffer a serious side effect from a vaccine.

According to the report, approximately one out of one million to one out of 10 million doses administered result in serious reactions.

These types of compensation programs, which are government-funded, exist in 17 “high-income” countries but Quebec is the only province in Canada to establish one, the report states.

“Developing a vaccine injury compensation program in Ontario or nationally would strengthen vaccine acceptance, and provide strong ethical public health policy."