Impact of varicella vaccination on health care outcomes in Ontario, Canada: effect of a publicly funded program?

Varicella vaccines have been available for private purchase in Canada since 1998. Ontario introduced publicly funded varicella vaccination in 2004. We assessed the effects of private availability of varicella vaccines and subsequent implementation of a publicly funded vaccination program on varicella-related hospitalizations, emergency department (ED) use, and visits to physicians' offices in Ontario. Rates of hospitalizations, ED use, and office visits decreased 53% (95% CI, 48-58%), 43% (95% CI, 41-44%), and 45% (95% CI, 44-45%) after publicly funded vaccination, compared to only 9% (95% CI, 4-14%), 23% (95% CI, 22-24%), and 29% (95% CI, 28-29%) after private availability. Varicella vaccination is effective at reducing varicella-related health care use, with benefits extending beyond those who receive the vaccine. Publicly funded vaccination programs may be more effective than private vaccine availability.