Disparities in varicella vaccine coverage in the absence of public funding

Varicella vaccine has been licensed in Canada since December 1998 but not provided free in all provinces. Through a cross-sectional telephone survey to a random sample of parents, we assessed factors associated with varicella vaccine uptake in the absence of public funding. Parents of children aged 2–3 years (Group I) and 6–7 years (Group II) were contacted between March and May 2003 in British Columbia, Canada. Response rate was 82% (Group I = 571; Group II = 704). Among susceptible children, varicella vaccine coverage was 21% (95% CI 18–25%) and 28% (95% CI 22–33%), respectively. There were significant disparities in vaccine coverage based on income and residence. Physician or nurse recommendation was a strong determinant of vaccine uptake as were belief in the safety and efficacy of vaccine. Among parents of susceptible children, 59% (343/582) would vaccinate their child if it were provided free; 25% (148/582) were undecided.