Pediatric vaccination is one of the cornerstones of public health strategy. Despite their proven effectiveness, a proportion of the population habitually remains unvaccinated; vaccine-preventable infections therefore represent an incremental and avoidable economic burden. The extent of this burden depends on the changing epidemiology of each particular agent. The objective here was to estimate the past and present epidemiologic burden of severe vaccine-preventable illness in Canada. Data on children (age<15 years) hospitalized with influenza (and lower respiratory tract infections), measles, mumps, meningitis, rubella, pertussis, or varicella were identified by International Classification of Diseases (ICD) codes for years 2004 to 2014 from the national Discharge Abstract Database. Counts were stratified by province, age, and sex. Data on population size were obtained from Statistics Canada, and used to estimate rates of infectious disease hospitalization per 100,000 population. Data were compared over time, modelled using Poisson regression, and trends compared across provinces. There were 1,845 hospitalizations for infectious diseases among children in 2004/05, increasing to 1,909 hospitalizations in 2014/15. National hospitalization rates per 100,000 children aged <15 years in 2004/05 were: 12.2 (influenza), 0.1 (measles), 8.0 (meningitis), 0.2 (mumps), 4.6 (pertussis), and 7.1 (varicella). Counts of rubella were not reported in 2004. In 2014/15, national rates were 20.1 (influenza), 0.2 (measles), 9.4 (meningitis), 0.3 (mumps), 1.8 (pertussis), 0.02 (rubella) and 1.4 (varicella). Temporal trends observed were consistent when considered according to province. While severe vaccine-preventable illness among children in Canada occurs infrequently, nonetheless almost 2,000 hospitalizations occur annually for these conditions. While in general rates of severe infections are constant and low, as expected, rates of illnesses prevented by more newly-introduced vaccines (e.g. pertussis and varicella) are declining. Understanding the attributable length of stay and frequency of sequelae will be important to accurately estimate the associated economic burden.