[Social inequalities and prevention: vaccination status of adolescents]

Abstract

2423 medical school files of adolescents aged 14 to 18 years were analysed according to five socio-economic categories in order to assess existing disparities in vaccine coverage. The poliomyelitis, tetanus and mumps vaccination coverage decreased progressively with decreasing social class. Depending on the type of vaccination, the risk of not being vaccinated was 1.5 to 4 times higher in children in the lowest socio-economic class than in those in the highest class. Disparities in vaccine coverage observed among very young children continued during childhood. Almost one quarter of adolescents in the lowest socio-economic category were not correctly vaccinated against tetanus and more than one third had not received the fourth dose of oral poliomyelitis vaccine which is recommended at the age of 6. Rubella vaccination in girls was the only type of vaccination which did not show any social gradient. Vaccination at school, such as that currently carried out for rubella, would be an effective strategy for reducing the social disparities in vaccine coverage. School health services should be able to play a more active role in preventing social inequalities in vaccination.