Traveller Gypsies and childhood immunization: a study in east London.

The immunization status of the children of Traveller Gypsies presenting to two general practices and a paediatric accident and emergency department in east London between July 1988 and February 1990 was compared with that of a control group presenting to the same services. Study of parental reports and other records for 72 Traveller Gypsy children and 106 control children aged 10 months to six years revealed that Traveller Gypsy children had significantly lower completion rates for pertussis, measles, diphtheria/tetanus and poliomyelitis vaccines than the control group. The difference between the uptake of the first and third diphtheria/tetanus, pertussis and poliomyelitis vaccines was significantly greater among the Traveller Gypsy children than among the control group. The low immunization rates are due to poor access to services as well as rejection of certain vaccines by Traveller Gypsies. The 1990 general practitioner contract and reforms to the health service may result in decreased access for Traveller Gypsies unless steps are taken by family health services and district health authorities to meet the health care needs of this group. Possible solutions to this problem include outreach services to caravan sites, opportunistic immunization, better records and targeted health education.