This report is based on the processing and analysis of data from the vaccination coverage survey conducted in Mayotte from June 6 to August 2, 2019. The objective of this study was to assess vaccination coverage among children and adolescents in order to better guide public policy on vaccination. The analyses focused on vaccination data collected from the health records of children aged 24–59 months, 7–11 years, and 14–16 years and were compared with those from the first vaccination coverage survey conducted in 2010. The results of this survey show that regardless of the vaccine type and age group considered, the proportion of children up to date with their vaccinations was always below the absolute target of 95%. However, among children aged 24–59 months, vaccination coverage for 7 of the 12 vaccine types studied (DTP, Coq, HiB, HepB, and BCG) ranged from 90% to 95%. MMR and Hepatitis B coverage exceeds 80% for all three age groups. The same applies to BCG, with the exception of 7- to 11-year-olds, who have slightly lower BCG coverage. In contrast, DTP, pertussis, and Hib coverage among 7- to 11-year-olds and 14- to 16-year-olds is largely insufficient. Pneumococcal coverage is low among children aged 24–59 months (71.7%) and among 7–11-year-olds (50.9%). The very low coverage for meningococcal C among children aged 24–59 months (13.3%) reflects the delay in implementing vaccination recommendations for this valence, which has been recommended in the vaccination schedule since 2017 and is mandatory for children born after 2018. Overall, vaccination coverage among children aged 24–59 months—significantly improved by the catch-up vaccination campaign conducted by Santé publique France in 2018—is close to the national average. Conversely, vaccination coverage in the two oldest age groups is largely insufficient, with only 41.4% of 7- to 11-year-olds and one-quarter of 14- to 16-year-olds up to date on at least 8 of the 12 tested valences. The existence of unvaccinated groups constitutes potential epidemic hotspots, the public health consequences of which can be significant. Several complementary strategies can be proposed to improve vaccination coverage. These strategies are based primarily on strengthening measures to monitor vaccination status, followed by individual catch-up vaccinations or a mass vaccination campaign to better combat vaccine-preventable diseases still present in Mayotte.