[Skip to Content]
[Skip to Content Landing]
October 31, 1977

Childhood Immunization Procedures-Reply

Author Affiliations

Duke University Medical Center Durham, NC

JAMA. 1977;238(18):1914. doi:10.1001/jama.1977.03280190016014

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Dr Nitzkin is quite correct in his approach. Those children whose attendance in health facilities is so sporadic and unreliable that one visit may be their only appearance certainly may receive simultaneously DTP, TOPV, measles, rubella, and mumps vaccine. This is certainly not ideal because the anticipated febrile and other possible responses from each may be additive, and, if there is any illness in the subsequent several days, it is further confusing to delineate its cause—from the vaccines or some intercurrent infection. However, one must be pragmatic, and the ideal can certainly be compromised to meet reality. There is no concern about the antigens interfering with one another in such a mass single administration schedule. The only caution relates to the surveillance of reactions.