In the August 1995 issue of the Archives, Woodin et al1 presented an interesting survey of physicians and parents regarding multiple immunizations given by separate injections at health visits. This is interesting information and should be used accordingly by those who are working on the technology to combine many antigens, so that a single injection would be polyvalent. Until that time, however, if one uses the already available diphtheria-tetanuspertussis toxoids (DTP) plus Haemophilus influenzae type b (Hib) conjugate combination, there is no need for more than two injections per visit, with the sole exception of that after the first birthday, when one might administer the combination of DTP and Hib conjugate vaccine (DTP-Hib) with measles-mumps-rubella (MMR) and varicella-zoster vaccine (VZV).
Our neighbors in Canada already have available to them a combined vaccine that includes DTP, Hib conjugate, and inactivated polio (IPV). With the demonstrated success in overseas trials of
Katz SL. The Need for Combination Vaccines. Arch Pediatr Adolesc Med. 1996;150(3):330-331. doi:10.1001/archpedi.1996.02170280100025