To the Editor.—
As a practicing public health officer, I find one element of the immunization recommendations by Krugman and Katz (237:2228-2230, 1977) to be somewhat impractical. Almost by definition, children not immunized during infancy are very likely not to return to the office for subsequent immunization visits. I therefore feel that the immunization schedule should be modified to provide simultaneous administration of these vaccines at the single initial visit: diphtheria, tetanus, and pertussis (DTP); trivalent oral poliovirus vaccine (TOPV); measles; rubella; and mumps. Information currently available suggests that this should be as effective in providing adequate immune response and as safe as the schedule currently recommended by Krugman and Katz and by the American Academy of Pediatrics, a schedule that does not give measles, rubella, and mumps vaccine until one month after the initial visit.