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.