To the Editor.
—In the April 14 issue of JAMA, Dr Shalala,1 secretary of the Department of Health and Human Services, fails to deal with reality concerning immunizations of children. Connecticut provides immunization material free, yet our rate of immunization is not much better than states that do not provide it. This is because parents fail to take advantage of the services available.Second, it is easy to say that we should screen every patient and immunize when necessary immediately in each and every encounter. Is the secretary advocating forced immunization without informed consent? I doubt it but it wasn't clear.