To the Editor.
—Readers of THE JOURNAL may be interested in the development of the "Standards for Pediatric Immunization Practices" as announced by President Bush on May 11, 1992, and published April 14, 1993.1The National Vaccine Advisory Committee, composed of national and state public health officials, academicians, and consumers, approved similar recommendations in late April 1992 (these are unpublished). The Immunization Practices Advisory Committee of the Centers for Disease Control and Prevention (CDC) reviewed and approved the recommendations after formal adoption by the US Public Health Service.These points might be insignificant except for two factors. Nineteen standards were approved by the National Vaccine Advisory Committee, but only 18 appeared 2 weeks later when signed by the President. The eliminated standard read as follows: "Providers obtain permission to vaccinate a child from a parent, legal guardian, or an adult knowledgeable about the child's medical history and responsible for