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We read with interest the article by Bell et al1 regarding using the emergency department (ED) as a site for routine childhood immunizations. Although we strongly advocate universal, complete immunization of children (to do otherwise would be to profess ignorance of recent major outbreaks of measles, mumps, rubella, and pertussis),2 we do not support the concept of using the ED as the major "modus operandi." We believe that administering catch-up immunizations in an ED setting would be expensive, inefficient, and would reinforce the negative behavior of seeking incomplete, episodic, rather than comprehensive, medical care.