This booklet outlines 18 national standards for pediatric immunizations. The standards were developed by a 35-member working group drawn from 24 different public and private sector organizations and from numerous state and local health departments and approved by the U.S. Public Health Service. The first three standards state that: immunization services should be readily available; there should be no barriers or unnecessary prerequisites to the receipt of vaccines; immunization services should be available free or for a minimal fee. Standards 4-18 also state that providers should: (1) use all clinical encounters to screen and, when indicated, immunize children; (2) educate parents and guardians about immunization in general terms; (3) question parents or guardians about contraindications and before immunization, inform them of the risks and benefits of specific immunizations; (4) follow only true contraindications; (5) administer simultaneously all vaccine doses for which a child is eligible at the time of each visit; (6) use accurate and complete recording procedures; (7) co-schedule immunization appointments in conjunction with appointments for other child health services; (8) report adverse events following immunization promptly; (9) operate a tracking system; (10) adhere to appropriate procedures for vaccine management; (11) conduct semiannual audits to assess immunization coverage levels; (12) maintain up-to-date, easily retrievable medical protocols; (13) operate with patient-oriented and community-based approaches; (14) have vaccines administered by properly trained individuals; and (15) receive ongoing education and training on current immunization recommendations. A guide that lists contraindications and precautions to the administration of several vaccines is appended. (MDM)