Since the debut of vaccines, global health has improved as diseases have become less common and, in some cases, eradicated. “Herd immunity,” the overall immunity established when a significant portion of a community is immune to a disease, can be achieved through widespread vaccination. The result of herd immunity is an extreme reduction in disease prevalence (Fine, Eames, & Heymann, 2011). Current herd immunity saves forty-two thousand lives and fourteen billion dollars each year in the United States in direct medical costs alone (Buttenheim, Jones, & Baras, 2012). Reaching the threshold of the number of individuals needed to achieve herd immunity has generally been a non-issue for countries. However, smaller-scale communities sometimes struggle to meet thresholds due to larger numbers of unvaccinated individuals. Individuals may not be vaccinated due to age, medical problems, or personal objections. Such objections can have many roots, including philosophical, moral, personal, and religious reluctance. Imdad et al. (2013) indicated that throughout the United States, while regulations for vaccination exemptions are determined on a state-by-state basis, the overall rate of exemptions for mandatory vaccinations granted for religious reasons has increased in recent years, when previously the rate of these exemptions the exemptions have remained constant. Individuals with religious exemptions for vaccinations are not only at greater risk of contracting vaccine-preventable diseases, but they also increase the risk to others. Individuals who cannot be vaccinated due to medical conditions or age are at greater risk from religiously exempt people, who may become infected and transmit the disease to them. Vaccinated individuals are also more... middle of paper ......449Marlow, L.A.V., Wardle, J., Forster, A.S., & Waller, J. (2009). Ethical differences in human papillomavirus awareness and vaccine acceptability. Journal of Epidemiology and Community Health, 63(12), 1010-1015. http://dx.doi.org/10.11 36/jech.2008.085886Muhsen, K., El-Hai, R.A., Amit-Aharon, A., Nehama, H., Gondia, M., Davidovitch, N., . . . Cohen, D. (2012). Risk factors related to underutilization of childhood vaccinations in ultra-Orthodox Jewish communities in Israel despite high access to health services. Vaccine, 30(12), 2109-2115. http://dx.doi.org/10.1016/j.vaccine.2012.01 .044Ruijs, W.L.M., Hautvast, J.L.A., van der Velden, K., de Vos, S., Knippenberg, H., & Hulscher, M.E. (2011 ). Religious subgroups influencing vaccination coverage in the Dutch Bible Belt: An ecological study. BMC Public Health, 11(1), 102. http://dx.doi.org/10.1186/1471-2458-11-102