Since the early days 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 proportion 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 allows the United States to save forty-two thousand lives and fourteen billion dollars in direct medical costs alone each year (Buttenheim, Jones, & Baras, 2012). Reaching the threshold number of individuals necessary to achieve herd immunity has generally been achieved. is not a problem for countries. However, smaller-scale communities sometimes struggle to meet the thresholds due to larger numbers of unvaccinated people. Individuals may not be vaccinated due to age, medical issues or personal objections. Such objections can have many roots, including philosophical, moral, personal, and religious reluctance. Imdad et al. (2013) reported that across the United States, although regulations for vaccination exemptions are determined on a state-by-state basis, the overall rate of exemptions from mandatory vaccinations granted for religious reasons has increased in recent years, as previously the rate of these exemptions Exemptions have remained constant. People with religious exemptions for vaccinations are not only at greater risk of contracting vaccine-preventable diseases, but also increase the risk to others. People who cannot be vaccinated due to health conditions or age are at greater risk due to religiously exempt people, who can become infected and transmit diseases to them. Even vaccinated individuals are found in a larger...... middle of paper ......449Marlow, LAV, Wardle, J., Forster, AS & 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.2008.085886 Muhsen, K., El-Hai, RA, Amit-Aharon, A., Nehama, H., Gondia, M., Davidovitch, N., . . . Cohen, D. (2012). Risk factors for underutilization of childhood vaccinations in Israel's ultra-Orthodox Jewish communities despite high access to health services. Vaccine, 30(12), 2109-2115. http://dx.doi.org/10.1016/j.vaccine.2012.01.044Ruijs, WLM, Hautvast, JLA, van der Velden, K., de Vos, S., Knippenberg, H. and Hulscher, ME (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