Rhode Island allows some exemptions, and clearly some exemptions are necessary. Some children cannot get vaccines for medical reasons. And we don’t want to create a situation where the families who are truly terrified of vaccines feel that they cannot send their child to public school; not only could this be a true hardship for families without the means to pay for private school, but we could end up with private schools filled with underimmunized children, creating a perfect breeding ground for vaccine-preventable diseases and causing outbreaks. But exemptions should be really hard to get. Many states allow “philosophical” objections, no questions asked—and that needs to be changed.