Vaccine compliance continues to be a challenging issue for medical group practice managers. This article explores the issue and highlights solutions that several members have pursued. It explores the pros and the cons of member examples, including terminating patients who refuse to have their children vaccinated and how providers can educate patients (and parents) while continuing to protect the safety of other patients in their practices. This piece takes a hard look at the practical realities MGMA members face when parents refuse to follow physicians’ orders for vaccination and what types of resources are available for providers, who struggle with next steps. The article poses the question: Up until now, we haven’t seen an epidemic of these preventable diseases large enough to create hysteria. But if the health of our citizens is put at risk when immunization rates become reduced, that might soon change. Are you ready?