West Virginia’s school-vaccination policy is the subject of continuing litigation and political conflict over religious exemptions. The state historically maintained one of the nation’s strictest school-entry vaccine requirements, allowing medical exemptions but not a general religious exemption. Supporters of broader exemptions emphasize religious liberty and parental authority. Opponents warn that falling vaccination rates can expose medically vulnerable students and increase outbreaks in schools. Community immunity occurs when enough people are protected against an infectious disease that transmission becomes less likely, indirectly protecting those who cannot be vaccinated. Parents deserve respect for sincere beliefs, but every child shares classrooms, buses, teams, and hallways with students who may face serious medical risk. An exemption policy has consequences beyond one household.