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A pediatric practice faces the ethical and practical dilemma of whether to accept an 18-month-old child whose parents have chosen an alternative vaccine schedule, omitting key immunizations such as the measles, mumps, and rubella (MMR) vaccine. The case highlights the balance between respecting parental autonomy and ensuring public health safety. Two approaches are presented: accepting the child without mandating the MMR vaccine or declining care unless the vaccine is administered. The first argument emphasizes trust-building with vaccine-hesitant families, potentially increasing immunization rates over time, while the second highlights the risks of measles transmission and the responsibility to safeguard other patients. This discussion reflects broader challenges in vaccine hesitancy, ethical medical practices, and community health protection.