Vaccine hesitancy poses a growing threat to the success of vaccination efforts worldwide. In the United States, support for routine childhood vaccination, as reflected in national vaccination rates, has remained very strong despite concerns among some parents over the necessity or safety of recommended vaccines.1 However, national vaccination coverage data mask the presence of clusters of large numbers of unvaccinated children in specific communities,2 which understates the risks of vaccine-preventable diseases for these individuals and those around them, as well as the magnitude of the challenge that public health officials face when outbreaks occur in these areas.