I leave it up to the family and their doctor to determine the sequence and timing. I have not yet had to deal with anyone that was adamently against vaccination but if I did I would make it very clear on their contract that if for any reason there was even a hint of an outbreak in the city of a disease they were not immunized from that they would be excluded from care but that fees would still be due since it was the parent's choice to take the risk not mine. I am thinking here of things like measles and whooping cough. The same would apply to a child that had special needs and was not allowed immunizations such as an egg allergy. The same potential exclusion would apply at my discretion.