It’s hard to argue with the premise that in the United States, some parents take lightly their ability to vaccinate children against childhood diseases. Recent studies suggest that as many as 21 percent of parents in the U.S. are delaying or refusing some or all of the recommended early childhood vaccines.

Schools in some areas — educated, upper-middle-class regions — have startlingly low vaccination rates: In one Washington state county, 72 percent of kindergarteners and 89 percent of sixth-graders are either not compliant with or exempt from vaccination requirements for school entry, and at a Bay Area Waldorf school I wrote about last year, only 23 percent of the incoming kindergarten class had been fully vaccinated.

That’s in the United States. In India and other developing countries, educated parents seem far less relaxed about the risks that measles, mumps, rubella or pertussis could present to their children. Instead of going to great lengths to delay or avoid vaccination, as some American parents do, mothers in the developing world may struggle to get to clinics and to get the required vaccinations.

Speaking by phone through a UNICEF translator, I was able to ask two mothers in Uttar Pradesh, India, to describe what it takes to get their children the protection they want them to have. The two women have been educated about vaccination through community outreach programs, and they are working to educate their families and other women in their areas.

Nimmi takes her 3-year-old son in a three-wheeled bicycle taxi, then a bus, then walks again to the hospital, a journey of about three hours. Sometimes, the vaccinations aren’t available; sometimes, there is no one to give them — there’s no way to know ahead of time. Nimmi keeps a careful record of Hamza’s shots (Harsha, my translator, described it as being amazingly detailed, and said that Hamza had gotten nearly all the shots he needs at his age), and takes extra sewing jobs to pay for their transportation. She’ll make this journey again many more times before Hamza is 5.

Her neighbor Shanno faces the same trip, and an added difficulty: Her husband and her mother-in-law forbade her to vaccinate their children. She has to travel in secret, and save money from her household accounts — and she has been able to vaccinate only her youngest child.

The United Nations Foundation is working with the Shot@Life Foundation to make getting vaccinations easier for mothers like Nimmi and Shanno. But among Shot@Life’s goals lies an irresistible irony: It seeks to rally the American public to support global vaccination while an increasingly large subset of that public doesn’t support fully vaccinating their children. This week, on the Shot@Life website, a pair of mothers from Portland, Ore., wrote about fundraising with their children’s preschool classroom. They collected enough change to vaccinate three children for life (about $20 per child), and painted the children’s pinkies the way doctors in Africa do to show which children have been vaccinated during a campaign.

But a study published online recently in the journal Pediatrics shows that rates of delaying or refusing vaccines in Portland tripled from 2006 to 2009.

Of course, the individual risk from common childhood diseases is much greater in the developing world than in the United States, both because of access to medical care and because of the success of vaccination overall. But the community benefits are the same: Every child who has had all of her shots protects not just herself, but others around her, including those who can’t be vaccinated themselves. India, and other countries with still-low childhood vaccination rates, stand on the verge of offering that protection to their population. In the United States, a few communities are at risk of losing it. Sometimes, I wonder how long it will be before Nimmi and Shanno are working to educate us.

Contact KJ Dell’Antonia at:

kj.dellantonia@nytimes.com