Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, and experiences in health behavior of individuals in a community. The development of a 20 question survey was guided by 4 research questions designed to evaluate any differences in Amish parents' decision to defer recommended childhood immunizations. Multivariate analysis of variance was used to evaluate the 4 research questions based on the 84 individual surveys received. Results revealed a significant link between knowledge, beliefs, and opinions toward immunization and immunization adherence. Results also revealed that age and gender had no effect on the relationship between knowledge, beliefs, attitudes, and opinions toward immunization adherence. This study contributes to positive social change by educating parents of Amish children as to why it is important to receive timely childhood immunizations; thereby, keeping their children safe from vaccine-preventable diseases.