Sarah Day is a school nurse with “street cred” when it comes to the polarizing issue of vaccines on an idyllic island in Washington state known for its rural beauty, counterculture lifestyle and low immunization rates.

Since she began communal living on Vashon Island more than 20 years ago, the registered nurse has advocated for getting kids their shots against a loud contingent of anti-vaccine parents in the close-knit community of about 11,000 accessible only by ferry, a serene 20-minute ride from Seattle.

And it may now be working, thanks to a “perfect storm” of changes being felt on the island, Day said.