Measles was declared eliminated in the United States in 2000, but in the midst of a growing anti-vaccination movement, it’s making a comeback. A state of emergency has been declared in the Pacific Northwest in response to 26 confirmed cases in Washington, and all three individuals affected by a separate outbreak in Georgia had not been vaccinated.

Children of anti-vaxxers seeking vaccinations against their parents’ wishes are caught in the rise of the anti-vaccination movement. States must equip these children with access to vaccinations and the resources to reverse misinformation while closing loopholes that allow families to opt out of vaccination requirements for personal reasons.

The risks to public health posed by personal objections to vaccines are very real. The World Health Organization lists “vaccine hesitancy” as one of the top 10 threats to global health in 2019, being responsible for a 30 percent increase in global measles cases. Many of the people who contracted measles in the outbreak in Washington state had not been vaccinated and were under 10 years old.

Even small shortcomings in vaccination rates — something possible with just a few anti-vaxxers — could cause a loss in the herd immunity effect intended to protect the few who can’t be vaccinated or for whom the vaccination was not successful. With the rise of the anti-vaxxer movement, groups of people who would once be protected by herd immunity are now becoming vulnerable, contributing to outbreaks.

States must be more aggressive in the fight against insufficient vaccinations and explore different approaches to limit the risks of anti-vaccination.

Helping children access vaccinations despite their parents’ objections is a valuable way to protect public health in communities where the risks are the greatest. Usually, a person must be 18 years of age to make medical decisions, but 15 states — Pennsylvania included — allow some decisions to be made by minors under the mature minor doctrine. Expanding the use of the mature minor doctrine for vaccinations can help push back on the damage done by the anti-vaccination movement

A small number of states, such as Ohio, extend causes for exemption beyond religious grounds to include personal objections as well. Ohio State University grants immunization exemptions for mere “good cause” but a 2014 on-campus mumps outbreak affecting hundreds of students caused university officials to recommend students receive vaccines. Encouraging states to close the loopholes that allow for personal objections may be an important step toward preventing the next outbreak.

Most importantly, states must acknowledge that “vaccine hesitancy” comes from a misunderstanding of medical history and technology. The CDC has attempted to reach out to misinformed parents and provide educational resources that recognize their desire to protect their children. States and school districts must also follow that lead.

The anti-vaccination movement is one of the most pressing threats to public health in this country. Adopting a wide-spectrum approach to countering its effects is the best and only way to permanently end the threat.