This year has seen an alarming increase in the number of cases of the measles, a disease that seemed to have been eradicated by the turn of the century. Blame has rightly been placed on a newly envigorated anti-vaccine movement that thrives on junk science and fear.

The outbreak raises two crucial questions, which must be answered separately. There is only one answer to the first question — whether it is wise to refuse vaccinations. There is more than one answer to the second — how should the state respond to those who do.

Modern-day anti-vaccination hysteria began with a get-rich-quick scheme by a few innovative British trial lawyers. While preparing a lawsuit against vaccine manufacturers, these attorneys paid for a bogus 1998 medical study that linked the vaccine for measles, mumps and rubella to the development of autism in children.

That study has since been discredited, retracted by the journal that published it, and contradicted by proper medical studies. Its author was found responsible for multiple deceptions and unethical practices and barred from practicing medicine in Britain.

A separate panic over vaccines occurred around the same time regarding the use of thimerosal, a vaccine preservative. There was never any evidence that thimerosal had a link to autism, but its use was discontinued anyway at the turn of the century.

All of this leaves no room for rational skepticism about today's vaccines. They work, and they don't harm healthy children.

That is one issue. A separate issue is how far the state should go to combat this paranoia. Over the years — and even this week — politicians from both parties have engaged in inexcusable pandering to the anti-vaccinators. Today, the pendulum seems to have gone all the way in the opposite direction. The mere suggestion that parents should have any say in the matter is now considered crazy-talk.

Those framing the issue in such absolutist terms need to get a grip. This is still America, where parents have always been responsible for their own children. One cannot simply deploy the SWAT Team to administer forced vaccinations or remove the offspring of those who resist science and common sense.

The state has an interest in vaccinating as many people as possible. A failure to do so affects more than just the children of anti-vaccine zealots. Some people simply cannot be immunized — infants, children suffering certain diseases, and a small number of vaccine recipients for whom it is ineffective. When parents refuse to vaccinate their children, they are also endangering all of these people as well. The recent incident at Disneyland, in which at least four dozen children were infected with the measles, illustrates this.

As every parent knows, schools cause diseases to spread through even the healthiest communities. Children bring them to school, and children bring them home to their families. There is thus an enormous state interest in making sure children who do not get vaccinations are barred from attending them with other children.

In Marin County, California, where vaccination opt-out rates are extremely high, some pediatric practices simply refuse to see unvaccinated children, lest their offices become breeding grounds for dangerous diseases. These are both legitimate ways of dissuading parents from foolishness without resorting to fascism.

Parents have the natural and legal right to make most decisions for their young children. It would set a terrible precedent to criminalize decisions like this one and create an individual vaccination mandate.

But those who refuse should not expect to be included in society the same way.