Parents erupted in anger Thursday after state lawmakers advanced a bill that would make it harder for families in New Jersey to avoid getting their children shots based on religious grounds.

Moments after the state Assembly Health Committee at the Statehouse in Trenton approved the measure, dozens of people leapt to their feet shouting, "You are going to hell!" "Shame!" and "You Democrats destroy America!"

The outburst followed two hours of testimony from parents, grandparents and religious leaders, which ranged from indignant and pleading to tearful and angry.

It took 20 minutes for Chairman Herb Conaway, D-Burlington, also the bill's sponsor, to read the names of opponents who declined to testify.

Under the bill, families who avoid getting their children shots based on religious grounds would have to submit a notarized letter explaining how vaccinations violates their faith.

The opponents called the proposal burdensome, intrusive and discriminatory, and sharply questioned why the government had the right to judge their beliefs.

Some said they would feel compelled to home-school their children, to protect them from the potentially harmful side effects of vaccines, which many said they had seen first-hand.

"My rights as a citizen are in jeopardy despite being protected by the constitution," Hilary Bilkis of Rockaway testified. "What will be the litmus test? Who will be the one to enforce it?"

Ashley Blackwell of Old Bridge said because vaccines are aborted fetal tissue, she "could not go against the word of God" by allowing that material to enter her child's body.

"A parent's choice is none of your business," she told the committee.

New Jersey's religious exemption requires only that parents send the school district a letter stating vaccines violate their family's religious beliefs.

Schools granted more than 10,000 students, or 2 percent of the student population, religious exemption during the 2016-17 academic year, according to the state Department of Education.

But public health experts have argued the religious exemption functions more like a philosophical protest, which puts children at risk of contracting mumps, measles, whooping cough and other preventable and potentially serious diseases that vaccines have all but wiped out.

Lawmakers have attempted to tighten the rules for six years with no success.

Michael Weinstein, director of the New Jersey Immunization Network -- one of two people who testified in support of the bill, said he saw it as a way to "enhance public health, and not as a restriction to on religious belief." The law would "rein-in what I like to call an exemption of convenience, to bypass the mandate."

The legislation (A3818) says parents who want to claim a religious exemption must submit a notarized statement to the school explaining how permitting their child to be vaccinated "would violate, contradict, or otherwise be inconsistent" with a tenet or practice.

The letter must show the parents' request is not solely based on "political, sociological, philosophical, or moral views, or concerns related to the safety or efficacy of the vaccination."

The parents also must include a statement that says they understand the risks and benefits of vaccines, and that the Health Commissioner may exclude their unvaccinated child from school in the event of a communicable disease threat.

Finally, a doctor or other medical professional designated by the state must verify in writing the parents have been counseled to the risks of declining vaccine for their child, according to the bill

The committee vote was 7-3, with two Republicans and Democratic Assemblyman Tim Eustace of Bergen County voting no. Eustace said his adopted children were born HIV positive. "I had to make a decision on what kinds of vaccination they would have. I had the luxury of making that decision for my children," he said.

After the hearing, Conaway said he thought the bill struck the proper balance between public health and religious expression.

"This will provide for a clear and consistent approach to vaccinations for students at any educational level in the state, and will do so in a way that protects the children of New Jersey and those with whom they come in contact against serious communicable diseases," said Conway, a physician.

"Meanwhile, we'd allow appropriate exceptions based only upon valid medical reasons and genuine religious objections. This is the right and moral thing to do, and in the end, it's just also common sense based on science."

The bill now advances to the full 80-member Assembly.

Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.