AUGUSTA — The Maine Senate voted 18-17 Tuesday to remove religious exemptions from the state’s school vaccination law, reversing a vote taken last week and setting the bill to significantly strengthen childhood vaccination requirements on course for final approval.

The administration of Gov. Janet Mills, a Democrat, offered testimony in support of removing the vaccination exemptions in Maine law. Last week, her staff also reaffirmed her support for the bill.

If she signs it into law, Maine would be the fourth state – following California, Mississippi and West Virginia – to ban all non-medical exemptions that allow parents to forgo school-required vaccines for their children.

Tuesday’s vote followed an impassioned debate by opponents, who said ending the religious exemption, as well as a philosophical exemption, would send thousands of families packing while doing little to improve public health or protect children from preventable diseases.

The mostly party-line vote, with Republicans in opposition and Democrats favoring the change, saw three Democrats join Republicans in a failed effort to preserve the religious exemption. But one Democrat who supported the exemption in a vote last week changed his position Tuesday, altering the results.

“We are pushing religious people out of our great state,” Sen. Lisa Keim, R-Dixfield, said before the vote. “And we will also be closing the door on religious people who may consider making Maine their home. We are fooling ourselves if we don’t believe an exodus would come about.”

But supporters of the bill said religious exemptions for preventable diseases put others at risk, especially children with compromised immune systems, like those recovering from childhood cancers or other illnesses.

Supporters also said they had no intention of driving families from Maine or children from public schools here.

“It is absolutely not now, and it never will be, my interest in keeping any child from his or her education,” said Sen. Brownie Carson, D-Harpswell.

Carson told the story of his granddaughter’s experience with childhood leukemia and the risk she ran during recovery because she could not be vaccinated against infectious diseases.

Maine has one of the worst vaccination rates for children entering kindergarten in the nation, and the country’s highest rate of pertussis, a vaccine-preventable disease also known as whooping cough.

State law now permits parents to skip vaccines for their children by signing a form opting out on philosophic and religious grounds. In the 2018-19 school year, 5.6 percent of Maine children entering kindergarten had non-medical exemptions for immunizations, state statistics show.

Dozens of parents who opposed eliminating the exemptions had gathered at the State House on Tuesday but declined comment when approached by a reporter after the Senate vote.

The bill has been one of the most controversial measures to move through the Legislature in recent years, drawing hundreds of people to the State House to testify on the bill at a public hearing before the Education Committee. The hearing lasted for more than 14 hours before ending in the early morning.

Many of those people testified in opposition, and dozens of them were on hand for the vote Tuesday.

Sen. James Dill, D-Old Town, a scientist who works for the University of Maine Cooperative Extension, supported the religious exemption in last week’s vote but changed his position Tuesday to push the measure through.

Dill said he was willing to change his position on the bill because he believed expanding categories of medical exemptions would satisfy most of the concerns he and many others had with the immunization requirements and schedule.

“As a scientist, I believe in vaccinations,” Dill said. “I voted the way I did the first vote to get people to take notice as we go forward. I believe the medical exemptions need to be broadened.”

Dill said additional testing before vaccinations are given could be allowed and the spacing between vaccinations should be lengthened based on a child’s reaction to them.

“There needs to be more testing of newborns for known genetic or other disorders, which may cause problems, which people then may link to vaccination,” he said. “The tests all need to be covered by insurance.”

One lawmaker charged that the specter of children with compromised immune systems was simply a “straw man” meant to scare people into supporting the bill, but Sen. Heather Sanborn, D-Portland, disagreed.

She then read portions of an impassioned letter from a mother in her district with a child who had a compromised immune system also from leukemia.

“These are real kids,” Sanborn said. “And they are real kids who had no choice in their medical experience.”

A motion in the House to accept a Senate version of the bill that would have restored the religious exemption failed by a 65-76 vote on May 7.

It’s unclear how much the measure will increase vaccination participation rates in Maine.

In 2015, California passed the first state law eliminating non-medical exemptions for required school vaccinations. Vaccine rates increased from 92.8 percent to 95.1 percent in the first two years following the bill’s passage, according to a study by the National Institutes of Health.

But the study also found that medical exemptions also increased dramatically, especially in regions of the state that previously had higher philosophical or religious exemption rates. Counties that had higher personal-belief exemptions saw medical exemptions increase from 0.2 percent to 0.7 percent, a 250 percent increase over the two-year period, the study found.

Opponents of the bill said the relatively small number of people taking a religious exemption in Maine has had no statistical impact on increased exposure to preventable diseases. Sen. David Miramant, D-Camden said many parents have obtained only partial exemptions and do vaccinate their children, although they may opt out of some of the vaccines or place their children on a schedule that is not compliant with the state’s regulation.

Miramant contended that 97 to 98 percent of students in Maine were receiving all or some of their vaccines. “We are in a range that should satisfy you and should not have you wanting to take away the choice of the people,” he said.

Others described the measure as a severe erosion of religious freedom and a direct attack on parental rights.

Sen. Brad Farrin, R-Skowhegan, brought up an earlier vote in the Senate, also along party lines, that approved a bill that would allow Medicaid patients in Maine to obtain abortions.

“Fundamentally, this vote isn’t about public health – it’s about how far is too far for the government to reach into our personal lives,” Farrin said. “A vote against this bill isn’t a vote against vaccinations – it’s a vote in support of parental choice and religious freedoms.”

The Maine Republican Party also criticized the vote.

“Maine is now known as a state where lawmakers are willing to violate their people’s religious freedom,” the party’s executive director, Jason Savage, said in an email.

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