Updated at 4:33 p.m. ET Friday
New York Gov. Andrew Cuomo signed a bill Thursday ending vaccination exemptions based on religious beliefs, the latest attempt to address the growing measles outbreak, the worst the U.S. has experienced in decades.
Cuomo said plugging the loophole should help contain the spike in measles cases in New York, the state hardest hit by the uptick in the contagious virus due to low vaccination rates in ultra-Orthodox communities.
"The science is crystal clear: Vaccines are safe, effective and the best way to keep our children safe," Cuomo said after signing the bill. "While I understand and respect freedom of religion, our first job is to protect the public health and by signing this measure into law, we will help prevent further transmissions and stop this outbreak right in its tracks."
The Democratic-controlled Legislature approved the measure, which also eliminates other nonmedical exemptions for schoolchildren across the state.
"We are facing an unprecedented public health crisis," said Sen. Brad Hoylman, the legislation's sponsor. "The atrocious peddlers of junk science and fraudulent medicine who we know as anti-vaxxers have spent years sowing unwarranted doubt and fear, but it is time for legislators to confront them head-on."
The exemption, which exists in some form in most states, allows parents of schoolchildren to cite their religious beliefs in opting their kids out of required vaccines. Supporters of keeping the religious exemptions say religious freedom should not be overpowered by state laws.
After the final vote tally was announced in the assembly, howling protesters, including the parents of unvaccinated children, filled the chamber, hurling expletives and chanting "shame on you" until lawmakers moved to recess.
Some backers of the bill have seen the measles outbreak up close, both in their districts and in their own homes, such as Assembly member Kenneth Zebrowski, who represents Rockland County. There, he noted, there have already been more than 266 confirmed measles cases, including 16 hospitalizations.
His 1-year-old daughter had to get her first vaccine shot at 6 months of age before her regularly scheduled immunization when she turned 1 recently.
"We had to get our kids overvaccinated," he said of his and other families in the district. "Because of this epidemic. I'm not particularly thrilled."
To those who question whether the recent measles outbreak in New York is indeed an epidemic, Zebrowski said that should not be the focus. The job of lawmakers, he said, is not to react to epidemics.
"Our job as legislators is to prevent epidemics," he said.
The Centers for Disease Control and Prevention reported last week that the number of new measles cases this year has exceeded 1,000, the highest count in 27 years.
Most of those new measles cases have been concentrated in ultra-Orthodox areas of New York, including Rockland County and parts of Brooklyn, adding urgency to the statewide debate around religious exemptions to vaccines.
The New York Assembly narrowly passed the bill by a 77-53 vote. It needed 76 votes for passage. Lawmakers in the state Senate advanced the measure by a tally of 36-26.
A small number of other states including California, Mississippi and Arizona have already passed laws banning vaccine exemptions on religious grounds. (Arizona law currently allows
for a parent to opt a child out of mandatory vaccinations because of "personal beliefs," but not on religious grounds. A proposed bill in the Arizona Legislature had sought to expand the vaccination exemptions to include religious beliefs, but it has stalled.)
In New York, about 96% of students have been immunized against measles, mumps and rubella, yet "a measles outbreak continues to affect communities in several parts of the state where the rate is lower," according to state health officials.
In the 2017-2018 school year, 26,217 students in New York, including those in public and private schools and children in day care and prekindergarten, had religious exemptions from vaccinations, officials said.
"Although the state can claim high immunization rates overall, preventable diseases like measles remain a public health threat when administrative loopholes allow children to go unvaccinated, carrying the potential to harm communities — and especially our most vulnerable residents," said Dr. Howard Zucker, the commissioner of the state Department of Health.
New York state Sen. John Liu, who represents Queens, said while he thinks removing the religious exemption is the right move, he has heard from constituents who hold "deep and sincere" religious beliefs who would be "absolutely outraged that anyone would suggest that they don't care about the health of their children." Liu suggested that the tenor of the debate on both sides could be more civil.
"We can respectfully disagree," Liu said.
The law eliminating religious exemptions takes effect immediately.
Unvaccinated students will have up to 30 days to show school officials they have received their first dose of each required immunization.
In April, New York City health officials declared a public health emergency because of the measles outbreak. Parents of unvaccinated children could be fined $1,000 for not complying with the order.
A previous version of this story misspelled a reference to Kenneth Zebrowski's last name as Zebrowsky.
Previously posted June 13: A previous version of this story misspelled several references to John Liu's last name as Lui.