AUGUSTA, Maine (AP) Maine could end non-medical exemptions for routine childhood vaccines required by schools and certain health care facilities by September 2021.

The House voted 78-59 on a Democrat’s bill Tuesday. Democrats control Maine’s House 88-56.

Multiple studies have debunked claims that measles, mumps and rubella vaccinations increase the risk for autism. Maine has one of the nation’s highest rates of pertussis, also known as whooping cough.

Oregon and Washington are considering similar bills.

But opponents argue Maine parents should remain able to opt-out on religious or philosophical grounds.

Republican Rep. Heidi Sampson has said Maine is stigmatizing thousands of kids who could face removal from school. Democratic Rep. Craig Hickman said the bill could increase fear of government.

Federal data shows Maine has among the highest rates of non-medical vaccine exemptions.