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Maine became the fourth state — joining California, Mississippi, and West Virginia — to end most non-medical exemptions for mandatory childhood vaccines, The Hill reports.

The state’s governor, Janet Mills (D), signed the bill, which eliminates religious and philosophical exemptions and will go into effect 90 days after the state legislature adjourns. Now, only doctors and pediatric primary care givers can determine if there is need for a medical exemption.

Maine reportedly has one of the highest rates of non-medical vaccine exemptions in the country. Last year, The Hill writes, the kindergarten vaccination opt-out rate was 5.6 percent, more than three times the national average. But with a confirmed case of measles in the state, it appears Maine’s government was not taking any chances. “It has become clear that we must act to ensure the health of our communities,” state Rep. Ryan Tipping (D) said.

Still, there are opponents to the new bill, who emphasize religious freedom. “We are pushing religious people out of our great state,” state Sen. Lisa Keim (R) said earlier this month. “And we will 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.” Tim O’Donnell

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