PORTLAND — With a measles outbreak creating alarm around the country, Maine lawmakers are proposing legislation that would either eliminate philosophical exemptions for childhood vaccinations, or require parents to consult doctors before receiving non-medical exemptions for their children.

Vaccination opponents, meanwhile, claim the medicines can harm children. They are pressing for additional protections for parents who decide not to vaccinate or believe their children have been “vaccine-injured.”

Under state law, parents are required to provide proof of immunization for preventable diseases like measles, mumps, rubella, pertussis and polio, before enrolling children in public school — unless they receive an exemption for medical reasons, or for sincere religious or philosophical opposition.

Advocates for tighter regulation of non-medical exemptions note that Maine now has one of the highest percentages of non-vaccinated children entering kindergarten in the country.

According to the U.S. Centers for Disease Control, 5.5 percent of incoming Maine kindergartners, or 852 students in the 2013-2014 school year, were not immunized, an increase from 4.3 percent the previous year.

Of non-immunized students, 766, or 90 percent, had philosophical exemptions, according to the CDC.

The concern is that if the if the number of non-immunized students continues to grow, it could compromise the so-called “herd immunity” created by the overwhelming number of immunized people, state Rep. Ralph Tucker, D-Brunswick, said.

Tucker has proposed a bill that would eliminate the philosophical exemption.

“My goal is to get the percentage of unvaccinated kids in schools down,” Tucker said. “I’m looking for performance.”

He said he is trying to protect school-age children who may not be able to receive vaccinations because of weak immune systems from serious health problems, or younger kids who aren’t old enough to get vaccinated.

Tucker proposed his bill before a recent measles outbreak in California refocused the nation’s attention on the vaccine issue, he said.

The California Department of Public Health has confirmed 92 cases of the disease since December. Fifty-nine of the cases have been linked to an outbreak at Disneyland in Anaheim, California.

While the last confirmed case of measles in Maine was in 1997 and the state has not seen cases of mumps or rubella, there is a continuing outbreak of pertussis, or whooping cough, in the state, Maine Center for Disease Control Director Sheila Pinette said.

According to the Maine CDC, there have been nearly 1,700 cases of the highly infectious respiratory disease since 2012, including 53 this year.

Eliminating the vaccination exemption is the clearest and most effective way to resolve the problem without adding further requirements for doctors and parents, Tucker said.

“I’m prepared to make the political calculation that this is a legislative matter and the exemption should be eliminated,” Tucker said. “I’m not prepared to kick the can down the road and leave it for the doctors to figure out.”

Two other Democratic legislators, Rep. Richard Farnsworth, who represents part of Portland, and Rep. Linda Sanborn, of Gorham, have proposed a bill that would require parents to provide written confirmation that they have consulted with a primary-care provider before receiving a non-medical exemption.

“I still believe people do have legitimate, philosophical reasons why they don’t do it,” Farnsworth said. Consulting with a physician could also help educate people who might be on the fence about vaccinating their children, he noted.

“My thinking is that if we give them the appropriate information, they might say ‘well, maybe it wouldn’t be such a good idea not to vaccinate,'” Farnsworth said.

Sanborn said the aim is to keep open lines of communication and encourage trust and respect between skeptical parents and their physicians.

“I think we need to respect the parents and where they are at, and hopefully they will have trust in their primary-care physician,” she said.

While their proposed bill has not yet been printed, Sanborn said she intends to add language that would eliminate the “philosophical” and “religious” descriptions, replacing them with “medical” or “non-medical” exemptions. The consultation requirement would apply to all non-medical exemptions.

Discussions about immunization are expected during routine visits to a primary-care physician and should not include extra medical expenses for parents, Sanborn said.

But the prospect of either eliminating exemptions or requiring informed consent angers vaccination critics like Ginger Taylor, a Brunswick mother and director of the Maine Coalition for Vaccine Choice.

Instead of penalizing and attacking parents for questioning the efficacy and safety of vaccines, the state should be supporting those who believe their children have been “vaccine-injured,” like her own son, who has autism, Taylor said.

Republican state Sen. Garrett Mason of Lisbon Falls is sponsoring the Vaccine Choice Consumer Protection Act, drawn up by Taylor, which would create a vaccine injury office in the Maine Department of Health and Human Services, advertise vaccine injury in the state, and establish a complaint and review process for families asking specific questions, among other measures.

Mason did not respond to an email and phone call requesting comment.

The proposals drawn up by Tucker, Farnsworth and Sanborn are discriminatory and inappropriate, Taylor said.

Requiring consultation with a physician would amount to a “forced sales pitch,” she said.

“We shouldn’t be legally compelled to be in a sales pitch for a corrupt, broken program,” Taylor said. “And I am certainly not going to be judged and get paperwork filed that I am a bad parent for making this choice, because I know it is the right choice for my child.”

The fact that more Maine parents are deciding not to vaccinate their children only shows that people in the state are thinking more independently, Taylor said.

She said so far no one has died from the measles, so people are getting worked up about an “imaginary problem that might occur down the road.”

But Farnsworth noted that some parents may be misinformed by things they read on the Internet relating to vaccinations, without being fully informed.

“There’s so much garbage out there right now,” he said. Constituents have contacted him about the dangers of vaccinations and have suggested alternative treatments for disease, including using natural honey to build a natural immunity.

“From my estimation, I think it’s a lot of baloney,” Farnsworth said.

Peter L. McGuire can be reached at 781-3661 ext. 1oo or pmcguire@sunmediagroup.net. Follow him on Twitter @PeteL_McGuire.