While the House bill removes the philosophical exemption for just the combined measles, mumps and rubella vaccine, the Senate measure seeks to remove such exemptions for any required school vaccinations.

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OLYMPIA, Wash. (AP) — As health officials monitor an outbreak concentrated in southwest Washington, the state House approved a measure that would remove parents’ ability to claim a personal or philosophical exemption to vaccinating their school-age children for measles.

The vote comes in the midst of an outbreak that has sickened at least 71 people — mostly children age 10 and younger. As of Wednesday, Clark County Public Health said that they were investigating an additional three suspected cases.

The Democratic-led chamber passed the bill on a 57-40 vote late Tuesday night and it now heads to the Senate, which is expected to vote in the coming days on its own bill, which is broader. While the House bill removes the philosophical exemption for just the combined measles, mumps and rubella vaccine, the Senate measure seeks to remove such exemptions for any required school vaccinations.

The measure is sponsored by a lawmaker from that region, Republican Rep. Paul Harris of Vancouver, who said that the measure “will make our communities safer.”

Harris said that while most of his caucus didn’t agree with the bill, he pointed to the nearly three dozen states — including those with Republican leadership — that currently don’t have the option of the philosophical exemption.

“This is a bipartisan issue,” he said during debate. Joining Harris in voting for the measure were fellow Republican Reps. Drew Stokesbary and Mary Dye. Two Democrats voted against it, Reps. Steve Kirby and Brian Blake.

Republicans initially introduced more than three dozen floor amendments, but withdrew most of them before the late night vote after majority Democrats agreed to accept a few of them, including one that exempts a child from the requirement if a parent or legal guardian presents a written certification that a biological parent or sibling has immune system problems or adverse reactions to a particular vaccine.

Republican Rep. Norma Smith of Clinton said that most of the communication she’s gotten from voters in her district was in opposition to the bill.

“Please recognize that this is a complex issue and that we need to respect the decisions made by families,” she said during floor debate. “For us to take an action which doesn’t allow them to have a voice, I believe is wrong.”

It’s unclear which measure Washington lawmakers will ultimately move forward with if the Senate passes its measure before next week’s deadline to get policy bills voted out of the chamber of origin. The 105-day legislative session ends April 28.

Washington is among 17 states that allow some type of non-medical vaccine exemption for “personal, moral or other beliefs,” according to the National Conference of State Legislatures.

In addition, medical and religious exemptions exist for attendance at the state’s public or private schools or licensed day-care centers.

Unless an exemption is claimed, children are required to be vaccinated against or show proof of acquired immunity for nearly a dozen diseases — including polio, whooping cough and mumps — before they can attend school or child care centers.

Four percent of Washington secondary school students have non-medical vaccine exemptions, the state Department of Health said. Of those, 3.7 percent of the exemptions are personal, and the rest are religious.

In Clark County — an area just north of Portland, Oregon, where all but one of the Washington cases are concentrated and where two suspected cases are being investigated — 6.7 percent of kindergartners had a non-medical exemption for the 2017-18 school year, health officials said.

Last Friday, Oregon announced a new case of the highly contagious disease unrelated to the ongoing outbreak in Washington state.

An unvaccinated Illinois resident who spent time overseas visited Portland International Airport and various locations in Salem, Oregon, while contagious with measles, the Oregon Health Authority said. Potential exposure locations include a Red Robin restaurant and a trampoline fun park in Salem, officials said.

Before Friday, Multnomah County —home to Portland — had identified four people with measles and one who could have measles. Those cases were thought to be connected to the outbreak in southwest Washington.