CHARLESTON, W.Va. (AP) — West Virginia's GOP-controlled state legislature voted Saturday to allow some students who don't attend traditional public schools to be exempt from state vaccination requirements that have long been held up as among the most strict in the country.

The bill was approved despite the objections of Republican Senate Health and Human Resources Chair Mike Maroney, a trained doctor, who called the bill “an embarrassment” and said he believed lawmakers were harming the state.

“I took an oath to do no harm. There's zero chance I can vote for this bill,” Maroney said before the bill passed the Senate 18-12. The House already approved a version of the bill in February and swiftly approved the Senate bill on Saturday, the last day of the state's 60-day legislative session.

“It’s a bad bill for West Virginia, it’s a step backward. There’s no question, no question there will be negative effects," Maroney said. He added, “It’s an embarrassment for me to be a part of it, it should be an embarrassment to everybody.”

West Virginia, with some of the lowest life expectancy rates in the U.S. and a quarter of all children living in poverty, is one of only two states, along with California, that don't permit nonmedical exemptions to vaccinations as a condition for school entry.

Mississippi had the same policy until July, when a judge allowed people to start citing religious beliefs to seek exemptions from state-mandated vaccinations that children must receive before attending day care or school.

The new proposed vaccine law in West Virginia, which now heads to the desk of Republican Gov. Jim Justice, allows virtual public school students to be exempt and for private and parochial schools to institute their own policies either exempting students or not.

All students participating in West Virginia school activities that result in competition, including but not limited to sports, still need to be vaccinated.

The bill stipulates parents can’t sue private schools and school owners, administrators, boards and staffers for deciding whether to allow exemptions or not, as long as the school provides families with a notice for parents to sign acknowledging the policy annually and upon enrollment.

“I personally do not urge passage, but your health committee urged passage of this bill,” Maroney said before introducing the bill in the Senate.

The bill’s original intent, as introduced in the state House of Delegates, was to eliminate vaccine requirements for students in public virtual schools. It was expanded in a House committee to allow private schools to set their own vaccination standards, unless a student participates in sanctioned athletics.

The bill also created a religious exemption for any child whose parents or guardians present a letter stating the child cannot be vaccinated for religious reasons. That was taken out in the Senate.

During the Senate Health Committee meeting earlier this week, West Virginia University School of Medicine Professor Dr. Alvin Moss argued for the bill, saying the state's current compulsory vaccination policy is medically unethical because it doesn’t allow informed consent.

The number of parents who don't want their children to receive vaccinations is growing, Moss said.

In 2017, the anti-vaccine requirement group West Virginians for Health Freedom had 300 families included as members. That number has grown to at least 3,000 members in 2024, Moss said.

Former West Virginia Republican Delegate Chanda Adkins, a group member, said during the meeting that religious families who don't want to vaccinate their children deserve to be able to live their convictions.

Former West Virginia Medical Association Dr. Lisa Costello disagreed, saying West Virginia’s current vaccine policy is the "gold standard" across the nation.

“West Virginia is seen as a national leader when it comes to our routine, child immunizations," she said, later adding, “Measles does not care if you go to private school or public school. Measles does not differentiate depending on where you go to school."

West Virginia law requires children to receive vaccines for chickenpox, hepatitis-b, measles, meningitis, mumps, diphtheria, polio, rubella, tetanus and whooping cough, unless they receive a medical exemption. West Virginia does not require COVID-19 vaccinations.