California lawmakers on Monday sent the governor a contentious bill that would impose one of the strictest school vaccination laws in the U.S. after a series of emotionally charged debates that followed a measles outbreak.

The state Senate reaffirmed the bill striking California’s personal belief exemption for immunizations. Mississippi and West Virginia are the only two states with such strict requirements in place. If the bill becomes law, medical exemptions would still be granted to children with serious health issues.

Democratic senators introduced the measure after an outbreak of measles at Disneyland in December infected over 100 people in the U.S. and Mexico.

Democratic Gov. Jerry Brown has not said if he would sign it.

“The governor believes that vaccinations are profoundly important and a major public health benefit, and any bill that reaches his desk will be closely considered,” governor’s spokesman Evan Westrup has repeated in recent days.

Children whose parents refuse vaccination can try to obtain a medical exemption or be home-schooled. Otherwise, school-age children who claim a personal belief exemption will need to get fully vaccinated by kindergarten and seventh grade, the state’s two vaccine checkpoints.

The measure has prompted the most heated legislative debate of the year with thousands of parents taking to social media and flooding the Capitol in recent weeks to oppose the bill at legislative hearings. They and some lawmakers say that the state is trampling on parental rights.

Despite the opposition, the bill passed the Senate and the Assembly with bipartisan support, although not a two-thirds threshold that would be needed to override a veto.

The Senate on Monday voted on changes made to the bill in the Assembly that make it easier to obtain medical exemptions. The amendment would allow doctors to use a family’s medical history as an evaluating factor.

The bill authors also agreed to establish a grandfather clause, allowing students who already claim a personal belief exemption to maintain it until their next vaccine checkpoint.

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