California lawmakers on Thursday approved one of the toughest mandatory vaccination requirements in the nation, moving to end exemptions from state immunization laws based on religious or other personal beliefs.

The measure, among the most controversial taken up by the Legislature this year, would require more children who enter day care and school to be vaccinated against diseases including measles and whooping cough.

Those with medical conditions such as allergies and immune-system deficiencies, confirmed by a physician, would be excused from immunization. And parents could still decline to vaccinate children who attend private home-based schools or public independent studies off campus.

It is unclear whether Gov. Jerry Brown will sign the measure, which grew out of concern about low vaccination rates in some communities and an outbreak of measles at Disneyland that ultimately infected more than 150 people.

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