Public health advocates vowed Wednesday to continue fighting for stricter school vaccination requirements in upcoming years, despite falling short in a late-night attempt on Tuesday to override a veto by Gov. Paul LePage.

“There’s no doubt that this bill – or something like it – will be back,” said Deb Deatrick, senior vice president of community health for MaineHealth, the parent company of Maine Medical Center. Deatrick compared the vaccination debate to other public health campaigns – such as banning smoking in public places – that took several attempts in the Legislature before succeeding.

On Tuesday, the Maine House fell five votes short of a veto override on a bill that would have made it more difficult for parents to opt out of vaccinations required for school.

With strong majorities in both the House and Senate, the bill would have become law if LePage had signed the bill. LePage said in his veto message that he supports vaccinations but believed the bill infringes on parental rights. An override requires two-thirds of those present to vote in favor of the override.

The bill – which is now dead – would have required that parents opting out on philosophic grounds consult with a medical professional and obtain a signature before being allowed to forgo vaccines for their children.

LePage vetoed the vaccine bill in the final hours on the last day he could do so before the bill would have become law without his signature. The House vote was 83-49 with 19 absent, with 88 votes needed for an override.

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Maine has one of the highest vaccine opt-out rates in the country, and public health experts say the state is at risk of infectious disease outbreaks, including chicken pox, whooping cough, measles and mumps. Maine’s voluntary opt-out rates for children entering kindergarten is 3.9 percent for the current school year, and 5.2 percent for the 2013-14 school year, the fifth-worst vaccination rate in the United States. While the statewide results are available for the current school year, the U.S. Centers for Disease Control won’t report the 2014-15 school year results for the other 49 states until later this year.

Numerous studies have proven that vaccines are overwhelmingly safe and effective, however, some parents continue to fear that the vaccines cause autism or other injuries. A 1990s study that linked autism with vaccines has been debunked and retracted, and hundreds of other studies have not shown a link to autism.

Rep. David Sawicki, R-Auburn, who in May had compared vaccine requirements to the “horrors of Nazi Germany,” told the Press Herald on Wednesday that he’s glad the bill failed.

“I believe independent adults can make an informed choice,” Sawicki said.

LePage, in his veto message, said “children should be vaccinated” but he also agreed that parents should have freedom of choice.

But public health advocates say unlike deciding what to buy at a store, choosing not to vaccinate can have detrimental effects on the community. Herd immunity, which protects people who for medical reasons can’t be vaccinated, starts to wane for some diseases when less than 95 percent of the population is immunized. When herd immunity breaks down, infectious diseases can spread more easily.

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Most at risk are infants not old enough to get their vaccines, the elderly and the immune-compromised, such as a child with leukemia.

For Luisa De Luca, of Falmouth, the debate in Augusta has personal ramifications, as her son, Luka, is battling leukemia. She said she was disappointed in the veto and the Legislature’s vote and “continues to be worried” about the health of her son as he attends Falmouth Elementary School.

“The chicken pox could kill him,” De Luca said. “I’m all for parents having choices, but in this case their choices are affecting other people.”

De Luca, who immigrated from Italy in 2001, said she assumed that vaccinations were required for all schoolchildren until she learned this year that two children in Luka’s second-grade class were unvaccinated. Luka, 8, has been undergoing leukemia treatments since he was four, and De Luca said she’s had to carefully weigh the risks of being around other children with the social and academic benefits of being in the classroom with other children his age.

Falmouth Elementary School’s opt-out rates are about the state average of 4 percent for kindergarten and first-grade students – according to information released by the state last week. De Luca said the school has done all it can to protect her child, but it doesn’t change the fact that all parents have to do is check a box to opt out of vaccinations.

Rep. Linda Sanborn, D-Gorham, and the sponsor of the bill, said she hopes children do not have to die before the state changes the law.

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She said due to the Legislature’s procedural rules, it’s unlikely the bill would come back in 2016, but it will more likely return for the 2017 session.

“I’m extremely disappointed,” Sanborn said. “It’s such a simple step and it would have improved our vaccination rates.”

Still, Sanborn said they are not giving up.

“We are going to keep chipping away until we get it. In California and Vermont, it took several attempts,” Sanborn said.

The Maine bill’s failure happened on the same day that pro-vaccine advocates scored a victory in California, when Gov. Jerry Brown signed into law one of the most strict vaccine mandates in the country by eliminating non-medical exemptions for vaccines required to enter school. Vermont eliminated the philosophic exemption this spring.