The measles outbreak in the Pacific Northwest continues to spread with 53 recorded cases in Clark County, Washington, and four in the neighboring Multnomah County, Oregon, according to public heath officials.

Forty-seven of the 53 cases in Washington have occurred in unimmunized people, with the majority being between less than 10 years old. Both counties have above average numbers of unimmunized children that have received vaccine exemptions for either philosophical or religious reasons. Forty percent of kindergartners in Clark Country were not vaccinated with the recommended shots, according to USA Today.

Every state but California, Mississippi and West Virginia allow vaccine exemptions for religious reasons. Seventeen states, including Oregon and Washington, allow exemptions for both philosophical and religious reasons. In light of this recent outbreak, Oregon State Rep. Mitch Greenlick has proposed a bill in the state legislature that would prohibit the ability to get vaccine exemptions for religious or philosophic reasons and still attend school. Those who still decide not to get vaccinated would need to be home schooled.

Art Caplan, director of the Division of Medical Ethics at NYU Langone Medical Center, told Boston Public Radio Wednesday that Greenlick’s proposal was a step in the right direction and hopes to see a larger move to ban all religious and philosophical vaccine exemptions.

“The idea that you are going to be able to say it is against your religion to vaccinate your kid, it just doesn’t make any sense,” said Caplan. "The reason it doesn’t make any sense is that there is no religion that oppose[s] vaccination except maybe Christian Science, which doesn’t like medicine in general.”

“All of the holy books of the major world religions were written long before vaccination appeared and statements form the Catholic Church, statements from Orthodox Jewish communities, have all said you ought to get vaccinated because you protect your neighbor,” Caplan continued.