California and Hawaii are stepping up pressure on workers in the public and health sectors to get vaccinated against the coronavirus.
Health officials in California on Thursday ordered more than two million health care workers in the state to be inoculated, largely removing an option that let unvaccinated employees submit to regular testing instead.
In Hawaii, Gov. David Ige signed an emergency proclamation on Thursday that requires all state and county employees to provide their vaccination status by Aug. 16 or face weekly testing.
Last week, Gov. Gavin Newsom, a Democrat, had included testing as an alternative to inoculation when he ordered state employees and health care workers to be vaccinated. Other states and territories including New York, Virginia and Puerto Rico, have followed suit, telling their employees get their shots or go through regular testing.
President Biden adopted the same policy when he announced that federal workers would face restrictions and requirements, including testing, if they did not get vaccinated.
California’s public health officer, Tomás J. Aragón, said that the decision to remove the testing option for health care workers was a response to worsening conditions in the state. New cases and hospitalizations have increased dramatically, and unvaccinated health care workers contributed to the rise, Mr. Aragón said in the statement.
“Increasing numbers of health care workers are among the new positive cases,” he said. “Recent outbreaks in health care settings have frequently been traced to unvaccinated staff members.”
On Thursday, Hawaii set its single-day record for new virus cases with 655. Mr. Ige, a Democrat, said requiring vaccinations or frequent testing for state workers was necessary to prevent strain on the health care system.
Calls for vaccine mandates among health care workers have gained urgency, and more hospitals and major health systems are requiring employees to get vaccinated. But there is resistance, including in the nursing home industry, where some facilities say that requiring vaccines will cost them staff members in a field already plagued with high turnover.
California’s order not only mentioned employees who care for patients, like doctors and nurses, but those not directly involved in care, like security and administrative staff. It allows workers exemptions for medical reasons or religious beliefs, though they must be tested once a week and wear a surgical mask at all times. Workers have until Sept. 30 to be fully vaccinated.
The order covers workers in hospitals, doctors’ offices, clinics, hospice centers and substance abuse and mental health treatment facilities. Unvaccinated workers without a valid exemption will not be allowed to work, health officials said.
Fully vaccinated people are protected against the worst outcomes of Covid-19, including those caused by the highly contagious Delta variant, which is the dominant version in the United States. Nearly 79 percent of California’s adults have received at least one dose of the vaccine, according to federal data.
In Hawaii, 85 percent of residents 18 and older have had at least one dose, but only 65 percent of are fully vaccinated, according to a federal data. People younger than 12 are not eligible for the vaccine.