Health workers in about half of the United States Thursday will need to be vaccinated against COVID-19 as the Biden administration's requirement takes effect.
Enforcement of the requirement begins in 25 states and the District of Columbia, and will extend to every other state except Texas on Feb. 14. Enforcement in Texas will start Feb 22.
The Centers for Medicare and Medicaid Services staggered the deadlines because of various lawsuits brought by GOP-led states. Subsequent court rulings blocked the requirement in some states but not others, leading to a patchwork of different rules before the Supreme Court earlier this month allowed the requirement to take effect.
Thursday's deadline requires staff at all facilities and providers certified under Medicare and Medicaid to have received at least the first dose of a primary series or a single dose COVID-19 vaccine prior to providing any care, treatment or other services.
Employees will have another month to receive their second doses, if required.
The court ruled 5-4 to keep the health care worker mandate, with Chief Justice John Roberts and Justice Brett Kavanaugh joining the more liberal Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan.
The order will cover about 10.3 million health workers across every section of the health industry, including doctors, nurses, technicians and even volunteers at every facility that participates in Medicare or Medicaid.
It provides for narrow exemptions on religious and medical grounds.
Employees can be fired for not complying, and if the noncompliance is facility-wide, it could result in termination from the Medicare and Medicaid programs.
Health experts say there's clear evidence that mandates work in getting more people vaccinated. As the omicron variant rips through the country, infecting both vaccinated and unvaccinated health workers, there's a sense of urgency in making sure essential health workers are protected from serious disease or death.
But hospitals and nursing homes have expressed concern that the requirements could result in staffing shortages, especially in states that haven't had any mandates or where governors have banned them.
Just ahead of Thursday's deadline, Montana's Sen. Steve Daines (R), Rep. Matt Rosendale (R) and Gov. Greg Gianforte (R) sent a letter to the Biden administration asking for the vaccine requirement to be waived in the state's rural health facilities.
"We are deeply concerned that the vaccine mandate will penalize healthcare entities that simply cannot comply with the mandate due to ongoing workforce challenges," they wrote. "Some Montana facilities cannot afford to lose another healthcare professional, especially when alternative measures can be implemented, such as masking and testing, to protect the safety and health of employees, patients, and visitors from COVID-19."