The new policy marks a significant escalation from the requirement announced by Gov. Gavin Newsom just last week.,

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California mandates Covid vaccines for indoor health care workers, largely removing a testing option.

Preparing Moderna coronavirus vaccines in Los Angeles in February.Credit…Apu Gomes/Agence France-Presse — Getty Images

Aug. 6, 2021, 1:36 p.m. ET

California is now requiring all health care workers who work indoors with or near patients to be vaccinated against the coronavirus, largely removing an option that let unvaccinated employees submit to regular testing instead.

The order, issued and placed in effect on Thursday by the state’s Department of Public Health, allows workers exemptions for medical reasons or religious beliefs. Workers have until Sept. 30 to get a single-dose vaccine or the second dose of a two-shot vaccine.

Just last week, Gov. Gavin Newsom included testing as an alternative to inoculation when he said that state employees and health care workers would have to be vaccinated, a move that was echoed in rules issued since by states and territories including New York, Virginia and Puerto Rico. President Biden announced that federal workers would face restrictions and requirements, including testing, if they did not get vaccinated. The Veterans Affairs Department also became the first federal agency to require vaccinations for its frontline health care workers.

On Thursday, as Hawaii set a record for daily new coronavirus cases, the governor said all state and county employees must be vaccinated or face weekly testing.

Major employers like United Airlines, Google and Disney have also announced vaccine requirements.

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.

In the order issued in California on Thursday, the state public health officer and director, Tomas J. Aragon, said that the decision was a response to worsening conditions in the state. California’s new cases and hospitalizations have increased dramatically, though they remain lower than their winter peaks.

Unvaccinated health care workers contributed to the rise, Mr. Aragon said in the statement.

“Increasing numbers of health care workers are among the new positive cases, despite vaccinations being prioritized for this group when vaccines initially became available,” he said. “Recent outbreaks in health care settings have frequently been traced to unvaccinated staff members.”

There are more than two million health care workers in California. The order mentioned a broad range of employees who care for patients, like doctors and nurses, and those not directly involved in care, like security and administrative staff. Places like hospitals, doctors’ offices, clinics, hospice centers and substance abuse and mental health treatment facilities were specified in the order.

Workers who remain unvaccinated under the exemptions for medical reasons or religious beliefs will be tested at least once a week for the virus, and will have to wear “a surgical mask or higher level respirator,” like an N95, at all times while on site, the order said.

Understand the State of Vaccine Mandates in the U.S.

College and universities. More than 400 colleges and universities are requiring students to be vaccinated for Covid-19. Almost all are in states that voted for President Biden.Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get the Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force. In N.Y.C., workers in city-run hospitals and health clinics will be required to get vaccinated or else get tested on a weekly basis.Federal employees. President Biden announced that all civilian federal employees must be vaccinated against the coronavirus or be forced to submit to regular testing, social distancing, mask requirements and restrictions on most travel. State workers in New York will face similar restrictions.Can your employer require a vaccine? Companies can require workers entering the workplace to be vaccinated against the coronavirus, according to recent U.S. government guidance.

The facilities’ operators will have to maintain records of employees’ test results and provide them to state health officials if needed.

California issued a second public health order on Thursday that requires acute care hospitals, skilled nursing facilities and intermediate care facilities to verify that visitors are fully vaccinated or have tested negative for the virus in the 72 hours before their visit.

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.

Cases have jumped across the country in recent weeks, and the Centers for Disease Control and Prevention issued new guidance last week advising that even vaccinated people wear masks indoors in areas with surging cases, and that everyone in schools wear masks.

Mr. Aragon said that the new order was necessary to keep Californians protected from the virus.

“Thanks to vaccinations and to measures taken since March 2020, California’s health care system is currently able to address the increase in cases and hospitalizations,” Mr. Aragon continued. “However, additional statewide facility-directed measures are necessary to protect particularly vulnerable populations, and ensure a sufficient, consistent supply of workers in high-risk health care settings.”

Adeel Hassan contributed reporting.