Hundreds of health care workers across the country are being fired or suspended in droves for not complying with COVID-19 vaccine mandates.
President Joe Biden announced earlier this month a vaccine mandate for health care facilities that receive Medicare and Medicaid reimbursement, impacting some 17 million health care workers in the nation.
States including New York, California, Rhode Island and Connecticut also set vaccine mandates for health care workers that take effect this week.
But there are brewing concerns over staff shortages at already-overburdened hospitals still grappling with COVID-19 cases. Some hospital networks said they've ramped up hiring ahead of vaccine deadlines to stabilize their workforces.
ABC News contributor John Brownstein, an epidemiologist and professor at Harvard Medical School, noted that while overall the number of health care workers being terminated or suspended isn't huge, at the same time, "we can't afford to lose anybody at this point."
“By and large, vaccine mandates are working. Those in health care are taking these vaccine incredibly seriously to protect themselves and their patients." Brownstein said. "We’re seeing a greater need of health care -- there was a lot of deferred care for elective surgeries and behavioral health -- juxtaposed with existing shortages of health care workers. Any impact is going to create even more pressure on health care systems."
In the South and West
In North Carolina, the Novant Health hospital system, which has over 35,000 employees across 15 hospitals and over 800 clinics, fired around 175 of its workers for failing to get vaccinated, officials told ABC News.
Approximately 375 team members were noncompliant with the vaccine mandate last week and were given a five-day suspension period to get a COVID-19 shot.
Over the course of the week, nearly 200 additional team members became in compliance, Novant Health said Monday. The hospital system now has a vaccine compliance rate of over 99%, officials said.
Employees granted medical or religious exemptions must wear masks and undergo weekly COVID-19 testing.
Novant Health CEO and president Carl Armato said in a statement that the system has been steadily adding to travel staff numbers "to meet the needs of our organization throughout the pandemic.”
“Without a vaccine mandate for team members, we faced the strong possibility of having a third of our staff unable to work due to contracting, or exposure to, COVID-19. This possibility only increases heading into a fall season with the more contagious and deadly delta variant,” he said.
In Texas, Houston Methodist Hospital, which has some 26,000 employees, saw 153 employees quit or fired over the vaccine requirement after the June 7 deadline to get the shots. Of those, 26 were nurses.
“We staffed up prior to the mandate so that we would be much better prepared when our June 7 deadline arrived, and then we had the fourth surge in Houston starting in July. We continue to hire positions as needed, so we’ve not had any major turnover or staffing concerns,” hospital spokesperson Lisa Merkl told ABC News.
In California, health workers have until Thursday to be fully inoculated.
At Cedars-Sinai, based in Los Angeles with almost 17,000 people in its workforce, about 97% to 98% of staffers are projected to comply by the deadline. About 1% applied for medical or religious exemptions. Those who don’t comply by Friday will be suspended for a week and ultimately fired on Oct. 8 if they refuse the vaccine, The Associated Press reported.
California Hospital Association spokesperson Jan Emerson-Shea told ABC News that the mandate comes at a time "when many hospitals are facing serious staffing shortages."
"It’s hard to predict exactly how the vaccine mandate will play out -- every hospital is implementing its own processes and procedures," Emerson-Shea said. "While some health care workers may qualify for exemptions for either medical or religious reasons, it is possible that some health care workers may choose to leave their employment rather than get vaccinated."
On the East Coast
In Delaware, 150 employees left ChristianaCare, a major hospital system in the state, after they failed to meet the Sept. 21 deadline to get vaccinated, the hospital announced in a Monday statement.
Approximately 200 caregivers received religious or medical accommodations and will have to wear masks and be required to undergo regular COVID-19 testing to keep working.
"In late July, we made a commitment to put the safety of our caregivers and our patients first by requiring COVID-19 vaccination for everyone who works at ChristianaCare," CEO Dr. Janice Nevin said in a statement. "As we anticipated, a small number of caregivers chose not to be vaccinated and have left the organization."
The hospital network has also hired more than 200 caregivers over the past month to keep the workforce afloat.
In New York, hundreds of staffers have been suspended this week and risk losing their jobs as the statewide vaccine mandate for health workers reached its first dose deadline Monday.
Northwell, the state’s largest private hospital system with over 76,000 employees, confirmed Thursday that it let go “a few hundred employees” who refused to get vaccinated and now its workforce is “near 100%” vaccinated.
"Regretfully, we have had to exit a few hundred employees, but we are pleased to report that most team members are opting to be vaccinated so as to avoid being terminated," Northwell said in a statement.
In New York City, about 500 nurses for NYC Health + Hospitals are not at work and have been preemptively replaced. Unvaccinated workers have been placed on unpaid leave but can return once they get their shot. A hospital spokesperson told ABC News that today over 92% of the NYC Health + Hospitals' workforce is in compliance with the state vaccine mandate as of Wednesday.
"We anticipated there would be some losses of staff. We knew that no matter what our efforts, some people would not get vaccinated, we planned appropriately," hospital president Dr. Mitch Katz said Tuesday.
Erie County Medical Center Corporation based in Buffalo, New York, said about 276 employees, 7% of the workforce, was on administrative leave for failing to meet the requirement.
That total includes 5% of all ECMC hospital staff and 20% of staff at the Terrace View, a long-term care facility, hospital vice president of communications and external affairs Peter Cutler told ABC News. Those who have not gotten their shots are put on a 30-day period of unpaid leave, but if they get vaccinated they can return.
Similarly, Albany Medical Center suspended 204 employees of its over 11,000-member workforce for one week starting Tuesday for not complying with the vaccine, officials said in a press conference Tuesday.
New York Gov. Kathy Hochul said Tuesday that the numbers of state health care workers getting the COVID-19 vaccine are promising with 92% of hospital staff, 92% of nursing home staff and 89% of adult care facility staff inoculated with at least one vaccine dose.
"This new information shows that holding firm on the vaccine mandate for health care workers is simply the right thing to do to protect our vulnerable family members and loved ones from COVID-19," she said.
To grapple with any potential shortages in hospital and health care staff, Hochul signed an executive order Monday night which allows health care workers from other states and countries to practice in New York and waives re-registration fees.
ABC News' Aaron Katersky contributed to this report.
Editor’s note: This story has been updated to report that 97% to 98% of Los Angeles-based Cedars-Sinai staff are projected to comply by the deadline rather than 75% as previously reported.