Vaccine mandates are in effect at many medical facilities.
Either get the shot, get an exemption, or get a new job - that's been the message for months from Yale New Haven Health to its tens of thousands of employees.
Even with those clear rules in place, 583 workers across that health system are still not vaccinated. So what happens next?
Dr. Thomas Balcezak, chief clinical officer at Yale New Haven Health, says of those 583 unvaccinated employees, about 160 are "casual status" or "per diem" employees, who work relatively infrequently in the health system. But that means more than 400 employees could soon be out of a job if they don't comply by this Friday.
"It's getting closer to the deadline of October 1, so we see that we're probably going to end up parting with about 400 employees unless those numbers change substantially. And I think, frankly, getting closer to the deadline is also influencing people. Maybe some people sitting on the fence wondering if we're going to blink and change our time frame or change our approach. We have not. There are some employees that feel they will not get vaccinated and I think they're willing to live with those consequences," he told NBC Connecticut.
The consequences start with a verbal warning, which are happening this week. Then comes a written warning. Then suspension. Then Yale New Haven Health will move to terminate that employee by the week of October 18.
Having 400 fewer hospital workers across just one health system seems daunting, especially during a pandemic. But Balcezak points out that 400 employees is just a tiny fraction of the 30,000 people who make up Yale New Haven Health's workforce.
"That's not to say they will not be missed. We have a need for those employees. We have jobs that they do. Those jobs are important in the care of our patients but we don't think we can afford to bend the rules on our mandate because the communities look to us to provide safe, high-quality care. We just don't think we can do that without ensuring all of our staff are vaccinated or have appropriate exemptions," he said.
In recent weeks, the hospital system has pivoted to offering its staffers the Johnson & Johnson one-dose vaccine, in order to get more people fully vaccinated by the deadline.