Earlier this month, NewYork-Presbyterian became the first hospital system in the state to require employees to get vaccinated against COVID-19. It’s a step that a growing number of hospitals across the country are taking, but one that 1199SEIU, the largest health care union in the country, is prepared to fight.

“Whether there is a legal challenge that we can make, or whether it's just a pure organizational challenge that we can make, we are not going to just give in,” George Gresham, president of 1199SEIU, told WNYC/Gothamist. The union is headquartered in New York City but represents health care workers throughout the state and in Massachusetts, New Jersey, Maryland, Florida and Washington, D.C.

Gresham emphasized that he got vaccinated and has encouraged all union members to do so, but that he believes medical workers “have the right to make their decision about their own health.” Gresham said union delegates met with Dr. Steve Corwin, president and CEO of NewYork-Presbyterian, to express their concerns last week.

Another health care union, the New York State Nurses Association (NYSNA), has voiced opposition to mandatory vaccination, although it did not respond to requests for comment for this story.

Likewise, when WNYC/Gothamist contacted NewYork-Presbyterian to respond to the unions’ stances, it pointed to a memo sent to staff on June 11th. The memo says all employees must take at least one COVID-19 shot by September 1st to keep their jobs. Those seeking a medical or religious exemption must apply for one by August 1st. About 70% of staff at NewYork-Presbyterian have been vaccinated so far.

“The stakes in this matter are high, and the evidence is clear that getting vaccinated against COVID-19 is the most important and responsible action we can take as NYP team members for the safety and well-being of our patients and visitors, our communities, and ourselves,” read the memo, signed by Dr. Corwin and Dr. Laura Forese, chief operating officer at NewYork-Presbyterian.

Other hospitals in the New York City area are considering similar policies. Northwell Health, the largest hospital system in the state, requires all new hires, volunteers and students working in its facilities to get vaccinated against COVID-19 and will soon order employees who are not inoculated to submit to regular testing for the coronavirus. About 75% of Northwell staff have taken shots so far.

Meanwhile, only 57% of employees at NYC Health + Hospitals are fully vaccinated, but the city’s public hospital system has no plans to make the shots a condition of employment. The COVID-19 vaccine rollout has stalled in the city and nationwide, even as the delta variant causes new outbreaks in highly inoculated populations overseas.

Health care employers considering these mandates may be encouraged by a recent ruling in Texas. Last week, a federal judge dismissed a lawsuit in which employees of Houston Methodist Hospital challenged the health care provider’s vaccine requirement. Ultimately, 153 people resigned or were fired over their refusal to get the vaccine, according to The Washington Post. The federal Equal Employment Opportunity Commission has also issued guidance saying it’s legal for employers to necessitate staff to get vaccinated in order to enter the workplace.

Gresham of 1199 says that the union’s members are overwhelmingly against mandatory vaccination, even if they have taken shots themselves. But not all NewYork-Presbyterian employees share the position of the health care unions.

One nurse in the hospital system, who is an NYSNA member, said there “needs to be more education to encourage employees to get it, with an emphasis on its safety.”

But the nurse, who declined to be named because she is not authorized to speak to the press, said she was happy about the hospital’s requirement. “We are mandated to have so many other vaccines to protect our patients as well as our colleagues and ourselves,” she said.

NewYork-Presbyterian noted in its memo to employees that it already has vaccination requirements for the flu, measles, rubella and varicella. While considered safe, the COVID-19 vaccines are still classified under emergency use authorization from the U.S. Food and Drug Administration and are awaiting full approval.

Other health care institutions may also consider a similar caveat to public universities in New York, which will only require COVID-19 vaccines for students for the fall semester if one receives FDA approval by then.