Days away from having to comply with a health order that requires proof of vaccination or weekly coronavirus testing, more than a third of New York City's municipal workforce is still holding out on getting a vaccine shot.

As of Tuesday, only 65% of city workers, or approximately 239,000 people, have received at least one dose of the vaccine, according to data provided by the mayor's office. That rate is below the citywide coverage for adults—78% with at least one dose—but on par with the 66% for all ages. City officials said their workforce, which expands with the hiring of seasonal staffers, was roughly 367,000 people in mid-August.

But the vaccination rate among city workers has been slow to improve since the announcement of vax-or-test orders in late July. It stood at 58% three weeks ago. This slow pace could provide a stronger case for the city to move to a stricter vaccine mandate as the delta variant continues to surge, almost entirely among the unvaccinated.

"I think that city employees are trailing the rest of adults in the city by so much suggests that there is a lot of vaccine hesitancy in the city worker population," said Dr. Denis Nash, an epidemiology professor at the City University of New York. "I could be wrong, but don’t think that is it due to work-related barriers to getting vaccinated since the city has endeavored to remove barriers."

Mayor Bill de Blasio, who has urged the private sector to require vaccinations as a way of bringing workers back to the office, has repeatedly said he would be willing to consider such an option.

"We've been moving the mandates so far that we thought were absolutely essential, but we continue to look at that," he told reporters last week. "And, as I've said, we've been climbing the ladder."

Some experts predicted that more employers, including government entities, would issue full vaccine mandates after the U.S. Food and Drug Administration approved the Pfizer-BioNTech vaccine last month. De Blasio had also expressed confidence that vaccination rates would pick up as the deadline approached for his so-called "vax-or-test" mandate.

With that policy set to take full effect on Monday, it now appears that a large swath of city workers, from first responders to public housing employees, are willing to opt for weekly testing rather than getting vaccinated. The mayor has summoned all of its workers to resume their pre-pandemic in-person schedules beginning on the same day, and offices with too many unvaccinated employees could carry an increased potential for outbreaks.

"Telework will end, except in very limited circumstances," according to an email sent September 1st to employees and first obtained by The New York Times. The message noted that employees are entitled to "reasonable accommodations" for disability and medical conditions. The Times reported that the order applies to roughly 80,000 city office workers.

Not all city employees can avoid vaccination by getting tested. Department of Education staffers, including teachers and custodians, are required to get at least one dose by September 27th. And under a health order directed by former Governor Andrew Cuomo, all statewide health care workers, including hospital and nursing home staffers, must also be vaccinated by the same date.

The slow pace of municipal vaccinations comes as the mayor has trumpeted the success of the city's broader vaccination effort, which has included cash incentives and mandates for indoor activities like dining, gym workouts and concerts. After falling below 8,300 new recipients a day in early July, fresh demand climbed to roughly 17,000 people a month later. It has now dropped slightly again, hovering around 14,000 new takers every day.

A spokesman for the mayor's office noted that the city's data on municipal employee vaccinations does not include workers who were vaccinated outside the city, meaning that the numbers were a "conservative" estimate.

The breakdown of vaccination rates by a list of 47 city agencies showed a wide range, from the highest level—92% for the Conflicts of Interest Board—to the lowest—44% for the city's Sanitation Department. A worrisome trend was the coverage among the city's first responders, who tend to have frequent contact with the public: 57% of fire department employees have received one dose, while the rate for emergency management workers is 54%. Lower still was the vaccine rate within New York City Police Department. The agency's roughly 52,000 civilian and uniformed members had an uptake of 53%.

At the New York City Housing Authority, the vaccination rate was 46% among its roughly 12,000 workers. The Department of Corrections, whose workforce consists of around 11,000 uniformed and civilian officers, had a similarly abysmal inoculation rate, that of 45%.

"The more than two-fold variability from the lowest to the highest agency in terms of [the] first dose of vaccine coverage suggests that this is not an effective citywide policy," said Nash from CUNY.

He added that he was surprised vaccination in the city's healthcare workers—78% for Department of Health staffers and 77% for city hospital workers—was not higher given their ease of access to shots and the nature of their work. By comparison, the Department of Education, whose 143,000 employees are also required to be immunized, has a 72% vaccination rate. (Unlike other city agencies, the vaccination rate for educators was determined by a self-reporting portal the DOE is using.)

Mark Levine, a Manhattan City Councilmember who chairs the health committee, speculated that non-clinical staff members may be delaying the shot, but he also pointed out that even nurses have expressed hesitance over getting vaccinated.

"They are not too different from the broader city workforce," Levine said. "It’s part of the broader challenge of people being fed misinformation and having an understandable fear based on the history of racism in the medical field."

But the vax-or-test rule has also been opposed by some unions, many of which argued the mayor should have consulted them first. “While we encourage everyone to get vaccinated and support measures to ensure our members’ health and wellbeing, weekly testing is clearly subject to mandatory bargaining,” said Henry Garrido, president of the union DC37, which represents cafeteria workers and school aides, in a statement back in July.

"This is politically challenging," Levine said. He said he would support a full mandate now for city workers, with a carveout for medical and religious exemptions.

Vaccinations, he argued, are "most critical for public workers with contact with members of the public."