RALEIGH, N.C. (AP) — North Carolina’s health department will require workers, volunteers and others at 14 state-run health care facilities to be fully vaccinated for COVID-19 by Sept. 30 unless they qualify for a medical or religious exemption, according to a memo.

What You Need To Know

North Carolina’s vaccine requirement will apply to “all facility employees, volunteers, students, trainees” in addition to “contracted and temporary workers” at 14 state-run health care sites

Medical or religious exemptions will only be given to those who qualify

According to the state health department, 75% of staff at the sites are already vaccinated, and, at three facilities, more than 90% of workers are vaccinated

The Associated Press obtained a departmental FAQ about the vaccine mandate that says those who don’t get fully vaccinated or exempted by the deadline could face “disciplinary action, up to and including dismissal, for unacceptable personal conduct.”

Republican House Speaker Tim Moore first shed light on the development through a news release Tuesday evening. Although he is vaccinated and encourages others to get the shots, he believes residents should have the ability to make their own decisions without fear of reprisal.

“At the end of the day, the decision whether or not to vaccinate is a personal one and should be made between a doctor and patient,” Moore wrote. “North Carolinians will not be bullied into being vaccinated against their will.”

The speaker also noted that none of the available COVID-19 vaccines the U.S. Food and Drug Administration approved for emergency use have thus far received full FDA approval.

North Carolina’s Department of Health and Human Services did not comment on Moore’s criticism, but confirmed it will require many within the Division of State Operated Health Facilities to get vaccinated.

In the Tuesday memo, North Carolina health officials cite May guidance from the Equal Employment Opportunity Commission confirming that federal law does not prohibit employers from mandating vaccination for employees who work on-site.

North Carolina’s vaccine requirement will apply to “all facility employees, volunteers, students, trainees” in addition to “contracted and temporary workers” at 14 state-run health care sites. The locations across the state include three alcohol and drug abuse treatment centers, three developmental centers, three psychiatric hospitals, three neuro-medical treatment centers and two residential programs for children.

According to the state health department, 75% of staff at the sites are already vaccinated. At three facilities, more than 90% of workers are vaccinated.

This is substantially higher than the overall share of North Carolina residents who have come in for a shot. As of Wednesday, 58% of residents eligible for a COVID-19 shot have had at least one dose and 55% are fully vaccinated.

The announcement from the health department comes after several hospital systems announced last week that they will require workers to get a COVID-19 shot if they want to remain employed. WakeMed Health & Hospitals, the leading health services provider in the state’s second largest county, said Tuesday that it will join the growing list of hospital systems compelling staff to get vaccinated.

In the memo, state health officials noted that the vaccine mandate is particularly necessary to combat the more contagious delta variant, which has contributed to a 121% increase in hospitalizations in the past two weeks. Over the past 14 days, the rolling average number of daily new cases has increased by nearly 208%.

Democratic Gov. Roy Cooper’s office has not responded to questions about whether the governor supports a COVID-19 vaccine mandate for state workers.