Rhode Island health care workers must now be vaccinated against COVID-19 or lose their jobs. By the Oct. 1 deadline, the overwhelming majority of those workers had decided to get vaccinated.

"I kind of have to get it for work, so (it's) not really an option," said Emma Landroche, 22, a nursing assistant, as she and her partner, Alyssa Sartini, 25, waited to be vaccinated Thursday at the Pilgrim Senior Center in Warwick.

Nearly 98 percent of Lifespan’s workforce is partially or fully vaccinated against the coronavirus, Dr. Timothy J. Babineau, President and CEO of Lifespan, said in a statement Friday. The state’s largest hospital system held vaccine clinics throughout the day to allow workers to get last-minute shots.  “If an employee chooses to get vaccinated at a later date,’’ he said, “we will welcome them back to work.’’ 

Care New England, the state’s second-largest hospital system, reported that 97 percent of its employees had at least one dose of the vaccine before the deadline. 

But 92 health care facilities -- including 35 nursing homes, 15 assisted living facilities and seven hospitals -- have been given another 30 days, until Oct. 31, to have 100% of their staff fully vaccinated, according to state health department data released Friday night. 

Among them are four hospitals operated by Lifespan -- Rhode Island Hospital, The Miriam Hospital, Newport Hospital and Bradley Hospital -- as well as Landmark Medical Center, Westerly Hospital and the state-run Eleanor Slater Hospital. All 92 facilities have agreed to comply with “corrective action plans” filed with the state Department of Health

Dr. Nicole Alexander-Scott, the state health director, said Thursday that the goal of the corrective action plans is “ensuring there is undisrupted care for patients”  by allowing facilities the additional time to get all of their staff fully vaccinated. “If there are unvaccinated staff that are providing critical patient care and they still need another day or two to get in line with achieving the full compliance,’’ she said, “the corrective action plan can allow for that.” 

Employees who are partially vaccinated, Alexander-Scott said, may be required to wear full personal protective equipment, or PPE, submit to daily COVID-19 testing and be prohibited from caring for the most medically vulnerable patients.

Staff who refuse to be vaccinated, however, will not be allowed to work at state-licensed health facilities, she said, and could lose their jobs.

The vaccine mandate had stoked fears about the impact on places like Rhode Island Hospital, which was forced to close part of its emergency department on Sept. 23 due to a nursing shortage.  

The vaccine requirement has had a “slight impact on our already tough staffing situation,” Kathleen Hart, a hospital spokeswoman, said in an email Friday. The unvaccinated employees are “well distributed across various departments, services and roles,’’ she said, and the hospital has been making contingency plans for weeks to hire contract staff and “reassign and reduce non-urgent services when necessary.”

The state Health Department’s vaccine mandate drove up vaccination rates among health care workers. During the first two weeks of September, vaccination rates among health care workers spiked 10 percent, Joseph Wendelken, a hospital spokesman, said. 

More than 5,000 health care workers in Rhode Island have been vaccinated since state health officials announced the mandate in mid-August, Gov. Daniel J. McKee said at a briefing Thursday.

A federal judge on Thursday denied a request by four unnamed people to block Rhode Island’s COVID-19 vaccine mandate, according to the Associated Press. U.S. Court Judge Mary S. McElroy wrote in her decision that courts have held over a century that mandatory vaccination laws, which have withstood numerous constitutional challenges,  are a valid exercise of a state’s police powers. The legal challenge to the mandate that takes effect Friday was filed by four people who work in the health care field, including a doctor and a nurse.

Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter @LynnArditi