Houston Methodist, one of the largest hospitals in Texas, has released an order demanding all 26,000 of its employees get the COVID vaccine by June 7 or have their jobs terminated.

Managers were given an earlier deadline, which was April 15. The decree makes this the first hospital system in the U.S. to mandate full vaccination for its employees. 

Originally, Houston Methodist—which has a medical center and six community hospitals—encouraged people to get vaccinated voluntarily, rewarding vaccinated employees with an extra $500 in March, though it was signaled that the vaccinations would soon become mandatory.

Houston Methodist’s President and CEO Marc Boom sent an email to workers, claiming the move was about maintaining their health and safety.

Boom explained, “Mandating the vaccine was not a decision we made lightly, but science has proven that the COVID-19 vaccines are very safe and very effective. Like I say to everyone who asks—whether they are reporters, the public, patients or our employees, it is our sacred obligation to do everything possible to keep our patients safe. By choosing to be vaccinated, you are leaders—showing our colleagues in health care what must be done to protect our patients, ourselves, our families and our communities.” 

Boom then stated that other hospitals would follow suit, saying he had “spoken to countless hospital leaders across the country who plan to mandate COVID-19 vaccination soon,” even alluding to two Texas hospitals: Baylor College of Medicine, and Memorial Hermann. 

After saying this was getting through the “last mile” of people skeptical of COVID vaccines during a town hall-style Q&A, he told viewers to “trust the vaccines. They are safe, they are effective, and they are the answer to this pandemic.”

As of Friday, April 23, 89 percent of employees have complied with the vaccine mandate. Of the 1,200 employed in management, two chose to leave.

When asked about this Boom said, “we are sorry that they made that choice, but by doing so, they are putting themselves before the safety of our patients, which is not consistent with our culture. By getting to 100 percent, we can show our community and our patients how much we care about them.” 

The mandate has received public backlash, with a petition to rescind the vaccine order created by an anonymous person claiming to be on hospital staff. The petition has already received more than 3,000 signatures.

While the ethics of private businesses mandating people to receive the vaccine is already a contentious topic, hospitals like Houston Methodist also obtain taxpayer funds in various forms, turning the discussion towards one of public policy.

Gov. Greg Abbott has repeatedly stated the vaccine will always be voluntary, never mandatory.