Delta Air Lines said Wednesday that it will require employees to be vaccinated against the coronavirus or face the alternative of weekly testing and a $200 monthly surcharge for health insurance.

Chief executive Ed Bastian outlined the new policies in a memo to the airline’s 68,000 employees, saying that with the Food and Drug Administration’s full approval of the Pfizer coronavirus vaccine this week, “the time to get vaccinated is now.”

“We’ve always known that vaccinations are the most effective tool to keep our people safe and healthy in the face of this global health crisis,” Bastian wrote. “That’s why we’re taking additional, robust actions to increase our vaccination rate.”

Delta will be the latest big employer to push workers to get immunized, an approach that is gathering steam after the FDA approval and President Biden calling on corporations to institute mandates. CVS Health, Deloitte and Walt Disney Co. are among companies that have added vaccine requirements for workers.

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United Airlines became the first domestic carrier to impose a vaccine mandate for U.S.-based employees earlier this month.

Delta stopped short of a vaccine mandate, but in coming weeks will increase pressure on employees as new policies phase in, according to Bastian’s memo. The company said that about 75 percent of its employees are vaccinated.

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Unvaccinated employees will immediately be required to wear masks indoors on company property. On Sept. 12, unvaccinated workers will be required to be tested weekly for the coronavirus, then isolate if the results come back positive. On Sept. 30, a coronavirus pay protection program offered through the company will apply only to breakthrough cases.

On Nov. 1, the $200 health insurance surcharge will begin.

“The average hospital stay for COVID-19 has cost Delta $50,000 per person,” Bastian wrote. “This surcharge will be necessary to address the financial risk the decision to not vaccinate is creating for our company.”

He said that since the spread of the delta variant – which he referred to as B.1.617.2 – no company employee hospitalized with covid-19 had been vaccinated.

Delta began requiring all new employees to be vaccinated in May.

The airline industry has not settled on any single approach to vaccine mandates. Shortly after United announced its policy, Frontier Airlines said it would take a tack similar to that now being used by Delta – giving employees the choice of getting fully vaccinated or undergoing regular testing. American Airlines chief executive Doug Parker ruled out a mandate, saying he hoped bonus vacation days and gift cards would be sufficient incentives. Southwest Airlines has said it strongly encourages employees to get vaccinated.

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The FDA’s approval of the Pfizer vaccine moves up the date at which United’s mandate will take effect, from Oct. 25 to late September.

In announcing the policy, Scott Kirby, United’s chief executive, and Brett Hart, the company’s president, wrote in a letter to employees that “we have no greater responsibility to you and your colleagues than to ensure your safety when you’re at work, and the facts are crystal clear: everyone is safer when everyone is vaccinated.”

The pandemic hit the airline industry hard, with travel all but grinding to a halt in the spring of 2020. Airlines have received tens of billions of dollars in government aid designed to keep workers on the payroll, but have shed tens of thousands of jobs.

Although passengers are not required to be vaccinated, they must wear masks under federal rules in place until at least January. People arriving in the United States from overseas must show a negative coronavirus test result.

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