The deadline for most state government, health care and school workers in Washington to get their COVID-19 vaccination is days away. When Gov. Jay Inslee issued the sweeping order this summer, his announcement was clear: Show proof of vaccination on or before Oct. 18 or lose your job.

Since then, however, labor unions have worked on ironing out conditions of employment, thousands of workers have requested exemptions and the state has granted new extensions for certain employees.

In the past few months, more and more questions have emerged.

We rounded up some of the most pressing ones and answered them. Here’s what to know:

How many workers who are subject to the state mandate have been fully vaccinated?

More than 90% of Washington state government workers have been verified as fully vaccinated as this week, Inslee announced Thursday. That’s up from 68% a couple weeks earlier. 

The state’s Office of Financial Management reported earlier in the week that the rates vary between the largest state agencies: 91% among Department of Social and Health Services workers; between 84% and 91% among Department of Corrections prison employees depending on the facility; and 89% among Washington State Patrol workers.


As for hospital workers, about 88% are fully vaccinated, according to a recent Washington State Hospital Association survey. The survey included all hospital workers, but didn’t cover data from independent physicians’ offices, dentist offices, military hospitals and a few other types of health care facilities. 

The remaining 12% of hospital workers include those who are partially vaccinated, have an approved exemption and accommodation, have applied or plan to apply for an exemption that hasn’t yet been reviewed, have not yet provided vaccination verification, or are choosing not to be vaccinated.

It’s unclear how many K-12 school employees have received their COVID-19 shots; the state Office of Superintendent of Public Instruction doesn’t plan to share statewide compliance data until the end of the month.

What does this mean for the already strained health care systems, and are hospitals and its workers concerned about losing staff? What about state agencies and their critical services?

Vaccination rates are fairly high among state and health care workers. While hospitals aren’t expecting to lose a large percentage of staffers due to the mandate, health care leaders say staffing levels remain strained — so even a small number of resignations or terminations could create further challenges for the health care system.

This week, the state hospital association estimated about 2% to 5% of hospital staff — between 3,000 and 7,500 employees — could leave their jobs, with rural Washington hospitals likely to see the biggest impact.


Many of Washington’s health care workers are more concerned about long-term staffing shortages unrelated to the vaccine mandate, said Jane Hopkins, executive vice president of SEIU 1199 NW, one of the state’s largest labor unions for health care workers. 

“The mandate has not been the issue,” she said. “Short staffing for years has been the issue.”

Unrelated to the vaccine requirement, the state has secured a contract with ACI Healthcare, a national staffing agency, to help with ongoing worker shortages in hospital settings, according to Lacy Fehrenbach, the state Department of Health’s deputy secretary for COVID-19 response. State officials are in the process of securing funding for those extra workers through the Federal Emergency Management Agency.

Vaccination rates among the state’s largest agencies are also high, dispelling the notion that a mass exodus of state employees unwilling to get their shots could cripple government services. Still, some prisons that lose too many staffers could potentially cut back on educational and religious programming, or addiction recovery programs.

School district superintendents also expect to lose "only a small percentage of their staff," though the state hasn't done any formal surveys, OSPI spokesperson Katy Payne said. This week, however, Seattle Public Schools announced it was suspending 142 school bus routes, cuts that became necessary because of national bus driver shortages and because some drivers refuse to get vaccinated.

The state has explored a few options to help districts address current labor shortages, such as increasing the cap on the number of hours retirees can work or potentially accelerating the process for staff to get licensed and qualified as a bus driver.


Many workers have opted out of vaccinations with an approved religious or medical exemption. Should the public, particularly patients visiting hospitals, be worried about going into facilities with lower vaccination rates?

If an unvaccinated worker has been granted a religious or medical exemption, their employer is required to try to set up accommodations within their workplace. In most Washington hospitals, the likelihood of a patient working directly with an unvaccinated health care provider will be low, said Hopkins, of SEIU.

Accommodations might include requiring an unvaccinated worker to get frequent coronavirus tests or moving a worker to a position where they’re not providing direct patient care.

Some hospitals have already imposed some new policies for unvaccinated patients to protect their and staffers’ safety. UW Medicine now requires patients who need organ transplants to be fully vaccinated, unless they have a medical exemption. If a transplant patient is unvaccinated, they’ll be removed from the waitlist.

UW Medicine has for years required up-to-date vaccinations for all transplant patients, and just recently added the COVID-19 shot to the list.

If employers can’t work out proper accommodations, however, it’s possible some workers could still lose their jobs.

If I work for a state agency, health care facility or school and won’t be fully vaccinated by the governor’s deadline, will I be fired immediately?

Not necessarily. Labor unions throughout the state continue to negotiate agreements with employers about possible accommodations and extensions, allowing many workers about 30 extra days to become compliant with the mandate. 


At the beginning of the month, Inslee also extended some union provisions to about 12,500 nonrepresented and exempt state workers, giving them a little more time to get vaccinated. The group includes those in management, or who serve at the pleasure of an agency executive.

The union provisions being extended come from a deal struck in early September between the Inslee administration and the Washington Federation of State Employees. Under that deal, if a state worker’s request for a medical or religious exemption is denied by the state, that worker can use up to 45 days of unpaid or paid leave to get vaccinated, according to an outline of the deal.

Hospitals and health care facilities have agreed on similar understandings for their staff, including how long a staffer has to meet the immunization requirement without losing seniority or vacation/comp days.

At UW Medicine, for example, if workers choose not to get vaccinated and will leave their job, they can use vacation or comp time until their official resignation date. If workers have received their first vaccine dose but won’t be fully vaccinated by Oct. 18, they can use “leave without pay” for up to 30 days to become fully vaccinated — at which point, they can return to their previous position or a vacant position in the same job class.

Swedish Health Services has agreed on a similar understanding for its workers. Anyone who doesn’t meet the deadline and is fired will be eligible for rehire once becoming fully vaccinated.

If workers don't meet the deadline and have no plans to become immunized, they’ll no longer be able to work at their health care facility beginning Oct. 19.


How will the state enforce the mandate?

Local health departments, law enforcement agencies, the state Department of Health and the state Department of Labor & Industries can request proof of vaccination from health care facilities or their employees at any time. If a state or health care worker hasn’t been fully vaccinated or been approved for an accommodation by Oct. 18, they won’t be legally allowed to work within their current place of employment. Failure to comply is a gross misdemeanor. Violations could also result in civil enforcement action, according to the state. 

L&I is in the process of reviewing its enforcement strategy for private employers subject to the proclamation, including health care, Inslee spokesperson Lee said.

Are employees at long-term care facilities included in the state's mandate for health care workers?

Vaccinations are required for employees in Washington’s 1,495 long-term care facilities, which account for 37% of all COVID-19 deaths in the state. Coronavirus cases and deaths plummeted after vaccinations became widely available, but began creeping up in late July.

As of Oct. 3, 80% of nursing home workers have submitted proof of vaccination, according to the Centers for Medicaid & Medicaid Services, which doesn’t track other types of long-term care facilities. The rate is 3 percentage points higher from the week before and a 12 percentage-point increase from when Inslee announced the vaccine mandate. Across the U.S., 69% of workers are vaccinated.

Patricia Hunter, the state’s long-term care ombudsman, said the increased rate points to the mandate’s effectiveness.

“We have long supported a vaccine mandate for care workers in long term care homes,” Hunter said in a statement. “And the numbers prove the state’s vaccine mandate is working to raise vaccinated rates, which is essential to protect our vulnerable elders, our children, and other at risk populations.”


Students just returned to in-person classes this fall. How will the mandate for their teachers and staffers affect them?

All K-12 and college educators, school staff, coaches, bus drivers, school volunteers and others working in school facilities were also ordered to be fully vaccinated by Oct. 18. The mandate includes higher-education staff and contractors, as well as certified, licensed and contracted early learning and child-care providers.

This set of workers amounts to roughly 363,000 public and private employees, Inslee’s office has said. Tribal schools are not included in the vaccine mandate.

The state hasn't formally been keeping track of vaccination compliance rates among school employees, but ongoing labor demands in the education world have already resulted in shortages, cuts and delays that could worsen once the immunization deadline hits.

While Seattle's public school district doesn't yet know exactly how many students will be affected by the suspension of more than 140 routes, district spokesperson Tim Robinson estimated about 6,740 of 18,000 students could lose their normal route.

Custodians, in higher demand because of increased cleaning protocols, and district nurses are also working overtime. And school districts are bracing themselves for possible resignations prompted by the vaccine mandate.

More information about the state's mandate is available at

Staff reporters Paige Cornwell, Joseph O'Sullivan, Jim Brunner, Monica Velez and Dahlia Bazzaz contributed to this report.