The Los Angeles Times reports that the city of San Francisco’s 35,000 employees will need to get vaccinated against COVID-19 or risk losing their jobs.

The new policy would make San Francisco the first major city and county in California to require COVID-19 vaccinations for its employees. Workers who refuse, or fail to provide a religious or medical exemption, could be terminated.

The mandatory vaccination requirement, which goes into effect once the vaccines have been formally approved by the Food and Drug Administration, extends to all city government employees, including police, firefighters, custodians and City Hall clerks. Teachers are not covered by this policy because they are school district employees. Earlier, San Francisco mandated that front-line workers in hospitals, nursing homes and jails be fully vaccinated against COVID-19.

Carol Isen, San Francisco’s director of human resources, said that employees will have until July 29 to report their current vaccination status to the city as a condition of their employment. Staff will need to upload their vaccination cards or documentation showing proof of vaccination through the city’s payroll system. Medical exemptions for employees who are ineligible for a COVID-19 vaccination must be verified by a healthcare provider. Religious exemptions will also be considered.

San Francisco enacted some of the nation’s strictest pandemic regulations and has the highest vaccination rate in the state, with at least 71% of eligible residents fully vaccinated, according to the city’s Department of Public Health. As of Wednesday, 55% of city employees have reported receiving at least one dose of a COVID-19 vaccine, according to the Department of Human Resources.

Not everyone is on board with the new policy. Theresa Rutherford, regional vice president of the Service Employees International Union Local 1021 chapter, said it threatens the livelihoods of front-line essential workers. The chapter represents more than half of all workers employed by the city and county of San Francisco.

At this point, Los Angeles County isn’t planning to follow in San Francisco’s footsteps, according to Public Health Director Barbara Ferrer. “We’d obviously be working very closely with our labor partners, with the Board of Supervisors and the CEO’s office on making a decision of that magnitude,” she said during a briefing Thursday. “You know, there’s about 110,000 county employees, so we would want to really have a healthy discussion with our employees and particularly with our labor partners about what’s the most sensible path forward.”

The University of California and California State University systems have announced they will be requiring all students, faculty and staff on their campuses to be vaccinated.