AUGUSTA, Maine — Maine will be one of the first states to require COVID-19 vaccines for health care workers after Gov. Janet Mills announced an aggressive policy shift on Thursday that sets an Oct. 1 deadline for them to be fully inoculated.

The mandate will come through an emergency change to state rules governing vaccinations for workers in health care settings, including hospitals, nursing homes and residential care facilities and home health agencies. Paramedics and dental practitioners would also be covered. Vaccine requirements were amended this year to also mandate the flu vaccine.

The new standards are among the strictest in the nation. Maine will not have a testing alternative for those who refuse vaccines like ones instituted recently in California and Oregon. Washington issued more stringent rules similar to Maine’s this week. There is a medical exemption in Maine law for people whose doctors deem immunization “medically inadvisable.” 

Mills first floated the idea of requiring employees to get vaccinated on Tuesday as cases continued to climb and after Maine Medical Center in Portland and Waldo County General Hospital in Belfast both reported outbreaks among staff. The requirement was supported by the Maine Hospital Association and other groups representing nursing homes and dentists.

During a news conference, the Democratic governor mentioned the more contagious delta variant spurring the majority of new cases in the country as a reason for the change, noting it could challenge the state’s comparatively low virus rates. 

Mills rejected concerns about staffing levels at health care facilities after the mandate is in effect, saying the universal statewide rule will make it so “there won’t be many places to go” if unvaccinated workers want to leave their current jobs. She said Mainers “have a right to expect that everybody who cares for you” is vaccinated.

“Our first priority is to protect the life and health and welfare of our citizens,” she said. 

Conservatives slammed the mandate, with Maine Senate Republicans characterizing the governor’s actions in a statement as “directing the health care decisions of Maine’s health care professionals.” They said requirements should be left to individual employers.

Maine’s hospitals never bumped up against their capacities at the height of the pandemic. The number of people hospitalized here stands at 67, a number that has increased in recent weeks but has yet to stress the system. Other states, such as Texas and Florida, are struggling as virus patients pack emergency rooms.

Vaccination rates vary across the five different kinds of health facilities that Maine is tracking, with 12,000 unvaccinated workers in hospitals, nursing homes, assisted living facilities, ambulatory surgical centers and care facilities for people with intellectual disabilities as of late July. Overall, 80 percent of hospital workers were fully vaccinated then. The rate was 73 percent in nursing homes.

The mandate gives cover to health care facilities wary of alienating staff. Nursing homes, which the virus hit hard last year prior to vaccines all but stopping deaths there, have expressed support for requiring vaccinations but have held off due to long-standing staffing concerns.

More and more places, including colleges and restaurants, are requiring vaccinations for employment or entrance. MaineHealth, Northern Light Health and Millinocket Hospital are already among the hospitals requiring workers to be vaccinated.