Philadelphia health care workers, as well as college students, faculty and staff, will need to be fully vaccinated against COVID-19 by Oct. 15, officials announced Friday.

The definition of "health care worker" is intentionally broad and includes school nurses, nursing home employees and home health aides, Acting Health Secretary Dr. Cheryl Bettigole said. The vaccination requirement will be waived for those with medical or religious exemptions, though exempted health care workers will need to submit to antigen or PCR testing twice per week, she said.

“These regulations are aimed at protecting the most vulnerable through the vaccination of health care workers, and they’re aimed at preventing the further spread of COVID-19 through the vaccination of college and university students, understanding that young adults are the population with the lowest vaccination rate and the highest rate of COVID-19 vaccination,” Bettigole said.

Colleges and universities will need to offer exempted individuals a PCR test once a week or an antigen test twice a week, Bettigole added. Antigen tests can offer faster results, but are less accurate than PCR tests.

At schools with a vaccination rate of 90% or higher, exempted individuals may instead be asked to double mask and maintain six feet of social distancing while at indoor public spaces, the health secretary said. When feasible, colleges and universities may offer a virtual option instead of in-person attendance.

The new mandates follow the recommendations of the Philadelphia Board of Health, which Thursday night expressed concerns about rising infections among college students.

“It affects everyone beyond the college and we have to take a bold move,” board member Amid Ismail said Thursday nigh. “We need to reach 80-90% vaccination rate to get out of this pandemic.”

Bettigole asserted Friday that the Philadelphia Board of Health has the authority to mandate vaccines at universities and pointed out that vaccine mandates are already common, such as public schools requiring that children be immunized for various diseases.

She also provided updated guidelines to the mandate the city issued for businesses, which stipulates they must require either masks or proof of vaccination from employees and customers.

After hearing from parents concerned about not being able to go to the grocery store with their kids, the Philadelphia Board of Health created a list of essential businesses that includes grocery stores, pharmacies, doctors' offices and urgent health centers, Bettigole said. These businesses, unlike restaurants or retail establishments, must require masks instead of proof of vaccination, since vaccines are not yet approved for kids under 12.

The latest mandates come as the city experiences a rising number of infections, driven largely by the more transmissible delta variant, and a refusal by many to get immunized.

Bettigole noted that while Philadelphia is in better shape than many other cities – especially those in the South, where some lawmakers have railed against measures like vaccine and masking mandates – the number of coronavirus infections has nonetheless continued to rise.

The average number of new infections per day has doubled three times in the last month, and the city is now averaging nearly 200 new daily cases, Bettigole said. Additionally, she noted, for the first time since early June, more than 100 people are currently hospitalized with COVID-19.

"At a certain point, with cases soaring and hospitalizations on the rise, we have to act. There are hospitals in this country that are full, where soon doctors will be in the position of having to decide which critically ill patient gets the ventilator or the ICU bed, and where emergency departments will be telling ambulances that they have to drive to another hospital, even if that hospital is miles away," Bettigole said. "People who need emergent care for heat attacks, strokes or trauma will wait longer, and for some of them that extra time will be too long. We cannot let that happen here in Philadelphia."

Data from the Philadelphia Department of Public Health shows that a little more than 63% of adult residents have been fully vaccinated, with just over 77% having received at least one dose.

Bettigole did not discard the possibility of mandating vaccines for other groups of people.

“As I’ve said consistently, we will do what we have to do to keep the city safe. This is what we’re doing today, and we’re hopeful that this will be enough to control spread and to protect people who are most vulnerable," she said. "I can’t promise you that we wouldn’t be adding other groups to this; it just depends what happens."