The deadline for city employees to receive a COVID-19 vaccination, apply for an exemption or face possible termination passed Monday with police, firefighters and emergency medical services workers among the more than 640 county employees who have not been inoculated.

The county expects the number of vaccinated workers to increase now that the U.S. Food and Drug Administration has given full approval to the Pfizer vaccine for adults 16 years of age and older. Statistics on the total number of inoculated workers by department will be available Wednesday, but Mayor Rick Blangiardi said he’s encouraged by the initial read.

First responders were shortstaffed before the pandemic, and any loss for refusing to comply with the mandate would “certainly impact public safety.”

“That’s my concern … that’s my appeal to first responders who have chosen not to get vaccinated. We all signed up to serve. My astonishment is that we have first responders who have chosen not to get vaccinated,” said Blangiardi, addressing the media during a news conference announcing a four-week ban on large events on Oahu. “Now that Pfizer has been approved by the FDA, people who supposedly had issues with this being an experimental drug, hopefully they will come around.”

Every city and county employee received a digital attestation form where they must indicate whether they are vaccinated, applying for a religious or medical exemption, or not participating.

About 94.1% of the county’s 10,877 workers were vaccinated, leaving about 642 workers who have yet to receive the vaccine. City leaders and health care executives highlighted the dire situation facing Oahu’s hospitals and unvaccinated population on a day that saw 320 people hospitalized for COVID-19 with nearly 60 in intensive care units, according to Honolulu Emergency Services Department Director Dr. James Ireland.

“At some point all of these institutions run out of physical space. This has been a 19-month disaster now. … As a community we’ve undergone extraordinary measures to fight this. … We don’t have a finish line yet,” said Ireland, speaking to the media Monday with Blangiardi. “In EMS, I don’t hesitate to say this, I think they are working harder than anybody, answering the calls to 911, responding to people who can’t breathe and need to be intubated and put on ventilators.”

State and county leaders continue to urge all employees to get vaccinated to help stem the spread of COVID-19 and alleviate the stress on hospitals and health care workers.

The city mandate originally required all county employees to be vaccinated by Aug. 16, but that deadline was extended to encourage more workers to participate.

If a request for a religious or medical exemption is denied, the employee “will be given up to five calendar days to initiate the COVID-19 vaccination process or be placed on leave without pay until their employment status is determined,” according to the city’s policy.

Acting Honolulu Police Chief Rade K. Vanic, acting Honolulu Fire Chief Lionel E. Camara Jr. and acting EMS Chief Christopher Sloman, and their leadership teams, are vaccinated.

Through spokespeople, the acting chiefs did not respond to questions about how their departments are encouraging vaccinations, dealing with those who decline the vaccine or how losing staff would affect operations and public safety.

The majority of the 1,100 members of the Honolulu Fire Department are vaccinated, according to the Hawaii Firefighters Association, Local 1463, but there are holdouts. Whether they accept the vaccine or not, no firefighter wants to risk public safety or lose their livelihood.

“We’ve had feedback from both sides of the spectrum: those that are happy with the vaccination push and those who are unhappy with it,” said Bobby Lee, HFFA president. “We strongly advise them (firefighters) to get vaccinated. All of the public safety departments right now are shortstaffed. We don’t want to lose anyone because of something like this (refusing the vaccine).”

Vanic told the Honolulu Police Commission Wednesday that about 75% of HPD employees, sworn officers and civilian staff, signed up to receive the vaccine, and HPD leadership believes they followed through.

The immunization records are kept with the state Department of Health, so HPD cannot confirm past an employee’s admission and display of a valid vaccination card. Some employees might receive the vaccine from their personal physicians without telling the department, and Vanic believes about 80% of the 2,200 workers are inoculated.

“If at that point they indicate they are not going to participate and they are not willing to get tested … we are working with DHR (Department of Human Resources) to send letters to move forward with possible action against them,” Vanic told police commissioners.

A “handful” of officers tested positive for COVID-19, are quarantined after possible exposure or are awaiting testing, Vanic said, and the loss of officers has not affected the department’s operations.

On Aug. 13, 1,200 first responders filed a class-action lawsuit in federal court, asking that the city’s mandate be voided. A hearing is set for Sept. 8 before U.S. District Judge Derrick K. Watson.