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RALEIGH, N.C. (AP) — The North Carolina Healthcare Association announced on Thursday that several of the state's largest hospital systems will require employees to get a COVID-19 vaccine in order to continue working at their facilities.

The sites that will soon mandate vaccinations for workers include Duke University Health network and several UNC Health hospitals.

Other hospital systems that will compel staff to get the vaccine will include Charlotte-based Atrium Health, Greensboro-based Cone Health, Wake Forest Baptist Health and Winston-Salem based Novant Health.

“Hospital and health system employee vaccination against COVID-19 is vital to safely care for patients by protecting them from infection, and to mitigate the spread of the virus within healthcare facilities and among clinicians, patients and their families and friends,” the group wrote in a message to its 130 members.

The move comes as North Carolina decided on Wednesday to eliminate its statewide mask starting July 30. The state has seen a surge in cases and hospitalizations fueled by the more lethal delta variant.

On May 6, most adult residents had received at least one dose of vaccine, according to the state Department of Health and Human Services. The office told The Associated Press on Thursday that 94% of cases and deaths reported between May 6 and July 11 have been among people not fully vaccinated.

The latest state data shows 54% of residents eligible for a shot are fully vaccinated, less than the national average of 57% of Americans 12 and older being fully immunized, according to data from the U.S. Centers for Disease and Prevention. Vaccination rates are far worse in several North Carolina counties. In Hoke County, a rural area outside of Fayetteville, less than 1 in 4 residents have gotten at least one COVID-19 shot.

North Carolinians 12 years of age or older are eligible for a COVID-19 shot, which are widely available and free of charge. At participating vaccination sites, unvaccinated adults who come in for their first dose can get $25. Drivers who bring someone in for their initial shot also qualify for the prepaid Mastercard.

Dr. Mandy Cohen, the state's top public health official, praised the association for encouraging hospitals to compel their workers to get vaccinated.

“Thank you to the North Carolina Healthcare Association, and the health systems that are leading the way requiring vaccination for employees, for taking action to protect the health care workforce, their patients, our communities and the state," Cohen said in a news release. "Vaccinations are our way out of the pandemic. Don’t wait to vaccinate.”

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