Health care providers ranging from Mayo Clinic in Jacksonville to small physicians' offices are beginning to put requirements in place for staff members to get vaccinated.

"It is something that is very important to me and to the safety of my other employees and my patients. Because we see a lot of patients," St. Petersburg-based immunologist Mona Mangat said of mandating COVID-19 vaccinations for her office staff. "We see a lot of children, and we see a lot of immunocompromised [patients], so it's very important as we promote good health we lead the way."

The office has eight staff members, but Mangat said only one person has refused to get vaccinated.

Mangat is a solo practitioner, but larger medical providers also are moving ahead with vaccine mandates.

The 7,400 employees at Mayo Clinic in Jacksonville will have to be fully vaccinated, or complete a declination process, by Sept. 17. Staff who refuse to be vaccinated will be required to wear masks and socially distance.

Mayo did not release information about the percentage of staff members who have been vaccinated. But in a statement released Monday, Mayo said that vaccination rates at its clinics in Jacksonville, Rochester, Minn., Scottsdale, Ariz., and Phoenix range between 75% and 85%.

"We are proud of our staff's high vaccination rates and are grateful that the vast majority have embraced the opportunity to get vaccinated," Gianrico Farrugia, a physician who is Mayo Clinic's president and CEO, said in a prepared statement. "Our patients expect to be safe when they come to Mayo Clinic, and we need to do everything we can to protect everybody."

Mayo's Florida clinic is in Duval County, which has the lowest vaccination rate among the state's most heavily populated counties. According to federal Centers for Disease Control and Prevention data, 41.5% of the county's residents were fully vaccinated as of Saturday. That compared to 60.1% in Miami-Dade County and 50.8% in Broward County.

Duval has had an average of 671 reported COVID-19 cases for every 100,000 residents over the past week, the federal data show. By contrast, Miami-Dade has had about 408 reported COVID-19 cases for every 100,000 residents during the same frame.

Mayo's announcement about staff vaccinations came as more than 50 health-care organizations, such as the American Medical Association, the American Nurses Association and the National Association for Home Care & Hospice, signed a letter Monday calling for all health-care workers, including those in the long-term care industry, to get vaccinated.

Florida Gov. Ron DeSantis, while calling vaccinations a lifesaver, has been adamant that he will not support any vaccine mandates, leaving health-care providers in the state to deal with a potential political backlash if they go against him on the issue.

No Florida medical organization or trade group signed onto the Monday letter, and no statewide medical organization contacted by The News Service of Florida has issued a directive encouraging members to require vaccinations.

The U.S. Food and Drug Administration gave emergency-use authorization to three vaccines, with millions of Floridians getting shots beginning late last year and continuing this year.

But the combination of the delta variant and millions of other Floridians who are unvaccinated has caused a spike in cases in recent weeks that has led to hospitals getting inundated with COVID-19 patients. While not foolproof, the vaccines have proven effective in preventing patients who become infected from dying.

Meanwhile, according to a recent AARP report, just 42% of employees at the state's 698 nursing homes had been fully vaccinated as of last month, putting Florida well behind the national average of 56% and ranking it second from last in the nation.

The Florida Health Care Association, the state's largest nursing-home trade group, has promoted national vaccination efforts but has not issued a directive on mandatory vaccinations, according to spokeswoman Kristen Knapp.

Knapp said, however, she has heard that "several" facilities across the state are working on policies that would require mandatory vaccination.

Similar to the nursing home association, the Florida Senior Living Association has not issued policies about mandatory staff vaccinations. Sandi Poreda, a spokeswoman for the association, said "we're definitely promoting the vaccine to our members, but we're also allowing each of them to make their own decisions about whether to mandate it."

Jeff Scott, general counsel of the Florida Medical Association, said his organization, which represents roughly 25,000 physicians, hasn't "considered the issue of vaccine mandates."

The American Hospital Association Board of Trustees last week approved a policy statement that "strongly urges" vaccination of all health care workers at its member hospitals.

But the Florida Hospital Association and the Safety Net Hospital Alliance of Florida, the state's two leading hospital groups, have been mum on vaccine mandates.

The Safety Net Hospital Alliance, which includes public, teaching and children's hospitals, has not weighed in on mandatory vaccinations, according to Justin Senior, the association's chief executive officer.

Senior told the News Service that his member hospitals "are all very much encouraging staff to get vaccinated." But Senior said the hospitals also are "watching the litigation" surrounding vaccine mandates.

In addition, Florida hospitals are watching to see whether the FDA gives full approval to the COVID-19 vaccines, Senior said.

But the emergency-use approval did not stop the federal Department of Veterans Affairs from mandating vaccinations. Secretary Denis McDonough said in a statement that the department will require health care personnel who work in VA facilities, visit VHA facilities or provide direct care to patients to be vaccinated.

The VA operates about 50 outpatient clinics and more than two dozen counseling centers across Florida.

"Getting vaccinated for COVID-19 is the single most important thing all of us can do to protect our patients, visitors, colleagues and communities," McDonough said in a statement.