SPRINGFIELD, Ill. (NEXSTAR) — A new state vaccine mandate is now in place for hundreds of thousands of teachers, nurses, and other medical professionals in Illinois. Staff at schools, hospitals, and clinics will now have to show proof they’ve been vaccinated or submit to weekly Coronavirus testing after a new statewide requirement went into effect on Sunday.

The Pritzker administration delayed the initial vaccine mandate to buy enough time to negotiate a testing option with schools and hospitals. Most school districts are now offering rapid saliva tests from the University of Illinois’ SHIELD testing system. Some others are using PCR or antigen tests from a provider named Achieve. Both programs use federal funding to pay for the tests, which are available at no cost to teachers in many school districts. Hospitals report using a wide variety of tests.

“It was hard for some of them to implement that,” Governor Pritzker said at a press conference in Peoria on Monday. “Particularly the healthcare institutions, interestingly, because of not having enough personnel.”

While most teachers and nurses are already vaccinated, administrators at school districts and hospitals are now bracing for tough conversations with some of their unvaccinated employees who may refuse to submit to testing. A small group of protesters, including some health care workers, rallied outside the state Capitol on Saturday to voice opposition to the vaccine mandate. Since unvaccinated workers have a week to show their employers a negative Coronavirus test, the first hard deadline will come at the end of this week.

“If they do not test or provide the beginning of their vaccination, then we can we cannot let them then work in the school building after this week,” Springfield’s District 186 superintendent Jennifer Gill said.

Worker shortages have plagued the the education and health care sectors since long before the pandemic began. Now employers are concerned they may lose some ground in filling open positions if the mandate forces some workers off the job.

“My primary job in an education system is to educate our students, and we are also in the middle of a very deep and important employee shortage that we have across the state,” Gill said. “It’s not just the teacher shortage. It’s paraprofessional shortage, it’s bus driver shortage, it’s all of the above. And operating a district to educate students is my primary goal. And that is something that we have to keep in mind.”

“Of course, I’m concerned about people who will refuse to get vaccinated and refused to get tested,” Governor Pritzker responded when asked about the potential for the vaccine mandate exacerbating staffing shortages. “We don’t want to cause any shortages, but we do want to keep everybody safe,” he said. “We do have these alternatives available to people. But again, vaccination is the safest thing that people can do for themselves for their communities for the schools, as well as healthcare groups for their health care.”

Vaccine mandates have caused unintended consequences in other areas. A hospital in New York recently had to suspend services in the birthing unit after several nurses resigned in protest to a vaccine mandate.

The Illinois Health Care Right of Conscience Act does provide civil protections for patients who decide to refuse vaccines or medical tests. Gill says the new state vaccine mandate policy allows teachers to decline the vaccine for medical or religious objections, but she cited new emergency rules from the Illinois State Board of Education, and said that a religious exemption “does not apply to testing.”

A spokeswoman for the State Board of Education said any school district that does not enforce the vaccine mandate “risks state recognition,” which could result in a school district losing state funding.

“ISBE will investigate all complaints of noncompliance,” spokeswoman Jackie Matthews said in an email. “School districts will maintain records at the local level to ensure the compliance of all school personnel.”

School districts have to identify personnel in three categories: “fully vaccinated, unvaccinated workers in compliance with testing requirements, or excluded from school premises.”

The Pritzker administration expects legal challenges to the vaccine mandate.

“I know that there are people who are attempting to challenge these things in court,” Pritzker said. “I would just say that this is a very unhelpful thing to do, and it is going to make schools and healthcare settings less safe.”

Most teachers and students who are old enough to be vaccinated have already had their shots. Gill said 72.3% of teachers in Springfield schools are fully vaccinated, while 20% have not yet responded to the district’s questions, and 6.4% say they will refuse the vaccine despite the mandate.

More than a year-and-a-half into the pandemic, the virus is still spreading so quickly through unvaccinated populations that it’s putting severe strain on health care systems, especially in Central and Southern Illinois.

Region Five, which consists of 20 of the state’s southern-most counties, has no ICU hospital beds left available, according to the Illinois Department of Public Health. St. Anthony’s hospital in Effingham set a pandemic record with 24 patients hospitalized with Covid-related illness last week. All but two of them were unvaccinated.