LANSING, Mich. (AP) — Two of Michigan’s largest health systems will require all employees and physicians at their hospitals and other facilities to be vaccinated against COVID-19.

Spectrum Health, a 14-hospital network, and eight-hospital Beaumont Health announced the mandates Wednesday, July 28. At least five major hospital systems in the state have announced such requirements.

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Grand Rapids-based Spectrum has 31,000 employees. Beaumont, based in Royal Oak, has 33,000 workers. They join the Henry Ford Health System in Detroit, Livonia-based Trinity Health, and Ascension Health, which is headquartered in Missouri but has 15 hospitals in Michigan. About 70% of Spectrum’s onsite staff are vaccinated, a spokesman said.

“We must do all we can to take care of each other, and our community,” Spectrum President and CEO Tina Freese Decker said in a statement that cited the coronavirus vaccines’ effectiveness in reducing the risk of hospitalization, death, and long-haul symptoms. “Together, our actions will serve to save lives and shorten the impact of the pandemic — both clear benefits to the public good.”

Both Spectrum and Beaumont said their requirements will go into effect after the U.S. Food & Drug Administration approves one or more of the current vaccines. Three vaccines currently have emergency use authorization.

Full approval is expected early this fall, Beaumont said, adding that if the positive coronavirus rate in surrounding communities begins to spike or if the health system experiences a fourth pandemic surge, the mandate will begin sooner. Both hospital systems cited the delta variant, a mutated and more transmissible version of the virus.

Employees and providers who do not meet exemptions and refuse to get vaccinated will initially be suspended, and those who “choose not to be vaccinated will no longer be allowed to work at Beaumont,” the health system said.

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“We have a duty to protect our patients and our staff,” Beaumont Health Chief Executive John Fox said. “The vaccine is the only safe and effective way to truly protect against COVID-19.”

The announcements came a day after the Centers for Disease Control and Prevention recommended that vaccinated people wear masks indoors in areas of “substantial or high transmission.” That includes 10 of 83 counties in Michigan, whose overall two-week infection rate ranks low nationally.

The state currently requires health care employees to wear masks at work.

The Michigan State Medical Society, a trade group of doctors, said it supports vaccine mandates for health workers.

“Many have been vaccinated, and we have made great progress bringing life back to the way it was early last year,” said Dr. Pino Colone, the group’s president. “Still, COVID is not gone. In fact, it is changing and spreading and right now infecting an increasing number of people who, in most cases, have yet to be vaccinated.”

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