ALBANY, N.Y. — Some hospitals and nursing homes in New York began removing workers Monday for failing to meet a state-mandated deadline to get a COVID-19 vaccine as Gov. Kathy Hochul pleaded with holdouts to get 11th-hour inoculations.

It was not clear Monday if a wave of suspensions and terminations of healthcare workers who refused be inoculated would cause dramatic staff shortages around the state. Hochul said workers had until the end of the day Monday to get at least one dose of the COVID-19 vaccine, as required.

"To those who have not yet made that decision, please do the right thing," Hochul said at a press briefing. "A lot of your employers are anxious to just give you the jab in the arm and say you're part of the family, we need your help to continue on."

The rules apply not just to people like doctors and nurses, but also to others who work in health care institutions, like food service workers, administrators and cleaners. Employees who refuse the shots face suspensions and termination. And workers terminated because of refusal to be vaccinated are not eligible for unemployment insurance without a doctor-approved request for medical accommodation.

Hochul has held firm on the mandate in the face of pleas to delay it and multiple lawsuits, insisting that the state needs to protect vulnerable patients.

Some holdouts say vaccination should be a personal choice.

"I really got to a point where if I got it, I would be disgusted with myself for being strong-armed into it. Just morally, I feel like it would put me in a bad place of self-loathing," said Jessica Bond, who was a physical therapy assistant at the Brothers of Mercy nursing home in the Buffalo suburb of Clarence.

Her last day was Friday.

Bond, who feared side effects from the shot, said she worked extra shifts during the pandemic to help fill gaps after a lot of her co-workers quit.

"So it kind of is a kick in the face now to be going through all this, because it's like, well, I was good enough then," said Bond, who was part of an unsuccessful legal challenge to the mandate.

She plans to start a home cleaning business.

The Erie County Medical Center Corporation in Buffalo said about 5% of its hospital workforce has been put on unpaid leave due the mandate, along with 20% of staff at its nursing home. The state's largest health care provider, Northwell Health, said about two dozen unvaccinated employees it characterized as leaders were "exited from the system," and that they would begin that process for the rest of the unvaccinated staff. A spokesperson declined to clarify.

Noncompliant employees at hospitals run by the State University of New York face "immediate suspension and pending termination" on Tuesday, according to a memo sent to administrators by Chancellor Jim Malatras.

"If people are not vaccinated, they're not going to get paid for today," said Mitchell Katz, head of New York City's public hospital system. "But we're keeping lines of communication open, and we're hoping that if not today, then by tomorrow people will go and get vaccinated and resume their posts."

About 84% of over 450,000 hospital workers in New York were fully vaccinated as of Wednesday, according to state data. Nursing home data, which was through Sunday, showed about 89% of nursing home workers fully vaccinated.

Northwell Health said nearly 100% of its workforce was vaccinated. The city's hospital system reported a 95% rate for nurses and a higher rate for doctors. Albany Medical Center reported that 98% of its staff was vaccinated.

As the vaccination deadline loomed, hospitals and nursing homes came up with contingency plans for staff shortages that included cutting back on noncritical services and limiting admissions at nursing homes. The mandate comes as hospitals are already reeling from staff shortages fueled in part by workers retiring and employees seeking other jobs after 18 months of the pandemic.

Hochul said she will sign an executive order giving her additional power to address staff shortages. She is looking at calling in medically trained National Guard members and retirees, or vaccinated workers from outside the state, to fill any gaps. The state also will convene an "operations center" to shift resources to healthcare facilities with workforce shortages, she said.

Health care workers can apply for a religious exemption, at least for now. A federal judge on Oct. 12 will consider a legal challenge arguing that such exemptions are constitutionally required.

Brittany Jane France, a nurse practitioner at Strong Memorial Hospital in Rochester was granted a temporary religious exemption so is continuing to work for now, but if a judge revokes that, she would consider leaving her profession until something changes.

"I worked really hard to get where I am," said France, who believes she has natural immunity after recent mild case of COVID-19. "But I'm also not willing to give up my personal freedoms because someone else thinks they know what's best for me."

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Associated Press writers Carolyn Thompson in Buffalo, Marina Villeneuve in Albany, New York, and Michelle L. Price in New York contributed. Associated Press researcher Rhonda Shafner contributed to this report from New York.