The North Carolina-based Novant Health group has fired approximately 175 medical employees after they remained defiant of the hospital system’s mandatory vaccination policy. It is one of the largest-ever mass terminations over a mandate, according to The Washington Post.

Novant Health first announced a mandatory vaccination policy in July, setting a deadline of Sept. 15 for its 375 unvaccinated workers to get jabbed. By Sept. 21, the system announced that close to 400 employees working for its hospitals remained unvaccinated and would be suspended. Those staff members were given a grace period of five days to get immunized, after which they would otherwise be “terminated,” according to a news release. Close to 200 workers received their first dose before the weekend, according to a spokesperson’s tweet on Monday.

Novant Health released data this month showing that more than 90 percent of their COVID-19 patients are unvaccinated. North Carolina has a vaccination rate of around 50 percent, trailing a national rate of 55.4 percent. David Priest, Novant Health’s chief safety, quality, and epidemiology officer, acknowledged last month that the recent wave of infections threatened to overwhelm the local medical system. “They’re tired. I’m tired. We’re all tired,” he said.