President Joe Biden is requiring most federal workers to get COVID-19 shots, without an option to instead get tested weekly, and will propose that workers at large companies get vaccinated or undergo testing.

The president’s plan will also double fines for people not in compliance with federal masking requirements, such as on airplanes. Enforcement of the federal mask mandate on interstate public transportation has not been consistent.

The president on Thursday expressed the frustration of many vaccinated Americans about those who have not yet received the readily available vaccines.

“What more is there to wait for? What more do you need to see? We have made vaccinations free, safe and convenient,” Biden said. “The vaccine is FDA-approved. Over 200 million Americans have gotten at least one shot. We’ve been patient, but our patience is wearing thin, and your refusal has cost all of us, so please do the right thing.”

White House Press Secretary Jen Psaki said there will be limited exemptions for medical or religious reasons for federal workers, and the requirements for those employees would fully take effect in about two-and-a-half months. Biden signed two executive orders Thursday to start implementing the plan.

“So, how this will work is the task force — the interagency task force — would provide a ramp-up period, and we expect federal employees will have about 75 days to be fully vaccinated,” Psaki said at a Thursday White House press briefing. “That gives people more than enough time, in our view, to start and complete their vaccination series. If a federal worker fails to comply, they will go through the standard HR process, which includes counseling and face disciplinary action, face progressive disciplinary action.”

Some federal workers already have COVID-19 vaccine requirements, including members of the military.

“Each agency’s going to work with employees to make sure they understand the benefits of vaccination and how the vaccines are free, easy and widely accessible, but it will start to be applied once the second order is signed,” Psaki said.

She said the penalty for noncompliance could include termination from federal employment.

Thursday’s speech comes as the White House is trying to recast its efforts to control the pandemic as hospitalizations and deaths have risen.

One of Biden’s executive orders requires vaccinations against the coronavirus for most federal workers. The order goes further than a previous policy requiring federal workers to attest to their vaccination status or undergo regular testing.

In the second executive order, the administration’s message is in effect that if a company wants to sell products or services to the federal government, they should get their workers vaccinated.

Challenges in implementation are already arising, however. The American Federation of Government Employees said the union supports vaccinations for its members, but it pushed back against a mandate outside of collective bargaining.

“We expect to bargain over this change prior to implementation, and we urge everyone who is able to get vaccinated as soon as they can do so,” American Federation of Government Employees National President Everett Kelley said in a statement.

Biden will also direct the Labor Department to issue a rule that would require businesses with over 100 employees to require COVID-19 vaccinations or at least weekly testing, which the administration says would affect over 80 million private-sector employees.

“The bottom line: We’re going to protect vaccinated workers from unvaccinated co-workers,” Biden said of the upcoming Labor Department regulation.

The administration will also require health care facilities that accept reimbursement from the Medicare and Medicaid programs to mandate vaccinations for staff, which would affect about 17 million health care workers and cover most health care facilities in the United States.

The Occupational Safety and Health Administration would also require employers to provide paid time off for employees to get vaccinated.

The administration is also preparing a campaign for already vaccinated Americans to get booster shots once such a policy is approved by the Food and Drug Administration and the CDC’s Advisory Committee on Immunization Practices.

The president also urged schools to use a previously provided $10 billion to set up testing programs.

The administration will also require staff in Head Start programs, Department of Defense schools and Bureau of Indian Education-operated schools be vaccinated. The Department of Health and Human Services will issue rulemaking for the Head Start program.

Biden also called on governors to require school staff to be vaccinated, which nine states as well as Washington, D.C., and Puerto Rico have already done. Several Republican governors are unlikely to set such a requirement.

The administration is also taking steps to increase COVID-19 testing, including by invoking the Defense Production Act and purchasing $2 billion in rapid point-of-care and over-the-counter at-home COVID-19 tests, totaling 280 million tests.

Walmart, Amazon and Kroger will all offer COVID-19 tests at cost for the next three months, meaning tests will be up to 35 percent cheaper at those retailers by the end of this week, according to a white paper released by the administration. Medicaid will also cover the cost of at-home tests for beneficiaries.

But the lower price for the test kits may not matter as much if there’s limited inventory. The popular Abbott BinaxNOW rapid test kits were out of stock on both the Amazon and Walmart websites ahead of the president’s speech.

The administration will also double the number of DOD clinician teams to support hospitals that are handling a surge in COVID-19 cases. Officials will also increase the amount of monoclonal antibody treatments to states by a further 50 percent this month, up from an average of approximately 100,000 doses that were shipped weekly in July and August.

The administration’s COVID-19 surge response effort will also expand to include monoclonal anitbody strike teams that will deploy personnel to administer the treatments. HHS will also amend the Public Readiness and Emergency Preparedness Act declaration so that more providers, including pharmacists, can provide the treatment.