A federal judge on Friday ruled that a Cincinnati, Ohio-area healthcare provider could require its employees get vaccinated against COVID-19 or risk losing their job, in what appears to be the first ruling of its kind for a private employer in the United States.

The employees of St. Elizabeth Healthcare failed to establish that their individual liberties were being violated by the vaccine requirement of the hospital operator, which has the right to set employment terms, said U.S. District Judge David Bunning in Covington, Kentucky.

St. Elizabeth employees must get vaccinated by Oct. 1. The widespread availability of vaccines in the United States helped to reduce infections in the spring and early summer but the Delta variant has led to a new spike in cases and hospitalizations.

Alan Statman, who represented the employees, said they were evaluating their next steps.

Bunning’s ruling is the first involving a request for an injunction against a private employer’s COVID-19 vaccine mandate, said Mark Guilfoyle, a lawyer who represented St. Elizabeth.

In recent weeks, numerous large employers have begun to impose deadlines for employees to get vaccinated as COVID-19 infections remain elevated in the United States.

Also on Friday, the Biden Administration spelled out plans to require federal contractors to get vaccinated, which will apply to tens of millions of Americans.

Employer vaccine requirements have spawned numerous lawsuits, although most are still in the initial stages. A federal judge in June dismissed a lawsuit against Houston Methodist Hospital under Texas wrongful termination law.

The class action on behalf of St. Elizabeth employees was based in part on concerns about the safety and efficacy of the COVID-19 vaccines, among other claims.

Those suspicions cannot override the law, said Bunning.

“If an employee believes his or her individual liberties are more important than legally permissible conditions on his or her employment, that employee can and should choose to exercise another individual liberty, no less significant – the right to seek other employment,” wrote Bunning.