A health care provider in Minnesota fired 50 employees because they refused to get flu shots, KBJR reported. >> Read more trending news Essentia Health had imposed a Monday deadline for employees to get flu shots or receive an exemption for medical or religious reasons. Since September, Essentia employees, volunteers, students and vendors had three choices: get a flu shot, show an approved religious or medical exemption, or leave the company, KBJR reported. Essentia chief of patient quality and safety Dr. Rajesh Prabhu said the company wanted to increase patient safety and boost its 82 percent flu vaccination rate from 2016, which he said was not going to increase voluntarily. “Purely voluntary or more education doesn't get you those high levels of immunization compliance and as you know other states, other health care organizations have done the same thing we have,” he told KBJR. Prabhu said that as of Tuesday, 99.5 percent of employees have chosen the first two options, but 50 so far have been terminated with more left waiting to hear back on their exemptions. Minnesota Nurses Association Duluth chairman Steve Strand said with so many employees in limbo, his union doesn't know how many members may have lost their jobs yet. “We believe that they will be denying some of those, and then those individuals may end up terminated also,” Strand told KBJR. But Strand said his association intends to fight any terminations for a policy they say is unnecessarily intrusive and may not even be effective. He cited Centers for Disease Control research showing this year's vaccine is expected to be 60 percent effective against the flu. “The flu shot isn't a be-all end-all, it only has a certain efficacy,” Strand said. Essentia said it stands by its mandatory policy. 'People may debate on how effective that is but based on what the level of evidence is and what our peers are doing, we thought this was the best way to protect our patients,' Prabhu told KBJR.