MONTREAL -- Quebec health-care workers have been taken by surprise, they say, by a new decree that if they refuse to be vaccinated against COVID-19, they could be put on unpaid leave.

That option is part of a suite of new rules that came down this weekend for health-care employees who haven’t yet gotten vaccinated.

For some—those who simply haven’t qualified yet or managed to get an appointment—it’s a short-term measure.

But for those who don’t plan to get a vaccine at all, they now have a hint of what they can expect.

“There are some staff members who haven't been vaccinated yet because of personal choice,” said Naveed Hussain, a nurse at the Royal Victoria Hospital who spoke to CTV.

“There's a variety of reasons why that happens,” he said.

“Sometimes it's misinformation on the internet, social media—and also a lack of information.”

Hussain himself is set to get his second dose of vaccine on Monday, but some of his colleagues have opted out.

Workers in certain parts of health-care facilities are starting to be asked to provide proof of vaccination.

Those who can’t yet do that must undergo preventative testing, while those who refuse can be reassigned to similar tasks in the health network, or be put on unpaid leave, according to the new rules handed down by the health ministry.

This system applies to staff in hot zones, long-term care facilities and hospital intensive-care units, with the exception of psychiatric care, among other places.

The strictness of the new rules seemed like an about-face for a government that hasn’t given much indication it would make vaccines mandatory, some said.

“What we've heard is ‘We would like the employees to be vaccinated, but it's still a choice,’” said Hussain.

In fact, in January, the ethics board of Quebec’s public health institution said it didn’t recommend making vaccines mandatory for the province’s 325,000 health-care workers.

According to one health-care union, it won’t necessarily create big problems, since most employees who were hesitant on vaccines at first have since come around.

But that’s also creating new questions of why this is happening now, partway through the vaccination campaign.

The facilities with the low rates of vaccination were also the “places where we did it at the very beginning,” said Jeff Begley of the CSN union.

“Nobody really wanted to be first.”

According to Begley, with the announcement this weekend, the province has “taken a bazooka to kill a fly.”

A couple of things have changed in recent days, though.

One was vaccinations opening up to a wider group of health-care workers, including those who work in private clinics, interns, and other staff members who come in contact with patients.

Another was the third-wave rise of hospitalizations, which became much more obvious in the last week. Across the province, cases of the virus variants now top 16,000 and are leading to new hospitalization patterns.

“It's younger patients now,” said Hussain. “We're seeing 20-year-olds, 30-year-olds, 40-year-olds being affected more by COVID.”

He says that while he’s relieved to have his shot done, it’s still—even with the new consequences—up to each worker to decide to do theirs.