Anjali Sundararaman, a student nurse at San Francisco State University, gives Cuixia Xu a dose of Moderna-COVID during a vaccination clinic at the Southeast Health Center in the Bayview-Hunters Point neighborhood of San Francisco, Calif. On Monday, February 24 19 vaccine. 8, 2021.

Stephen Lam | San Francisco Chronicle | Hearst Newspapers via Getty Images

San Francisco became the first major US city on Thursday to require guests and staff to provide proof of full vaccination to enter restaurants, gyms, bars and entertainment venues.

The Mayor London Breed order goes into effect on August 20 for customers and October 13 for employees and prohibits residents from submitting negative Covid-19 test results as a substitute for a vaccination. Breed’s policy also applies to select health workers, including pharmacists, dentists, and domestic helpers.

“Vaccines are our way out of the pandemic and our way back to a life where we can be safe together,” Breed said in a statement.

According to the regulation, anyone over the age of 12 must present a vaccination card to attend an indoor event with more than 1,000 guests. In California, participants have so far only had to be vaccinated for events with over 5,000 people, according to the Breed statement.

Breed noted that the order completely excludes people under the age of 12 who are still not eligible for all current Covid vaccines. Customers who collect food instead of eating inside do not need to be vaccinated either.

San Francisco County recorded a total of 1,708 new coronavirus cases over seven days on Tuesday, a decrease of less than 3% from the previous week, according to the Centers for Disease Control and Prevention. But California reported a seven-day average of more than 12,000 new cases on Wednesday, a 24% increase from the previous week, measured Johns Hopkins University.

San Francisco joins New York City as one of the largest communities in the country with vaccination regulations for select indoor activities. New York City will begin enforcing its mandate on September 13, when customers and employees are required to demonstrate they have received at least one dose of vaccine to exercise, eat at restaurants, and access indoor entertainment.

San Francisco previously worked with six other Northern California counties to make face coverings mandatory for indoor public spaces on August 2, and updated a mask recommendation they first issued in July.

Several companies based in the Bay Area have ordered that all or part of their employees also immunize themselves against the coronavirus, including Google, Facebook and Gap. At least a dozen other major employers across the country have put in place similar guidelines as the Delta variant continues to rise.