Washington, D.C., Mayor Muriel Bowser (D) on Monday issued a vaccine mandate for all eligible student athletes as well as adults who are regularly in schools or child care centers.

All students over the age of 12 participating in extracurricular activities and adults must be fully vaccinated by Nov. 1.

“We know that vaccinations are the most effective tool to slow the spread of COVID-19 and protect children who are not yet eligible to receive the vaccine,” Bowser said in her announcement.

Her order does not include the option of instead getting regularly tested for COVID-19, as some local and state governments have included. However, it does include exemptions for religious and medical reasons.

“This new mandate requirement, without a test-out option, will add another critical layer to the robust measures we have implemented to reopen our schools and keep our child care centers safe,” she said. “We also know that sports are a high-risk activity. Requiring athletes to get vaccinated will ensure they not only stay safe, but also stay in the classroom and are able to participate in school-based extracurricular athletics.”

According to the D.C. government’s vaccine dashboard, nearly 70 percent of the city’s population has received at least one dose of a COVID-19 vaccine. Roughly 55 percent of those aged 12 to 17 in D.C. have received at least one dose of a coronavirus vaccine so far.

Following the Food and Drug Administration’s full approval of the Pfizer-BioNTech vaccine, numerous businesses, colleges and governments began issuing vaccine mandates.

Bowser’s order comes just weeks after the Los Angeles Unified School District voted to require all eligible students to get vaccinated by early next year.