Proof of vaccination will be required at indoor bars, restaurants, clubs, theaters and entertainment venues, as well as indoor gyms and other fitness establishments. This does not include individuals ordering or picking up food or drink to go.
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San Francisco's order also creates a new proof of vaccination requirement for large events at indoor venues, requiring attendees who are age 12 or older at events with 1,000 people or more to provide proof of vaccination.
Under the new order, a negative COVID test will no longer be considered an exemption to being fully vaccinated.
"We are not out of the woods as it relates to COVID, we are still going through it," said San Francisco Mayor London Breed. "Of course, we're sick and tired of it, but it's not sick and tired of us."
The health order will extend vaccination requirements to certain health care providers -- including workers at adult day centers, residential care facilities, dental offices, home health aides and pharmacists, who are not included in the state health order on vaccinations.
The mandate does not include children under 12 who are not yet eligible for the COVID vaccine or people picking up to-go food orders.
"We don't want people to think, a family of four with two kids seven years old that you can't go to a restaurant - you can," said Breed. "We know that your children cannot be vaccinated, but the parents will need to be."
The requirement for patrons goes into effect on Aug. 20 and for staff on Oct. 13.
VIDEO: San Francisco Mayor London Breed announces new vaccination mandate
However, some say they are not prepared to serve guests and check their vaccination status because they are short-staffed.
Danielle Reese owns Queen's Louisiana Po-boy Café on the Embarcadero.
She fears enforcing the mandate will mean a loss in tourist business.
"We don't want confrontation with anybody on their political views as far as vaccines go, I'm just here to feed people," said Reese.
Enforcing the rules is up to the business owners, and as Reese puts it, "We have enough going on as it is now."
VIDEO: SF restaurant owner fears loss of business over vaccine mandate
As far as the mask mandate, that will remain in place. The health officers' put the mask mandate in place to deal with the rapid spread of the delta variant, so they will continue to assess the indoor mask mandate.
County health officials say the city's COVID compliance team, also known as CERT team, will be reactivated on a smaller scale to help with educating businesses. But enforcement on verifying vaccines and exemptions will fall on the individual business owners.
"It's going to be a little unclear how to deal with an exemption situation," said Laurie Thomas, the executive director of the Golden Gate Restaurant Association. "Each restaurant owner or business might have different legal advice."
Businesses will be required to check a person's ID and vaccination card match before allowing anyone indoors.
"If there's six people in the party and one or two of them don't have a vaccine card, they're going to be asked to sit outside," said Thomas.
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Dr. Grant Colfax says vaccinations are strongly recommended but not required for outdoor 'mega' events -- where 5,000 or more people are attending. For example, vaccinations won't be mandated for Giants games, but will be mandated for anyone dining indoors at the stadium.
The city is reporting 263 new daily COVID cases and have at least 107 people in the hospital as of Thursday, according to the mayor's office.
The announcement couldn't have come soon enough for MX3 Fitness Co-Owner Dave Karraker.
VIDEO: San Francisco business owners say they're on board with latest vaccine mandate
"We're already a health-driven industry and this gives our clients that one more piece of assurance that they are going to be safe when they go into a gym to workout," said Karraker.
Karraker says his number one priority is the safety of his employees and members.
"We need to take every precaution possible to stop the Delta variant in its tracks."
Restaurant Owner and Executive Chef Mat Schuster says his business Canela Bistro & Wine Bar started requiring proof of vaccination for customers indoors two weeks ago.
"We saw the writing on the wall and we wanted to be part of the solution," said Schuster.
Customers will have the option of showing their actual vaccination card or a photo of it. You can also register your vaccination with the state.
Both Karraker and Schuster say they'll do their best when it comes to verifying what they're looking at is legit.
"As of now we are asking for pictures and for photo ideas but hopefully that process will get a little bit easier as it becomes more prevalent," said Schuster.
"I think we really need to trust each other on this," said Karraker.
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