LOS ANGELES — Patronizing indoor restaurants, bars, gyms, shopping centers, entertainment venues and personal care establishments in the city of Los Angeles will soon require proof of full COVID-19 vaccination under an ordinance approved Wednesday by the City Council and signed by Mayor Eric Garcetti.

The ordinance is one of the strictest mandates of its kind in the country.

The measure passed 11-2, with Councilmen Joe Buscaino and John Lee dissenting and two other members absent from the vote. Because the ordinance did not receive 12 votes, it will not go into effect until one month after its publication, or at least Nov. 6. The ordinance was originally anticipated to take effect Nov. 4.

"We've spent too much time placing restrictions on people who did their part by getting vaccinated and wearing their masks. We need to both limit the transmission of the virus as well as make it inconvenient for those who are unvaccinated to access indoor venues and put lives at jeopardy. The stakes are too high," Council President Nury Martinez said previously.

The ordinance applies to establishments that serve food or beverages, gyms and fitness venues, entertainment and recreation venues, including movie theaters, shopping centers and personal care establishments.

Retail establishments such as grocery stores and pharmacies are not included in the ordinance.

"Vaccinating more Angelenos is our only way out of this pandemic, and we must do everything in our power to keep pushing those numbers up," Garcetti said in a statement after the council's vote.

"These new rules will encourage more people to get the shot, and make businesses safer for workers and customers — so that we can save more lives, better protect the vulnerable and make our communities even safer as we fight this pandemic."

As of Sept. 30, 78% of eligible Los Angeles County residents age 12 and up have received at least one dose of vaccine, while 69% are fully vaccinated.

Of the overall county population of 10.3 million people, including those not yet eligible for the shots, 67% have received at least one dose, and 60% are fully vaccinated, according to Los Angeles County Public Health Director Barbara Ferrer.

The city's Chief Legislative Analyst told council members last week that the city does not yet have a department chosen to enforce the ordinance, but it has identified the Department of Building and Safety as the most relevant.

That department, however, does not have the staffing to enforce the law. Actual enforcement is set to begin Nov. 29, and businesses that violate the ordinance would be issued a $1,000 fine for a second violation, $2,000 fine for a third violation and a $5,000 fine for a fourth violation.

Buscaino opposed the measure over the lack of enforcement, while expressing concern that untrained employees in understaffed restaurants would be responsible for ensuring compliance.

Lee issued a statement after the vote saying he believes the measure "misses the mark in terms of addressing the underlying issues regarding why people are not getting vaccinated. Education and not politicization is the best way to defeat COVID-19." He added that the ordinance would create a false sense of security for people who are vaccinated and be punitive toward businesses.

Councilmen Bob Blumenfield, Mike Bonin and Paul Krekorian also expressed concern about details in the ordinance, including a lack of enforcement, but said it was imperative that the requirement goes into effect quickly, with the details ironed out later.

"All those concerns being said, we can't delay a day longer. We need to advance forward with an ordinance that is going to protect people from their fellow citizens who are making a choice not to be vaccinated," Krekorian said last week.

People can be exempted from the mandate if they have medical conditions that restrict their ability to get vaccinated or a "sincerely held religious belief.." Those exemptions will have to be reviewed by the location the person is trying to enter.

People who are exempt will be able to use outdoor areas of the location, but if unavailable, they may be allowed to enter the indoor area by providing proof of a negative COVID-19 test.

The ordinance also requires people to show proof of vaccination or a negative COVID-19 test to attend outdoor events with 5,000 or more people, which would be stricter than the LA County requirement taking effect Thursday, which applies to outdoor events with 10,000 or more people.

The ordinance is similar to policies in West Hollywood, New York and San Francisco. West Hollywood's policy to require adult patrons entering many indoor businesses to submit proof of at least partial vaccination goes into effect Thursday, with full vaccination required beginning Nov. 4.

Los Angeles County will implement a vaccination mandate beginning Thursday that applies to employees and patrons of indoor portions of bars, breweries, wineries and distilleries. That rule requires at least partial vaccination beginning Thursday, with full vaccination required by Nov. 4.

The Los Angeles Area Chamber released a statement after the city ordinance passed, saying it was concerned that the policy wasn't consistent with the county's requirements.

"We are concerned by the City Council's ordinance because it does not align with the health orders from the County of Los Angeles, which could cause confusion for businesses that are already navigating multiple health orders," said Maria S. Salinas, president and CEO of the chamber.

"The order applies to more businesses and events than the LA County order, which creates inconsistent health guidelines throughout the broader region."

Salinas called for a statewide mandate to ensure consistency across jurisdictions. The chamber also sent a letter to Gov. Gavin Newsom.

Rep. Mike Garcia also criticized the ordinance.

"Hospitalizations and deaths are down 45% from last month, but the City is now putting in place the most radical measures yet," Garcia, R-Santa Clarita, tweeted.

"These restrictions will kill struggling businesses and effectively remove 30 percent of LA residents from public life. This is absolutely discriminatory and unconstitutional! Let the lawsuits fly!"

While Los Angeles County continues to see falling numbers of COVID-19 hospitalizations and other metrics, the pace of residents being vaccinated has slowed dramatically, and Ferrer has warned that the pandemic will only end if that pace quickens.

According to the U.S. Centers for Disease Control and Prevention, fully vaccinated people can still contract COVID-19 and transmit it to others, although they are far less likely to develop symptoms, require hospitalization or die from the virus.

There is some evidence that fully vaccinated people will likely spread the more contagious Delta variant of the virus for less time than unvaccinated people, the CDC says.