Unvaccinated airline workers will be charged $200 (£146) extra per month for their health insurance, one American carrier has said.
Delta Air Lines says the surcharge will be in effect from 1 November, and is necessary to offset the risk those who are not jabbed put on their insurance – similar to how smokers have higher premiums for insurance.
A spokesman for the company added that each COVID hospital stay for its staff costs the carrier $40,000 (£29,000).
Delta’s chief executive, Ed Bastian, said all of those workers admitted to hospital with COVID in recent weeks were not fully vaccinated.
The move from Delta Air Lines comes in comparison to competitor United Airlines – which says anyone not getting jabbed could get fired.
On the other hand, American Airlines and Southwest American Airlines are offering rewards to workers who get vaccinated.
US President Joe Biden has encouraged private companies to implement so-called vaccine mandates, as the Delta variant sweeps through the US.
Airlines have struggled during the pandemic, with things looking worse for operators since the variant took hold in the US.
There are hopes that the approval of the Pfizer-BioNTech COVID vaccine by the Food and Drug Administration (FDA) may improve the situation for the businesses however.
As well as the surcharge, unvaccinated employees at Delta Air Lines will have to wear masks inside immediately, according to a memo sent to staff.
Any unvaccinated employee based in the US will also be required to take weekly COVID tests, starting on 12 September.
At least one union says it will not oppose the move, as it does not affect their negotiated healthcare plan.
People testing positive will be required to isolate and stay away from work.
The memo, sent by Mr Bastian, stated that around three-quarters of the workforce were vaccinated already.
Pay protection for those isolating with COVID will be offered to people who are fully vaccinated.