DENVER (CBS4)– The Colorado Board of Health on Wednesday approved a plan that would require workers in health care settings to receive flu shots.

The vote was 7-1. The plan would be phased in over a period of 3 years. It will eventually require 90 percent of health workers to get flu shots.

READ MORE: Denver Public Schools Begins New Year Without School Resource Officers

It was not so much a debate over the effectiveness of flu shots, but more about civil rights at the state Capitol. Before a standing-room only crowd Bonnie Guzman, a nurse at two Denver area hospitals, insisted vaccinations should be a matter of choice.

“Last year we were offered the vaccination or face termination. It was either the shot or the job,” Guzman said.

But others backed the plan for reasons of health.

“We know that immunizations are one of the most effective ways to prevent the transmission of diseases,” Erin Suelman with the Colorado Children’s Immunization Council said.

READ MORE: Death Of Olivia Gant Impetus For New Mandatory Child Abuse Reporting Bill

Those not vaccinated would be required to wear masks and the facilities must provide signed medical exemptions for those who don’t receive the vaccine.

“I see this as a violation of my civil liberty and religious expression, to have this forced upon me,” Guzman said.

The flu vaccination requirement has the backing of the association representing hospitals across the state.

“Our patients are most vulnerable. Exposure to flu from an employee would protect them from flu. We want to protect visitors who come to the hospital to see patients. The other issue is we want to make sure our employees are not infected from flu so they can’t work,” said Colorado Hospital Association President Steve Summer.

“We have to insure that health care workers are treated the same way you and I are, as individuals. They have the same rights you and I do on informed consent. They should have the right to say no,” said National Vaccine Information Center spokeswoman Theresa Wrangham.

MORE NEWS: Colorado State University Celebrates Topping Out At Spur Campus At National Western Complex

Not all hospitals are in favor of the plan. Hospital volunteers are exempt from the rule.