In a decree issued earlier this month, the cardinal who heads the Vatican City State said that employees who refuse to receive the COVID-19 vaccine when deemed necessary for their work could face penalties up to termination of employment.

The Feb. 8 decree from Cardinal Giuseppe Bertello, president of the Pontifical Commission of Vatican City State, gave Vatican employees, citizens, and officials of the Roman Curia regulations to follow intended to control the spread of the coronavirus on Vatican territory, such as wearing masks and maintaining physical distancing.

Failure to follow the regulations could result in fines.

"The health emergency must be addressed to ensure the health and well-being of the working community while respecting the dignity, rights and fundamental freedoms of each of its members," the document, signed by Bertello and Bishop Fernando Vérgez Alzaga, states under article 1.

One of the measures included in the order is the Vatican's COVID vaccine protocol. In January, the city state began offering the Pfizer-BioNtech vaccine to employees, residents, and Holy See officials.

According to Bertello's decree, the supreme authority, together with the office of health and hygiene, "assessed the risk of exposure" to COVID-19 and its transmission to employees in carrying out their work activities and "may deem it necessary to launch a preventative measure which provides for the administration of a vaccine to protect the health of citizens, residents, workers, and the working community."

The decree states that employees who cannot receive the vaccine for "proven health reasons" may be temporarily given "different, equivalent, or, lacking that, inferior duties" which present less risk of contagion, while maintaining their current salary.

The order also says that "the worker who refuses to undergo, without proven health reasons," the administration of the vaccine "is subject to the provisions" found in article 6 of 2011 Vatican City norms on the dignity of the person and their fundamental rights regarding health checks in the employment relationship.

Article 6 of the norms says that a refusal can result in "consequences of various degrees that can go as far as the interruption of the employment relationship."

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The Governorate of the Vatican City State issued a note on Thursday regarding the Feb. 8 decree, stating that the reference to possible consequences for refusing to receive the vaccine "in no case has a sanctioning or punitive nature."

It is "rather intended to allow a flexible and proportionate response to the balance between the health protection of the community and the freedom of individual choice without putting in place any form of repression against the worker," the note said.

The message explained that the Feb. 8 decree was issued as "an urgent regulatory response" and "voluntary adherence to a vaccination program must, therefore, take into account the risk that any refusal by the person concerned may constitute a risk for himself, for others and for the working environment."

Other than vaccination, the measures contained in the decree include limitations on gatherings of people and movement, the requirement to properly wear a mask and to maintain physical distancing, and to observe isolation if required.

The fines for failure to observe these measures mostly range from 25 to 160 euros ($30 to $193).

If someone is found to have broken a legal order to self-isolate or quarantine due to either having COVID-19 or having been exposed to it, the fine ranges from 200 to 1,500 euros ($242 to $1,812).

The decree deputizes the Vatican Gendarmes to intervene when they see noncompliance with the measures and issue the fines.

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This report has been updated to include the Governorate of the Vatican City State's note regarding the decree.