ROME – Already strong advocates of the COVID-19 vaccines as a means to curb the pandemic, Pope Francis and his Vatican team have ratcheted up their position by making the shot mandatory for all employees.

According to a decree signed by Cardinal Giuseppe Bertello, President of the Pontifical Commission for Vatican City State, which was published online but went unannounced by the Vatican, employees who refuse the vaccine “without proven health reasons” face penalties that can include “the interruption of the working relationship.”

The decree was signed Feb. 8, but posted in the website of the Vatican City State ten days later.

Bertello’s decree begins by underlining that getting vaccinated is considered “the responsible decision,” given that refusing the vaccine can “pose a risk to others and that such refusal could seriously increase the risks to public health.”

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The Vatican has an estimated population of 450 people, but close to 3,000 employees. In addition to those working for the Holy See, the small city state has also offered anti-COVID-19 vaccine to over 50 homeless who regularly benefit from the Vatican’s charitable office that offers showers, shelter, and food through different initiatives.

The Vatican began its vaccination program began last month and Pope Francis, 84, and Pope emeritus Benedict XVI, 93, were among the first to get the two-dose Pfizer-BioNTech anti coronavirus vaccine.

Those who have a health concern not to get vaccinated, the decree says, may be assigned a different position but receive the same pay, even if the change constitutes a demotion. However, those who refuse to receive it without cause would be subject to a provision dating back to 2011 on employees’ rights and duties.

The 2011 article stipulates that when there’s a sanitary emergency that requires a preventive measure such as a vaccine, those who refuse such measures could be subjected to “varying degrees of consequences that could lead to dismissal.”

The decree made public this week also stipulates that when there is a sanitary emergency is declared- as was the case with the COVID-19 pandemic, which led, among other things, to the cancellation of Pope Francis’ public activities during most of 2020, including an announced trip to Malta- the Holy See will adopt the necessary measures to protect the safety and health of its employees.

When biological agents might be involved, as is the case now, the Vatican’s Health and Hygiene office will adopt all the needed procedures to reduce contagion, including the administration of vaccines scientifically proven to reduce the impact of the pathogen.

The 7-page decree is intended to serve in the case of any global health emergency, which is why it doesn’t actually mention COVID-19, but instead, quotes a 2001 definition of the World Health Organization of what a health emergency is.

“I believe that ethically everyone should take the vaccine. It is not an option, it is an ethical choice because you are gambling with your health, with your life, but you are also gambling with the lives of others,” Pope Francis said in an interview with Italy’s Canale 5 channel broadcast back in January, also confirming he was in line to receive the vaccine.

There have been some 30 cases of COVID-19 in the Vatican, including several Swiss Guards, Bertello himself, and Polish Cardinal Konrad Krajewski, who runs the pope’s charitable office.

After recovering from COVID-19 himself, the papal almoner encouraged people to not forget the poor and homeless as vaccination programs ramp up around the world.

Follow Inés San Martín on Twitter: @inesanma