Rome — The Vatican has taken a hard line against employees who refuse to be vaccinated for COVID-19, warning they risk losing their jobs. 

According to a decree by Cardinal Giuseppe Bertello, whose role as President of the Pontifical Commission for Vatican City State makes him the territory’s top administrator, employees who refuse the vaccine “without proven health reasons” face penalties that can include “the interruption of the work relationship.” 

Vatican City is the world’s smallest independent state, sitting right in the heart of Rome. It employs several thousand people, most of whom actually live outside the walled 100-acre territory and inside Italy proper. 

Those who do reside inside the Vatican’s walls tend to be elderly, such as retired Pope Benedict XVI, 93, and Pope Francis, 84. The pontiff was vaccinated for COVID-19 last month and has been a big supporter of inoculation in the global fight against the coronavirus. 

“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,” Francis told an Italian TV station last month.

Bertello, who runs day-to-day life in Vatican City, tested positive for the coronavirus in December. Fewer than 30 people at the Vatican have contracted the disease.

Last month the Vatican began vaccinating homeless people who are looked after in the territory’s food and health facilities. 

Under Francis the Vatican has set up a number of facilities to help Rome’s homeless population, offering areas for people to bathe and get haircuts, as well as food and health care. This winter it began offering free COVID tests to migrants and the homeless, directly beneath the window where the pope delivers his Sunday Angelus prayer in St. Peter’s Square. 

Italy, once the epicenter of the global pandemic, is now battling a second wave worse than its first, as well as new variants of the virus such as the one first discovered in the United Kingdom, which now accounts for one in five new cases. 

More than 94,000 deaths have been blamed on the virus in Italy, the second highest death toll in Europe behind the United Kingdom.