Can bosses insist you get a COVID vaccine? Yes, but with caveats.

Can bosses require you to get a COVID-19 vaccine? Legally, yes, they can.

But in reality, it depends on policies at your workplace.

More companies are requiring the vaccine, especially in health care and the public sector. But policies vary widely at the moment and many employers are reluctant to change.

It’s legal for companies to mandate vaccines, with three caveats, said Amy Traub, chair of the BakerHostetler law firm’s labor and employment practice.

The first is a medical exemption, say, an allergy or contraindication to components of the vaccine; second, religious beliefs or observances; and third, city or state law regarding pregnancy or other related medical conditions.

“A pregnant woman could request an exemption in cities that recognize the condition as one accommodated by an employer,” Traub said. But just this week, the American College of Obstetrics and Gynecology recommended vaccines for pregnant women.

“It’s hard for employers right now. On one hand, governments locally and federally are mandating vaccinations for different types of workers. There’s a wave to ride, and many of our business clients are now mandating it, too,” Traub said.

» READ MORE: Kline & Specter law firm founders require employees to be vaccinated and think other firms should, too

The Philadelphia region’s private companies are split on whether to require workers to get vaccinated.

Cleaning products company Scrub Daddy mandated that every one of its nearly 100 workers be back in office and fully vaccinated by June 1.

“I felt strongly it was within my rights to request this about two months before the major corporations joined in the same mandate,” said CEO Aaron Krause, whose firm is based in Pennsauken. “Everyone is vaccinated and it’s great to see everyone back in the office knowing we are in a protective bubble.”

Anthony Piccone, founder of 7th Level Mortgage in Cherry Hill, believes the opposite of the Scrub Daddy policy. Piccone, who employs nine people, said he would never force his workers to get vaccines he deems unproven and potentially harmful.

“Absolutely not, under any circumstances, would I require or force my employees to take an experimental vaccine,” Piccone said.

Claudia Timbo, founder of call center CompanyVoice in Blue Bell, takes a hybrid approach.

“We are not requiring employees returning to work to be vaccinated,” Timbo said.

“However, if they’re not, we require them to wear masks in public areas, similar to restaurants and stores. It’s very difficult to get qualified workers, due to high unemployment” benefits, she said. “To fulfill our agreements [with clients], we had to go in this direction.”

Nationally, 16% of companies are now mandating COVID-19 vaccines for current employees, up from 15% in February; 14% of employers mandate vaccines for new hires only, according to a July survey by the Blank Rome law firm.

Of the 150 companies surveyed — among them C-suite executives, in-house lawyers, and human resources professionals — a third are based in Pennsylvania, and 11% in New Jersey.

“Bosses have to adapt on the ground right now,” given surging Delta variant infections, said Susan Bickley, partner at Blank Rome’s labor and employment practice in Houston.

While 56% of employers ask only whether workers are vaccinated, 30% of employers require proof. Among those wanting proof, nearly half said they want a copy of a vaccination card, the survey found.

Uber, Google and Facebook are requiring inoculations for employees at corporate worksites; industrial stalwarts GE and Boeing aren’t. Amazon has said it wouldn’t require workers to get vaccinated. Walmart, the nation’s largest private employer, is requiring vaccinations for corporate employees but stopped short of mandating vaccinations for hourly workers at stores.

Meat plants were a big center for infections last year. On Tuesday, Tyson Foods Inc., the biggest U.S. meat company, announced it is requiring team members at U.S. office locations to be fully vaccinated by November.

On Monday, New Jersey Gov. Phil Murphy mandated that health-care workers or staff in congregate living facilities get vaccinated or undergo weekly testing effective Sept. 7.

That follows the announcement by the Centers for Disease Control and Prevention that even vaccinated people infected with the delta variant of COVID-19 can spread the virus. The elderly and those with compromised immune systems are most at risk.

Seventy percent of state and local government workers nationwide are fully vaccinated, and 6% more are partially vaccinated, according to a new paper by MissionSquare Research Institute, formerly the Center for State and Local Government Excellence.

More than half of government workers (59%) believe the vaccine will be effective, but only if everyone receives it; the number of municipal employees working in person has more than doubled from 26% in May 2020 to 58% in May 2021.

Philadelphia’s doctors and other front-line workers are demanding that vaccinations be made mandatory.

At Thomas Jefferson University, medical students are required to be vaccinated, but not faculty — at least not yet.

The Jefferson health system, the university’s parent, is taking a more aggressive approach. “We intend to make vaccines mandatory for all Jefferson employees,” said a spokesman for the hospital system, Brian Hickey, although timing is undetermined. Jefferson Health’s mandate would affect 35,000 employees at 14 facilities, including Abington Hospital.

The U.S. Department of Veterans Affairs last month announced that its 115,000 front-line medical workers have eight weeks to get the shots or risk losing their jobs.

Vaccine requirements are filtering into the hospitality industry, too. A few Center City Philadelphia restaurants are now asking diners for proof of vaccination.

“Rivers Casino Philadelphia is very strongly encouraging our team members to get a COVID-19 vaccine”; however, “it’s not a requirement at this time,” according to a statement from Justin Moore, general manager of Rivers Casino.

There is legal precedent for mandated vaccines at the state level. A U.S. Supreme Court case from 1905, Jacobson v Massachusetts, confirmed a state’s right to enact “reasonable regulations to protect public health and safety.”

Academics cite social and liability concerns. Ethicist Arthur Caplan recently suggested that fines and other financial penalties should be levied on the unvaccinated. “Want to reject expert opinion and the established facts about COVID and put yourself and others at risk?” he and Dorit R. Reiss, of the University of California’s Hastings College of the Law, wrote in Barrons Magazine. “Then you should pay, if your choice harms others.”

Employers should treat unvaccinated workers like drunken drivers, according to Marci A. Hamilton, the Fels Institute of Government Professor of Practice at the University of Pennsylvania.

“We don’t permit persons to recklessly endanger others by driving drunk. Why? Because driving drunk can kill others,” she wrote in a recent opinion piece.

Not every drunken driver kills someone, and “not every unvaccinated person will infect others, but in both cases, the risk is too high for society to permit the conduct. If a drunk driver kills someone, they can be prosecuted and sued by those who lost a loved one. Why not treat the unvaccinated the same, because they are imposing an unjustifiable risk on others?”

Mandating vaccines doesn’t mean a one-size-fits-all approach, according to Bickley of Blank Rome.

There’s less of a business case to require remote workers to get vaccinated, she said. But if you’re working onsite, the company has every reason to mandate a vaccine.