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Cynthia Foreman receives a free flu shot from a Walgreens employee during a free flu shot clinic at Allen Temple Baptist Church in Oakland, California. Residents received no cost flu shots during a flu shot clinic at Allen Temple Baptist Church. - 

If just one worker gets sick with the flu, the costs start mounting. 

“You can be actively infectious, and have no symptoms,” said Bruce Lee, director of operations research at the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health. “If they miss one day, then that’s on average, eight hours of lost productivity to the workplace."

According to the Department of Health and Human Services, Americans miss more than 100 million days of a work a year and rack up costs about $7 billion in sick days and lost productivity because of the flu. While only a handful of states require mandatory flu shots -- and then only  for hospital workers -- the CDC recommends the flu shot as a crucial preventative tool and has set a goal of vaccinating 90 percent of all health care workers by the year 2020.  

But what about mandatory flu shots for everyone else, something some companies, even if their workers don’t.

“It comes down to, if employees resist, what do you do," said Ivo Becica, an employment lawyer with the firm Obermayer, Rebmann, Maxwell & Hippel. Some workers, he said, are under a misconception that the flu shot will give them the flu.

“Others have more of a personal liberty objection and they say, how can my employer do this," he said. "Well — short answer to that is the employer is not the government."

Private businesses often have more leeway on deciding policy than the government, except, of course, if workers need to be exempt for health reasons or for religious beliefs, but that, says Becica, is often where things can get fuzzy. Take veganism, for example.

"Is that a sincerely held belief akin to religion? Courts haven’t addressed it straight on, but there was a case that suggested that you could come within a religious exemption for something that’s not theological. Faith does not need to be based on belief in a god," he said.

Correction: A previous version of this story misspelled Ivo Becica's name. The text has been corrected.