Italy’s Back-And-Forth on Vaccination Policy

Back in 2018, a populist government took office in Italy. The government was formed by a coalition of different political parties, as is often the case in parliamentary governments. The new government then moved quickly to abolish vaccination requirements for children to go to school, fueled by a small-but-vocal group of people who had deeply rooted fears of vaccinations. Here is how The Independent covered the news at the time:

“Italian state schools will no longer demand parents prove that their children have been vaccinated, the country’s new populist government has announced.

Lega leader Matteo Salvini said he considered 10 vaccines – the amount Italian schoolchildren are required by law to have – to not only be useless, but potentially dangerous, in the run-up to the general election in March 2018.

The new policy is likely to stoke fears that the coalition government, which also includes the Five Star Movement, may look to legislate other campaign promises which critics argue are not grounded in scientific proof.”

“Immunity fears as Italy abolishes requirement for parents to prove children have been vaccinated”, July 9, 2018

That same year, 2018, the number of cases of measles had started to steadily grow in Europe and other parts of the world. The situation was such that, by 2019, the United States was at risk of having its status of having eliminated measles revoked. Public Health officials began to worry that Italy’s move away from vaccination would mean that the country would not be spared from the epidemics of measles, and that the epidemics might be particularly bad if parents rejected vaccination for their children.

Because of that surge in measles cases in 2019, and other political changes in Italy, the law changed again. This time, parents who refused to vaccinate their children for childhood infectious diseases faced a fine. According to the BBC, the rates of vaccination against childhood diseases were in the 80% range, far from the necessary mid-90% to maintain community immunity. Here is how the BBC covered it:

“Parents risk being fined up to €500 (£425; $560) if they send their unvaccinated children to school. Children under six can be turned away.

The new law came amid a surge in measles cases – but Italian officials say vaccination rates have improved since it was introduced.

Under Italy’s so-called Lorenzin law – named after the former health minister who introduced it – children must receive a range of mandatory immunisations before attending school. They include vaccinations for chickenpox, polio, measles, mumps, and rubella.

Children up to the age of six years will be excluded from nursery and kindergarten without proof of vaccination under the new rules.

Those aged between six and 16 cannot be banned from attending school, but their parents face fines if they do not complete the mandatory course of immunisations.”

“Italy bans unvaccinated children from school” March 12, 2019

In early 2020, the COVID-19 pandemic hit Italy extremely hard. Entire cities and towns were in lockdown. With hundreds of deaths a day, Italy had one of the highest per capita death rates from COVID-19 in the European region. This week, as the government began to mandate vaccination passports for workers, protesters in Rome took to the streets, with violence breaking out in some parts of the city. Here is how Reuters has covered the events:

“Opponents of the Green Pass say it tramples on freedoms and is a back-door means of forcing people to vaccinate. Their cause has been backed by far-right neo-fascist groups who local politicians accused of orchestrating Saturday’s violence.

Local media reported that around 10,000 people took to the streets of the Italian capital, with many chanting “freedom, freedom” as some looked to break past police in riot gear deployed to guard access to Draghi’s office.

CGIL, which has accepted the Green Pass system for workers, condemned the attack on its offices.

“The assault on CGIL’s national headquarters is an act of fascist thuggery, an attack on democracy and on the world of work,” its leader Maurizio Landini said in a statement. “No-one should think that they can return our country to its fascist past.”

Under the pass system, any worker who fails to present a valid health certificate from Oct. 15 will be suspended with no pay, but they cannot be sacked.

Some 80% of all Italians over the age of 12 are now fully vaccinated and the vast majority of people seem to back the inoculation drive and the use of the Green Pass.”

“Anti-vax protesters in Rome target Draghi’s office, union’s headquarters”, October 9, 2021

In the span of four years, Italy has gone from having vaccine requirements like most developed nations, to rejecting those requirements, to reimplementing them when measles epidemics hit, to joining most of Europe in requiring a vaccine passport for working and traveling in the country. In more politically “stable” or “uniform” governments, policies don’t change so quickly, if they change at all. Which is the better system for vaccine policy is for another post at a later time.

Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen