How Italy is preparing for a Covid-19 vaccine

Which vaccine is Italy pinning its hopes on, and who'll get the first shots? Here's what we know so far about Italy's coronavirus vaccination strategy.

How Italy is preparing for a Covid-19 vaccine
Dozens of potential vaccines are currently being tested against the new coronavirus. Photo: Joel Saget/AFP

With scientists around the world racing to develop a vaccine hopes are high that protection against Covid-19 might finally be in sight.

READ ALSO: Italy warns public to remain cautious despite 'encouraging' vaccine news

Several potential vaccines have shown promising results in clinical trials, including one about to be tested in Italy on hundreds of volunteers.

The Italian government has appointed a task force to plan how and where the first doses will be delivered when international regulators approve a successful vaccine. 

The plan remains a draft for now, but here's what we know so far about how Italy's vaccine strategy will work.

Which coronavirus vaccines will be available in Italy?

Italy is not betting on a single vaccine. The government will invest in different options in order to make “larger numbers of vaccines available”, according to Franco Locatelli, head of the Health Ministry's expert advisory panel.

That means that different vaccines will become available as and when they get regulatory approval.

Italy was one of the first countries to sign up to an EU pact to reserve doses of the most promising vaccine candidates before they come on the market. 

Doses of the Oxford University vaccine, which are packaged by a company near Rome. Photo: Vincenzo Pinto/AFP

Along with its partners, it has already secured at least 300 million doses of the experimental vaccine developed by Oxford University and AstraZeneca, up to 300 million doses of an alternative being trialled by Sanofi and GlaxoSmithKline, at least 225 million doses of a CureVac candidate, at least 200 million doses of the vaccine developed by BioNTech and Pfizer, and at least 200 million doses of a version made by a Johnson & Johnson subsidiary. The bloc is also in talks with Moderna about a potential deal for an initial 80 million doses.

Italy has its own potential vaccine to offer, developed near Rome by Italian biotech company ReiThera, but it remains in the early stages of human testing and is not yet being considered for approval.

Domenico Arcuri, Italy's coronavirus emergency commissioner and the person tasked with planning its vaccination operations, has said he is working on the assumption that the vaccine most likely to become available first is the BioNTech-Pfizer candidate.   

When does Italy plan to start vaccinating?

That all depends on when regulators judge that a vaccine has proven safe and effective for public use.

Within the EU the decision lies with the European Medicines Agency, which has promised to fast-track the approval procedure for coronavirus vaccines. It is already reviewing preliminary results for three potential vaccines – the ones developed by Oxford-AstraZeneca, BioNTech-Pfizer, and Moderna – in order to get a head start by the time they submit a formal approval request.

In the best-case scenario, those requests would come “towards the end of 2020” and be followed by a full scientific evaluation, the EMA says – which makes it doubtful that any vaccine will be on the market by the end of this year.

But Arcuri is optimistic that things will move quickly in 2021.

“We're confident that we'll be able to vaccinate the first Italians at the end of January,” he told the press last week.

How widely available will vaccines be in Italy?

According to Italy's supply agreement with its EU partners, the doses they've reserved will be shared in proportion to each country's population – so Italy will get 13.5 percent, the third-largest share after Germany (18.6 percent) and France (15.0 percent). It will also have the opportunity to claim extra doses if other member states turn them down.

That entitles Italy to around 165 million at least of all the doses secured by the EU so far, for its population of 60.2 million people.

READ ALSO: Italy sets aside €400m fund for vaccines and anti-Covid drugs

But not all of those vaccines will be ready at the same time, nor will suppliers be ready to deliver all the doses at once.

What's more, since most vaccines are expected to require multiple shots to offer maximum protection against the coronavirus, the number of people vaccinated will be less than the number of doses. The 27.2 million doses of the BioNTech-Pfizer vaccine that Italy could get next year, for example, would be enough to vaccinate 13.6 million people once they've each received two doses a few weeks apart.

The supply of coronavirus vaccines is set to be very limited at first until several are approved and production ramps up.

According to Arcuri, the government expects its first round of vaccinations to deliver 3.4 million shots to 1.7 million people.

Potential Covid-19 vaccines are being tested around the world. Photo: Yasin Akgul/AFP

Who will be vaccinated first?

Italy will invite people in high-risk categories to get vaccinated first, based on their “vulnerability and potential exposure to the virus”, Arcuri says.

The elderly, people with certain pre-existing conditions, healthcare workers and nursing home staff and residents  are expected to be among the first recipients.

How is Italy preparing to carry out vaccinations?

The Italian government has decided to coordinate its vaccination plan nationally instead of leaving it up to regional authorities, who are usually responsible for local healthcare.

In addition to Arcuri's operational planning, a task force of 15 experts has been working on Italy's immunisation strategy since November 4th. 

The group is understood to be studying ways to distribute the various possible vaccines, including different ones at the same time, with one of the major challenges being how to store vaccines such as Pfizer's that need to be kept at temperatures as low as -80 degrees C. 

The task force is also reportedly planning where injections will be carried out: as well as at existing vaccination clinics and doctors' offices, the health service could set up large-scale, temporary centres in the same way it has created drive-through coronavirus testing sites.

Regional authorities have been asked to identify suitable storage facilities as well as sites that could potentially immunise some 2,000 people within 15 days, according to instructions sent by Arcuri earlier this week. 

More details of Italy's vaccination strategy are expected to become available in the coming days.

How much will it cost?

Getting vaccinated against the coronavirus will be free in Italy, Health Minister Roberto Speranza has long maintained.

“The vaccine is the only definitive solution to Covid-19. As far as I'm concerned it will always be a global public asset, a right for everyone, not the privilege of a few,” he said back in June.

Will coronavirus vaccination be voluntary?

While vaccinations against diseases including measles, mumps, rubella, polio and hepatitis are compulsory for children in Italy, the government has indicated that getting an anti-Covid shot will be voluntary.

“I don't think it should be mandatory, but it must be made available to the entire population,” Prime Minister Giuseppe Conte has said.

One recent survey found that nearly 50 percent of people asked in Italy said they would have doubts about getting vaccinated, including 11 percent who described themselves as “completely against” a vaccine.

Scientists estimate that 60-90 percent of a population needs to be vaccinated – possibly every year – to reach herd immunity against the coronavirus and stop future outbreaks.

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REVEALED: These are the most polluted towns in Italy

The northern cities of Milan and Turin were named Italy's 'smog capitals' in a new pollution report on Monday which urged the government to take action over poor air quality.

REVEALED: These are the most polluted towns in Italy
Photo: Pixabay

Smog and pollution are choking Italian cities year-round and many towns are exceeding limits on fine particles and other pollution, according to another report from Italian environmental watchdog Legambiente.

The Mal’aria di città (Air pollution in the city) report for 2023, unveiled on Monday, was the latest to warn about the risks to health posed by pollution in many parts of the country.

It found that 25 of 95 cities monitored had violated clean air ordinances by exceeding daily fine particle (PM10) emission limits, which are currently set at no more than 35 days a year with a daily average of over 50 micrograms per cubic metre.

Turin was ranked as the worst offender, exceeding this level on 90 days, closely followed by Milan (84), Asti (79), Modena (75), and Padua and Venice at 70.

These were followed by Cremona, Treviso, Mantua and Rovigo, all of which exceeded limits to a lesser degree.

All of the most polluted cities were in the northern Italian regions of Piedmont, Lombardy, Emilia Romagna and Veneto, with most within the north-western ‘industrial triangle’.

Some southern cities featured nearer the bottom of the ranking, with Andria (Puglia) and Ragusa (Sicily) exceeding limits on several days, as well as Rome, which overshot the permitted level for one day.

(Photo by Andreas SOLARO / AFP)

The average annual rate of PM10 emissions nationwide dropped slightly, by two percent year-on-year, the report found.

“This, however, is not enough to guarantee the health of citizens,” said Stefano Ciafani, president of Legambiente.

He pointed out that the situation looked even worse if air quality in Italian cities were measured against tighter limits under the new European Directive on air quality, in force from 2030, which lowers the PM10 threshold from 35 to 20 micrograms per cubic meter of air.

“Only 23 out of 96 cities (24 percent) would be under these limits,” Ciafani said, while 84 percent would exceed the threshold for PM2.5 and 61 percent for nitrogen dioxide (NO2).

Italy has repeatedly been reprimanded by the European Union over air quality, and has “persistently and systematically” breached EU recommended limits, the European Court of Justice ruled in 2020.

The north of Italy has long been ranked among the worst areas in Europe for polluted air according to data from the European Environment Agency.

“Air pollution is not only an environmental problem, but also a health problem of great importance,” said Ciafani. “In Europe, it’s the main cause of premature death due to environmental factors.”

“Italy has more than 52,000 deaths per year caused by PM2.5 emissions, equal to a fifth of those recorded throughout the continent,” he said.

The main causes of air pollution in Italian cities are reported to be industry, inefficient domestic heating systems, agricultural practices and, most of all, heavy traffic.

In Italy, cars continue to be by far the most-used means of transport. 65.3 percent of journeys overall are made by car, Legambiante wrote, with the emissions from some 38 million cars choking Italy’s towns and cities.

(Photo by Miguel MEDINA / AFP)

Legambiente said “drastic” measures were required to tackle the problem, including funds for more efficient heating systems in homes and public buildings and a major increase in public transport provision.

The group said Italy must “quadruple the availability of public transit, promoting integrated season tickets as done by Germany in 2022”, triple the number of electric buses, create zero-emission zones in town centres, and “create another 16,000 kilometres of cycle paths”.

It also praised local authorities choosing to bring in 30 km/h speed limits in city centres. Councils in Bologna, Turin, Milan and Cesena have all said they plan to implement these limits, following the lead of European cities including Paris and Madrid, despite fierce criticism from Italian transport minister Matteo Salvini.

Legambiente published a petition urging the government to make clean air and more livable cities a priority, saying Italy should follow Paris in attempting to create ’15-minute cities’, in which everyone lives within a quarter of an hour’s walk of vital amenities such as shops and schools and possibly also workplaces.