How does someone who doesn’t have an Italian healthcare card get vaccinated against Covid-19?
The Local has been receiving versions of this question ever since Italy began its vaccination campaign at the end of December, and it’s only becoming more urgent as the programme opens up to more and more sections of the population.
Health officials have repeatedly stressed that Covid-19 vaccines should be offered to everyone in Italy, including foreign nationals. “All people residing or permanently present on the Italian territory, with or without a residence permit or identity documents” are entitled to vaccination here, states the Italian Medicines Agency (AIFA) in its official vaccination FAQs.
The country has a principle of making essential healthcare available to everyone, regardless of nationality or immigration status. That includes vaccinations against potentially severe infectious diseases, such as Covid-19.
So we know that foreigners should be eligible to get vaccinated in Italy. But in practice, it’s a bit more complicated.
Italy’s vaccination programme is being administered by the national public healthcare service, the Servizio Sanitario Nazionale (SSN), or rather, by the various separate regional health services (Servizi Sanitari Regionali, SSR) that make it up. Covid-19 vaccines are not available privately.
AIFA previously stated that to get vaccinated you would need to show “a valid identity document and health card (tessera sanitaria)”: the health card that shows you’re enrolled in your region’s public health system.
As of late April, it has deleted this guidance from its FAQs, without replacing it with updated advice.
But most people will find that it remains the case when they try to register for a jab. Almost every regional health service has an online platform where residents can book an appointment, if they’re in one of the categories currently being vaccinated. Most of these require you to fill in the number of a tessera sanitaria.
- Who can register for national healthcare in Italy?
- Tessera sanitaria: How do you apply for or renew your Italian health card?
- The essential Italian vocab for getting tested or vaccinated for Covid-19
If you are signed up to the SSN but your health card is out of date, the good news is that it need not stop you from booking your shot. The Italian authorities have extended expired documents several times over the past year as the pandemic makes it harder to renew paperwork, and AIFA specifies in its FAQs that “holders of an expired health card” are entitled to get vaccinated in Italy.
If this is your situation, try calling your regional health service’s vaccination hotline and registering over the phone. You may be able to identify yourself using your codice fiscale (fiscal code) instead of your tessera sanitaria. Take your expired card to your appointment with you regardless.
If you do not have a health card because you are not enrolled in the SSN, things get trickier.
Italy’s Covid-19 emergency commission has told health services to make exceptions for a few specific categories of people who are not enrolled in the public system, namely Italian citizens who usually live abroad and are only in Italy temporarily; foreign diplomats; and current or retired employees of the EU or other international organizations, as well as their dependent family members.
Since the commission gave its instructions in late April, a few local health authorities have begun offering alternative means to register for vaccination without a tessera sanitaria – including Liguria, which since early May has directed people who fall into one of these categories to email or call its vaccine help services.
As well as the categories specified by the commission, Liguria also says it will offer appointments to people with either an STP code (Straniero Temporaneamente Presente – temporarily present foreigner) or an ENI code (Europeo Non Iscritto – non-registered European citizen). Both the ENI code – for EU nationals – and the STP code – for non-EU nationals – are only for foreigners in Italy who cannot afford the cost of medical care.
In the part of the region that borders France, a well-established route for migrants without documents trying to cross the border, health services say they will also vaccinate foreign nationals who are in Italy temporarily and don’t have either of these codes.
However, no other regions have yet made the same provisions. And in any case, they do not apply to foreign nationals who live in Italy permanently.
The Local has heard from several readers who say they were told flat-out by their local health authorities that they would not be able to register for vaccination without first signing up for national healthcare, which some residents might not do for a variety of reasons – including regional rules that prevent certain foreign nationals opting in to the public system if they’re not working in Italy.
At least one of those barriers came down this week: according to citizens’ rights group Beyond Brexit, Umbria, the region that most tightly restricted foreigners’ access to public healthcare, recently agreed to allow British residents who settled in the region before the UK’s transition out of the EU to opt in to the regional health service even if they don’t work.
That means UK nationals who moved to Umbria before the end of 2020 now have more options to enrol in the public health service, get a tessera sanitaria and book their vaccination via the usual route.
The Local has also heard from a handful of readers who were able to get vaccinated without an Italian health card, including an Austrian national who was (eventually) able to book an appointment in Rome by phone with only a codice fiscale, a British second-home owner who got his shot in Sicily when the island offered AstraZeneca to everyone over 60 without appointments one weekend, and a British teacher in Florence who qualified for vaccination through his job.
But a few success stories aside, Italian authorities have not yet agreed on a standard procedure for those who are not enrolled in the public health service. Until they do, some foreign residents who might otherwise be eligible are likely to face delays in getting vaccinated.
The Local put this question to the British Embassy in Rome back in March, who told us: “Further information is due to be made available on the process for those who live in Italy but who do not hold an Italian healthcare card to book a vaccine so please continue to consult the relevant Italian government websites”, including AIFA’s guidelines, regional health authorities’ websites, and the Ministry of Health’s vaccination site.
We have since contacted the Italian Health Ministry and the Covid-19 Emergency Commission to ask how they plan to address this issue.
We will publish any new information as we get it.
In the meantime, the best advice we can give is to contact your local ASL or call your regional vaccination hotline, rather than trying to register online, and to look into whether you are eligible to enrol in Italy’s public health system (find a guide here).
If you have a regular doctor in Italy, you should also consult them about your options.
Even without enrolling in the Italian health system, ultimately you should be able to get vaccinated at one of the walk-in clinics Italy has promised to set up around the country by the time doses are more widely available. For now, however, vaccination in Italy remains by appointment only.
Have you been able to get vaccinated without an Italian health card? The Local would like to hear from you. Email us with your story.