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EXPLAINED: What to do if you’re told you can’t book a Covid vaccine appointment in Italy

Everyone in Italy has the right to receive the Covid-19 vaccine, but many of The Local's readers have reported facing bureaucratic obstacles when trying to book their appointment.

EXPLAINED: What to do if you’re told you can’t book a Covid vaccine appointment in Italy
People wait to be vaccinated at a hub within the Castello di Rivoli Museum of Contemporary Art near Turin. Photo: Marco BERTORELLO / AFP

Question: I tried to book an appointment for the Covid-19 vaccine when my age group became eligible, but the online form requires a tessera sanitaria (health card) number. I don’t have one. What can I do?

Lacking a tessera sanitaria – the card which shows you’re registered with Italy’s national health service (Servizio Sanitari Nazionale, SSN) – should in theory not be a barrier to vaccination. 

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.

But in reality, things aren’t that simple – as the dozens of emails we have received from readers show.

While Italy’s foreign residents may not have an Italian health card for a number of valid reasons, the document has been made a requirement on most online appointment booking systems. And some Italian citizens are also having trouble making appointments because of this.

READ ALSO: ‘It felt like a betrayal’: Foreign residents in Italy report problems getting vaccinated

We’ve been getting questions about this at The Local since Italy began its vaccination campaign at the end of December, and the issue is only becoming more pressing as more and more people become eligible for the jab.

Eligibility, as well as the way booking systems work, varies from one part of the country to another as Italy’s vaccination programme is run by the various separate regional health services (Servizi Sanitari Regionali, SSR) that make up the national system. 

Residents wait to be vaccinated in Sicily. Photo: Gianluca CHININEA / AFP

From this week, regional health authorities can open up appointments to all age groups. Some are already offering the vaccine to younger groups, including under-18s in some regions.

And yet, many people in older age groups say they still haven’t been able to book due to the fact that most regions’ online platforms for appointment bookings require you to fill in the number of a tessera sanitaria.

OPINION: Bureaucratic barriers must not stop Italy vaccinating its foreign residents

Many people can’t complete this step, for example because they have private health insurance and therefore are not registered with the SSN, or because their health card is out of date. 

So if you’ve hit this roadblock, what should you do?

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.

And there’s no option to pay to get your Covid-19 vaccine done privately in Italy (although the microstate of San Marino is offering the Russian Sputnik jab to tourists for 50 euros).

But, before you book a trip to San Marino, our advice is to contact your local ASL (regional health authority) by email or phone, or call your regional health service’s vaccination hotline to explain the situation, rather than trying to register using the online form.

If you don’t feel confident stating your case in Italian, you can have someone else, such as a friend or family member, call on your behalf.

READ ALSO: 

If you have a regular doctor in Italy, you should also consult them about your options.

You may also want to look into whether you are eligible to enrol in Italy’s public health system (find a guide here). 

The Local has 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.

Unfortunately though, we’ve also heard from 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.

READ ALSO: Italy says diplomats and Italians who live abroad can get vaccinated without a health card

As with most things in Italy, what you may be told appears to vary between regions and provinces, and even depending on who you speak to.

Italian authorities have not yet agreed on a standard procedure for those who are not enrolled in the public health service. 

The Local has contacted the Italian Health Ministry and the Covid-19 Emergency Commission to ask how they plan to address this issue. We’ll publish any new information on this topic as we get it.

Until authorities address this issue, the best advice we can give is to know your rights and be persistent.

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.

Member comments

  1. I don’t have a tessera but easily booked an appointment over the phone with the Lazio vaccine hotline using my codice fiscale. At the Termini vaccine center I just showed my CF card and was ushered right in. Simple.

  2. Bless you and the Lazio health department, Max. Things are not so simple here in Sicily: constant reported confusion at the hubs, long unorganized lines, hubs running out of vaccines before half the queue of people holding reservations can get to the front–and sending people home with apologies such as “we’ll try to be better organized tomorrow,” not to mention that we still can’t get past the demand for a tessera sanitaria number when trying to make an online reservation. When the health department in a city issues a “free vaccine for all day” the lines are as much as eight-hours long. This warrants the Italian Health Ministry sending people here to help these hub workers and their team leaders sort out the confusion and put them on a proper path. In the meantime, half the people walking down the streets are not masking-up. If those of us who have a legitimate CF card and citizenship (but no health card for any variety of reasons) cannot get a vaccine, what will happen to the masses of immigrants and others with no ID out there who are so vulnerable? Isn’t the key to herd immunity to make sure “every person” is vaccinated? Fly into any one of many airports in other countries and the minute you’re off the plane you’re offered the vaccine–regardless of who you are or where you’re from. It’s a pityful mess here. CD

      1. The head of the local Sanitaria recently told a friend that there is NO way to get vaccinated without an Italian Sanitaria membership and invited him to come in and sign up. This situation does not sound like a bureaucratic oversight.This newspaper and many other people have informed the authorities of what is going on, yet it has persisted for months at great risk to the lives of the privately insured foreign residents, and it would seem, in violation of their human rights.

        This situation is clearly illegal by Italian law, yet potentially quite lucrative for the Italian Sanitaria.

        Below is a very rough calculation, as an example, showing what large sums of money the Italian Sanitaria could rake in by maintaining this situation.

        There are five million foreign residents, of whom 3.5 million are extra-comunitari, many of whom could be insured through working for international companies, through their pension plans, or by themselves. The minimum income required for a couple for an elective Permesso di Soggiorno, for instance, is about 35,000 euros. If despite the fact that these privately insured residents can legally remain outside the Italian Sanitaria, they can be chased into registering for the Italian Sanitaria by withholding life saving services, putting them at grave risk– in a “your money or your life” scheme, the theoretical “take”is large. For instance, at a minimum of 2,000 euros of contributo to the Italian Sanitaria per couple at the minimum income for elective residents, this scheme could furnish up to, or well above (in the event that the average income of the population in question is larger) a billion euros to the Italian Sanitaria.

        Some of the privately insured people could be students, who pay somewhat less than 400 euros to register for the Sanitaria, in which case the figure for 100,000 foreign students would be shy of 40 million euros, but still a very substantial sum.

        It would seem impossible that such large segments of the foreign population have been merely forgotten, especially when the authorities in question have been notified.

        The Italian government authorities have been informed of this problem by The Local and others. Yet people continue to be informed by some of the various regional organisations of the Sanitaria that they MUST be a member in order to be vaccinated–that they MUST have a Tessera Sanitaria. The Umbrian system looks like it functions with just a Codice Fiscale, but didn’t for our friend. It was the position of the head of the local sanitaria that one could not be vaccinated without joining the Italian Sanitaria, after the system to register with merely a Codice Fiscale was instituted in Umbria.

        Are privately insured foreign residents’ human rights still being deliberately violated in some parts of Italy in an attempt to mine them as a lucrative resource?

  3. After being refused the vaccine at my doctor’s surgery because I did not have a tessera, I logged on to the Umbria vaccine site and had no trouble making an appointment using just my codice fiscale. There were no problems when I went for my first jab last Saturday.
    Of course, no sooner had I managed the booking when the change in Umbria’s rules on UK residents lacking a UK government pension or the famous S1 form kicked in. The CUP in Umbertide actually called me to say I could now pay a contribution and have a card.

    1. Yes Umbria is easier. The Lazio website has a field for a tessera number and if you don’t have one you can’t continue–it’s a required field. So you have to call, and get put on hold (for me 20 mins), but then you can book an appointment.

      1. In Umbria when you use a Codice Fiscale, but are not a member of the Italian Sanitaria, you get a notice that you don’t fit into any of their current vaccination plans even if your age group fits into their current vaccination plan.

  4. I’m not sure how many people this may help but I found a very clever way to get around (in a completely legal and accepted way) around the issue that many are facing with the Health Card.

    I found that if you have the European Health Insurance card, you can simply insert the 20 digit number of that instead of the tessera sanitaria. I have done this (I live in Lombardia) through the online system which then gave me a notification that it may take up to 48 hours to verify the number. The next day I was invited to book my appointment!

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COVID-19 RULES

Is Italy’s government planning to scrap all Covid measures?

The new Italian government has announced the end of some remaining Covid health measures. Here's a look at what will - and won't - change.

Is Italy’s government planning to scrap all Covid measures?

Few Covid-related restrictions remain in Italy today, six months after the nationwide ‘state of emergency’ ended.

The previous government had kept only a handful of precautionary measures in place – which the new government, led by Giorgia Meloni, must now decide whether or not to keep.

The cabinet is holding a meeting on Monday and will issue a decree this week detailing any changes to the health measures.

Many expect the government to scrap all measures entirely by the end of the year, after Meloni and her party criticised the way Mario Draghi’s administration handled the pandemic throughout its tenure. 

Meloni clearly stated in her first address to parliament last Tuesday that “we will not replicate the model of the previous government” when it comes to managing Covid.

READ ALSO: Five key points from Meloni’s first speech as new Italian PM

While she acknowledged that Italy could be hit by another Covid wave, or another pandemic, she did not say how her government would deal with it.

Meanwhile, new health minister Orazio Schillaci issued a statement on Friday confirming the end of several existing measures, saying he “considers it appropriate to initiate a progressive return to normality in activities and behaviour”.

Workplace ban for unvaccinated medical staff

Schillaci confirmed that the ministry will allow doctors, nurses and other healthcare professionals to return to work after being suspended because they refuse to get vaccinated against Covid-19.

Those who refuse vaccination will be “reintegrated” into the workforce before the rule expires at the end of this year, as part of what the minister called a “gradual return to normality”.

They will be allowed to return “in light of the worrying shortage of medical and health personnel” and “considering the trend of Covid infections”, the statement said.

Fines issued to healthcare staff aged over 50 who refused vaccination would also be cancelled, it added.

There were some 1,579 doctors and dentists refusing vaccination at the end of October, representing 0.3 percent of all those registered with Italy’s National Federation of the Orders of Physicians, Surgeons and Dentists (Fnomceo) 

Daily Covid data reports

Schillaci also confirmed in the statement that the health ministry will no longer release daily updates on Covid-19 contagion rates, hospital cases and deaths, saying this would be replaced by a weekly update.

It said it would however make the data available at any time to relevant authorities.

Mask requirement in hospitals to stay?

The requirement to wear face masks in hospitals, care homes and other healthcare facilities expires on Monday, October 31st.

At a meeting on the same day the government is expected to decide whether to extend the measure.

READ ALSO: What can we expect from Italy’s new government?

While the government had looked at scrapping the requirement, it reportedly changed stance at the last minute on Monday after facing heavy criticism from health experts.

Media reports published while the meeting was in progress on Monday said government sources had indicated the measure would in fact be extended.

Confirmation is expected to come later on Monday.

Italy’s face mask rules in care homes and healthcare facilities are up for renewal. Photo by Thierry ZOCCOLAN / AFP

‘Green pass’ health certificate

There is no indication that the new government plans to bring back any requirements to show a ‘green pass’: the digital certificate proving vaccination against or recent recovery from Covid, or a negative test result.

The pass is currently only required for entry to healthcare facilities and care homes, and this is expected to remain the case.

‘Dismantling the measures’

Some of the confirmed changes were strongly criticised by Italy’s most prominent healthcare experts.

Head of the Gimbe association for evidence-based medicine, Nino Cartabellotta, said the focus on cancelling fines for unvaccinated healthcare workers was “irrelevant from a health point of view .. but unscientific and highly diseducative”.

He told news agency Ansa it was “absolutely legitimate” for a new government to discontinue the previous administration’s measures, but that this “must also be used to improve everything that the previous government was unable to do”.

The government should prioritise “more analytical collection of data on hospitalised patients, investments in ventilation systems for enclosed rooms … accelerating coverage with vaccine boosters,” he said.

However, the plan at the moment appeared to be “a mere dismantling of the measures in place,” he said, “in the illusory attempt to consign the pandemic to oblivion, ignoring the recommendations of the international public health authorities”.

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