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‘Mixed dose’ Covid vaccines – what are the rules in Italy?

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‘Mixed dose’ Covid vaccines – what are the rules in Italy?
MARCO BERTORELLO / AFP

As Italy updates its travel rules and green pass requirements, what is its latest official stance on which vaccines are recognised - and does a mixed-dose vaccination abroad ‘count’ to the Italian authorities?

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The practice of giving people two different Covid vaccines for their first and second dose is now relatively widespread, but different rules in different countries mean that people vaccinated in this way can run into trouble when travelling.

What Italy calls “vaccination crossing” – varying your first and second vaccine doses – was approved as safe and effective in specific circumstances by Italian medicines agency Aifa back in June of this year.

Italy changed its policy in response to concerns over blood clots in a small number of younger recipients led the Italian health ministry to recommend that no one under 60 should be offered the AstraZeneca vaccine, including those who had already had a first dose.

By then thousands of people, mainly health workers, had already received a first dose of AstraZeneca, so the government advised that people under 60 complete their vaccination cycle with either the Pfizer or Moderna mRNA vaccines.

Photo: Vincenzo Pinto/AFP

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Since then, a large number of Italian residents - including Prime Minister Mario Draghi - have successfully received mixed doses of the AstraZeneca and Moderna or Pfizer vaccines.

There have been no reports of mixed-dose vaccine recipients having trouble accessing Italy's Covid health certificate, known as the ‘green pass’.

READ ALSO: Where do you now need to show a Covid green pass in Italy?

But as Italy is now allowing people vaccinated in certain non-EU countries to use their proof of immunisation for travel into Italy - as well as within the country in place of an Italian green pass - many visitors, second-home owners and others have been wondering exactly what the Italian rules are if they had a mixed dose abroad.

People vaccinated in the UK are among those asking for clarification on the Italian government’s stance, after the British government in August said it refuses to recognise as ‘fully vaccinated’ travellers who did not have two vaccines of the same brand – despite the NHS using this practice in some cases.

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The UK’s rule proved problematic for many people travelling from European countries where vaccination with mixed doses had already been common practice for months, including France, Germany, Sweden, Norway and Austria as well as Italy.

However, Italian authorities have not issued any similar rules.

Neither Italy’s health ministry nor the foreign ministry specify in the official guidance on their websites whether or not mixed doses administered abroad are accepted for travellers from ‘List D’ countries hoping to enter the country without quarantining. Neither is it specified in separate rules covering Japan, Canada and the United States.

The Local has contacted both the Italian health ministry and the Italian embassy to the UK for clarification.

Q&A: Answers to readers’ questions about the new Italian travel rules

In August, Aifa expanded its approval of mixed AstraZeneca and Moderna/Pfizer vaccines to over-60s in cases where an adverse reaction to the first dose was reported.

The agency has not taken an official stance when it comes to mixed doses in other contexts.

For more information about the current coronavirus situation and health measures in Italy please see the Italian health ministry’s website (in English).

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