Italy’s vaccination campaign slows as 'green pass effect' fails to materialise

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Italy’s vaccination campaign slows as 'green pass effect' fails to materialise
Protestors demonstrate against the introduction of a mandatory "green pass" in the aim to limit the spread of the Covid-19 on July 27, 2021 at the Piazza del Popolo in Rome. Andreas SOLARO / AFP

As Italy falls just short of its goal of vaccinating 80% of the population, the impending requirement for all workers to show a health certificate has yet to make a significant impact on the immunisation effort.


For a moment, it looked as though the Italian government would reach its goal of vaccinating 80% of Italy’s population against the coronavirus by the end of September.

On September 30th, the counter hovered at a tantalisingly close 78.5%.

A couple of weeks earlier, in a push to make it over the finish line, government ministers passed a decree making it obligatory for all workers to produce a health certificate or ‘green pass’ to enter the workplace from October 15th.

READ ALSO: Italy extends Covid ‘green pass’ requirement to all workplaces

It was hoped that the requirement to show a green pass – which proves that the holder has received at least one dose of the vaccine, has recovered from Covid in the past six months, or has recently tested negative for the virus – would nudge the vaccine-hesitant over the fence and provide a boost to the final stages of the campaign.

But with just one week to go before the rule comes into force, the government’s vaccination counter remains stubbornly stuck at 79.74%, indicating that the hoped-for ‘green pass effect’ hasn’t materialised on a national level.

A report published by the Gimbe foundation for evidence-based medicine on Thursday shows that the rate of new vaccines administered declined by 22.2% in the week between September 27th and October 3rd.


Overall, the rate of vaccine dose administration shows a steady weekly decline between August 30th and the start of October, bar a brief bump in the week of September 20th-26th.

Weekly vaccination doses between July 5th and October 3rd. Weekly vaccination doses between July 5th and October 3rd. Source: Gimbe Foundation

One thing the green pass requirement does appear to have influenced, the report shows, is the public's use of rapid antigen tests.

These increased by 57.7% in the month between August 6th (when a green pass requirement was first introduced for entry to leisure and sport facilities and indoor dining) and September 7th.

The seven-day moving average in rapid test use increased from 113,000 on August 6th to 178,000 on September 7th, and has since plateaued.

Rates of newly vaccinated people and of rapid tests between July 22nd and September 6th. Rates of newly vaccinated people and of rapid tests between July 22nd and September 6th. Source: Gimbe Foundation

“The progressive expansion of the green pass has had a very clear effect in terms of population testing, contributing to reducing the circulation of the virus,” said the foundation’s president, Dr. Nino Cartabellotta.

“But up to now, it has not brought about a surge in the curve of newly vaccinated,"


"Considering that at least five million unvaccinated people are of working age, the litmus test to assess the effectiveness of the 'gentle push' will come around October 15th, when the mandatory green pass for public and private employees takes effect".

EXPLAINED: How Italy will enforce the new ‘green pass’ rules in all workplaces

The sluggish vaccine uptake rate of recent weeks stands in stark contrast to that of late July, when prime minister Mario Draghi first announced the introduction of the green pass as a requirement for entering sports and leisure facilities.

Despite widespread protests, online vaccination booking portals struggled to cope with demand for appointments in the immediate aftermath, with at least half a million appointments made in the 24 hours following Draghi’s televised address.

But with the majority of the population now inoculated against the virus, those who remain unvaccinated are likely to be the most staunch holdouts, with the greatest level of resistance to the government's efforts.

8.3 million eligible people in Italy currently remain unvaccinated, according to the foundation's report.

It is not known what proportion of those people are unable to get vaccinated for medical reasons.

In introducing a health certificate requirement for employees, Italy has followed a similar path to France, where workers in public-facing roles have since August 9th been required to show a health certificate.

From mid-October these employees will no longer be able to access free tests, but must pay for 'convenience tests' at a rate of €29 for an antigen test or €49 for a PCR test.

Despite some initial resistance, France's immunisation campaign has been broadly successful, with almost 90% of the eligible population now vaccinated.

Italy has never provided free testing, though the government has introduced similar caps on the cost (however the exact price varies between region) and recently extended the validity of green passes generated from a negative PCR test result from 48 hours to 72.

READ ALSO: 72 or 48 hours? How Italy has updated the rules on testing to obtain the Covid green pass

The Italian government however has not ruled out the possibility of introducing a vaccination mandate for all if its targets are not reached.

Ministers previously stated that any new rules would be evaluated partly based on the vaccination rate achieved by September 30th, as this would make clear the extent of vaccine hesitancy in the country.

At a press conference in September, Health Minister Roberto Speranza said the Italian government would proceed “without fear” with plans to introduce a mandate if it were deemed necessary “in the defence of the right to health and the need to avoid new deprivations of freedom”.



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