The measure, championed by Prime Minister Giorgia Meloni's Brothers of Italy party and strongly backed by its far-right coalition partner, the League, passed the lower house in October with support from National Future (FN), a rival far-right force. The bill still needs to clear the Senate, with a vote scheduled in January.
The move has alarmed medical experts, less because of the number of healthcare workers involved, believed to be very small, and more because of the risk of further eroding trust in vaccines. Nearly one in two Italian adults are hesitant about vaccination, according to a report by the University of Turin published in the Lancet Regional Health Europe in February, which sampled 50,000 adults across Italy. The report found the ambivalence was driven more by misinformation and lack of institutional trust than by fears over vaccine safety.
"Political communication and the lack of trust among Italians in institutions carry a significant weight," said Roberta Siliquini, the head of the school of hygiene and preventive medicine at the University of Turin and the report's chief researcher. "There really is a disinformation campaign in this sense – and those who want to disinform are very good at communicating."
The implications are already visible: this year there has been a resurgence in measles, with 472 infections reported during the first five months, compared with 322 in the same period last year, according to health ministry figures. More than half of the cases were in young adults. Flu vaccine uptake among people aged 65 and over has dipped to 49.81%, the first time it has fallen below 50% since the winter of 2014-15. In August, a four-year-old child in Palermo, Sicily, died of diphtheria. Her parents reportedly told doctors they had not vaccinated her because her cousin was autistic and they were convinced vaccines were the reason. There is no evidence of any link between autism and vaccines.
Roberta Siliquini warned that the rehabilitation of those who rejected scientific evidence could have a "devastating" impact on how people perceived vaccines. On 28 October, a day after the lower house vote, Claudio Borghi, a League politician, came under fire for hosting an anti-vaccine seminar in the Senate. Later that day, Italian President Sergio Mattarella used a speech to condemn the spread of anti-vax messages while warning against "irrational beliefs" and "destructive fake news".
Borghi has defended his position, arguing he is not anti-vaccine but that mandatory vaccines "lead to resistance". He told the Guardian the proposal's aim was "to foster reconciliation after all these years," adding: "In our view, nobody should lose their job because of a personal belief."
Lorenzo Mattia Signori, a nurse in Veneto and regional secretary for Cittadinanzattiva, a patient advocacy association, said politicians were "opportunists" and Meloni's coalition was simply trying to draw votes from anti-vax voters as it eyed a second mandate. "Ensuring that people get vaccinated is the largest prevention system we have," he said. "If everyone gets sick instead, the Italian healthcare system would not hold." He hopes that Mattarella will use his power as president to stop the measure from being signed into law. "We cannot have them in hospitals," Signori said. "It would be like going to church and hearing a priest who says he doesn't believe in God."