Measures requiring proof of recent vaccination or recovery to use public transport come into effect on Monday as Italy battles rising Covid-19 infections.

But in a letter to the government, Francesco Del Deo, head of the National Association of Municipalities of Small Islands (ANCIM), pointed out that boats and planes are the only means of getting off and on the islands.

The new rules risk “condemning to forced exile residents who for different reasons are not vaccinated”, he warned.

ANCIM represents 35 municipalities covering 87 small islands with a combined population of around 240,000, Capri and Ischia among them.

It wants an exception to the new rules to allow unvaccinated residents to show a negative Covid test to take public transport if they have to travel for reasons of health, education or work.

The health issue is particularly important as medical facilities are often rudimentary or non-existent, with some islands served only by a doctor who visits for a few hours once or twice a week.

“It’s a complicated situation,” Del Deo, mayor of a municipality on Ischia, off the coast of Naples, told AFP.

While he backed vaccination, “in a democracy, the rights of the minority must be protected”.

One solution could be the creation of special areas in ferries for the unvaccinated who could show a negative test, to avoid potential complaints from other passengers, he suggested.

Italy was the European country first hit by the pandemic in early 2020 and still has one of the highest death tolls, at more than 138,000.

More than 86 percent of people over 12 are fully vaccinated, and Del Deo said rates on the little islands were comparable.

Despite the campaign, infection rates are rising sharply – as elsewhere in Europe, a trend fuelled by the new Omicron strain.

From Monday, the ‘super green pass’ requiring proof of recent vaccination or recovery from coronavirus will be required for most indoor public venues and on public transport.

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The ‘reinforced’ health certificate is available only to those who are vaccinated against or have recovered from the virus – as opposed to the basic green pass, attainable by testing negative for Covid every two to three days (depending on whether the test taken is molecular or rapid antigen).

Previously, such venues and services were accessible with the basic green pass.

The extended super green pass has already been made compulsory for access to almost all leisure, social or sporting activities in Italy and will be a requirement at even more places from January 10th, including all restaurants and bars and public transport.