Italy gives green light to fifth dose Covid vaccines for at-risk groups

Italy's health ministry on Monday extended the use of dual-strain Covid vaccines to those who may need a third booster shot, including over-80s and care home patients.

Fifth doses of the Moderna and Pfizer bivalent Covid vaccines are now being offered to vulnerable groups in Italy.
Fifth doses of the Moderna and Pfizer bivalent Covid vaccines are now being offered to vulnerable groups in Italy. Photo by Sem van der Wal / ANP / AFP).

The use of new Moderna and Pfizer dual-strain or bivalent Covid vaccines was recommended for third booster jabs in groups more vulnerable to developing serious forms of Covid-19.

The update was issued in a circular on the new bivalent vaccines, which were first approved for use as first or second booster shots by Italy’s medicines regulator Aifa in September.

The fifth dose, or third booster jab, is now recommended for over-80s, vulnerable groups over 60, and residents of care homes.

Anyone over the age of 60 can also seek a fifth dose of the vaccine on request, regardless of their health status.

The fifth dose “should be taken soon as possible in the case of the elderly and frail people, as foreseen by the ministerial circular just issued,” said Roberto Cauda, ​​director of the Infectious Diseases Unit of the Agostino Gemelli University Hospital, in an interview with news agency Ansa on Tuesday.

But “for the rest of the population, for which there is no precise recommendation but the fifth dose is still possible, I would wait,” he said.

A fifth dose can be administered 120 days after the last booster shot, or last Covid infection.

However, the booster can be received at the same time as other shots (apart from monkeypox vaccines), and authorities recommend it be administered alongside the annual flu vaccine.

READ ALSO: Where and how to book a Covid-19 vaccine booster shot in Italy

The circular specifically referenced the new Spikevax and Cominarty bivalent vaccines; it’s unclear at this stage whether other, pre-existing vaccines will also be offered to those seeking the third booster.

The most up-to-date advice from Aifa says that patients will likely not have the option to choose their Covid vaccine.

A September press release from Aifa stated that the use of the bivalent vaccine for fourth dose/second booster shots is approved for ‘all subjects’ in Italy who want to get the booster, after the EMA previously gave them the green light for use in all patients over the age of 12.

How to book a booster shot

As health services are managed on a regional level in Italy, it may take some parts of the country longer than others to roll out the fifth dose programme. You can find contact details for your local health authority here.

Speak to your doctor for advice if you’re in an eligible group but booking for a fifth dose is not yet open via your region’s health authority website.

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Italy’s deputy health minister under fire after casting doubt on Covid vaccines

Opposition leaders called for health undersecretary Marcello Gemmato to resign on Tuesday after the official said he was not "for or against" vaccines.

Italy's deputy health minister under fire after casting doubt on Covid vaccines

Gemmato, a pharmacist and member of Prime Minister Giorgia Meloni’s far-right Brothers of Italy party, made the remark during an appearance on the political talkshow ReStart on Rai 2 on Monday evening.

READ ALSO: Covid vaccines halved Italy’s death toll, study finds

In a widely-shared clip, the official criticises the previous government’s approach to the Covid pandemic, claiming that for a large part of the crisis Italy had the highest death rate and third highest ‘lethality’ rate (the proportion of Covid patients who died of the disease).

When journalist Aldo Cazzullo interjects to ask whether the toll would have been higher without vaccines, Gemmato responds: “that’s what you say,” and claimed: “We do not have the reverse burden of proof.”

The undersecretary goes on to say that he won’t “fall into the trap of taking a side for or against vaccines”.

After Gemmato’s comments, the president of Italy’s National Federation of Medical Guilds, Filippo Anelli, stressed that official figures showed the Italian vaccination campaign had already prevented some 150,000 deaths, slashing the country’s potential death toll by almost half.

Vaccines also prevented eight million cases of Covid-19, over 500,000 hospitalisations, and more than 55,000 admissions to intensive care, according to a report from Italy’s national health institute (ISS) in April 2021.

Gemmato’s comments provoked calls for him to step down, including from the head of the centre-left Democratic Party, Enrico Letta.

“A health undersecretary who doesn’t take his distance from no-vaxxers is certainly in the wrong job” wrote the leader of the centrist party Action, Carlo Calenda, on Twitter.

Infectious disease expert Matteo Bassetti of Genoa’s San Martino clinic also expressed shock.

“How is it possible to say that there is no scientific proof that vaccines have helped save the lives of millions of people? You just have to read the scientific literature,” Bassetti tweeted. 

In response to the backlash, Gemmato on Tuesday put out a statement saying he believes “vaccines are precious weapons against Covid” and claiming that his words were taken out of context and misused against him.

The Brothers of Italy party was harshly critical of the previous government’s approach to handling the Covid crisis, accusing the former government of using the pandemic as an excuse to “limit freedom” through its use of the ‘green pass’, a proof of vaccination required to access public spaces. 

But since coming into power, Meloni appears to have significantly softened her stance.

Her appointee for health minister, Orazio Schillaci, is a medical doctor who formed part of the team advising the Draghi administration on its handling of the pandemic.

Schillaci, a former dean of the Faculty of Medicine and Surgery at Rome’s Tor Vergata University, has described the former government’s green pass scheme as an “indispensable tool for guaranteeing safety in university classrooms”.

Speaking at a session of the G20 on Tuesday, Meloni referenced the role of vaccines in bringing an end to the Covid pandemic.

“Thanks to the extraordinary work of health personnel, vaccines, prevention, and the accountability of citizens, life has gradually returned to normal,’ the prime minister said in a speech.