Italy last month took a groundbreaking step for a Western democracy: Requiring the nation’s workers — public and private — to get government-issued health passes. The move amounted to a grand experiment to persuade the unvaccinated, who could keep receiving a paycheck only by getting inoculated or undergoing regular testing.
Four weeks later, with many countries now considering mandates of their own, Italy is showing what might be feasible in the deep stages of a vaccination campaign.
The emerging lesson seems to be that a forceful policy can indeed reap a payoff — at least, a modest one. Many minds won’t change, but some might. For the price of some resistance, a country can vaccinate a sliver of its population that otherwise would have stayed out of reach.
In the two months since the measure was announced, vaccination coverage has ticked up by 4.4 percentage points — not a dramatic increase, but more than any other Western European Union member, according to Our World in Data. During that same span, the E.U.’s vaccination coverage has risen three points.
Some might argue that such a modest gain isn’t worth the social price. In Rome, police on one occasion used tear gas and water cannons to constrain protesters.
But health professionals and government officials say even a few percentage points can be crucial. Around 78 percent of Italians have received at least one vaccine dose — the fourth-highest rate among the 27 nations of the E.U. And as Europe confronts another wave, countries with vaccination rates in the upper 70s are faring far better than those in the 60s. Analysts say the country is well-positioned for the winter, and there is little indication that its hospitals will be overwhelmed.
“The pandemic is striking relatively softly here,” said immunologist Sergio Abrignani, who serves on a scientific committee advising the government. “I am convinced we are doing the right thing.”
But while some people can be persuaded by policy — Italy estimates 560,000 people have gotten vaccinated in response to the workplace Green Pass requirement — it’s also true that hundreds of thousands are locked in deep resistance. Over the last four weeks, the number of daily swab tests performed in Italy has shot up some 60 percent. Unvaccinated workers are spending up to 200 euros per month on tests just to continue earning a paycheck.
“If anything I am now even more dead-set against vaccination,” said Arturo Pitardi, 24, a porter at an office building in the northern city of Padua. He said the need to re-up his Green Pass through testing keeps him in a “constant state of anxiety.” One time, he could find availability only at 4 a.m.
“Many people I know caved in after just a week and got vaccinated,” Pitardi said.