EXPLAINED: When and how will Italy offer a fourth Covid-19 vaccine dose?

As Italy's health minister indicated that a fourth shot of a Covid-19 vaccine may be made available later this year, here's what we know about the plan so far.

EXPLAINED: When and how will Italy offer a fourth Covid-19 vaccine dose?
Italy’s health authorities say they will consider whether a top-up dose of a Covid-19 vaccine should be offered to everyone later this year. Photo: Andreas SOLARO / AFP

Health Minister Roberto Speranza on Sunday said top-up shots of a Covid-19 vaccine for the general population are “probable” later in the year, as the national drugs regulator gave the green light to fourth doses for the immunocompromised.

“We will have to evaluate [fourth doses] for everyone after the summer,” Speranza said in an interview with newspaper Repubblica. “It is to be considered probable, because the virus won’t shake hands and leave forever, unfortunately,”

READ ALSO: At a glance: What are the Covid-19 rules in Italy now?

He added that 2022 “is the crucial year in which to understand if we will return to a fully normal life.”

“I’m optimistic, but the game is not over. In a few months part of the world will enter autumn: by observing them, we will understand what awaits us.”

Speranza’s comments came as the health ministry confirmed in an ordinance on Sunday that a fourth dose of a Covid vaccine can be administered to immunocompromised people, following approval from Aifa.

A fourth shot for those with compromised immune systems will be made available starting in March for those who had their last dose at least 120 days previously.

Earlier in February, Aifa director Nicola Magrini ruled out offering second booster doses to the general population in the coming months, saying a top-up jab may be offered instead.

“There won’t be a fourth dose, but a follow-up, hopefully annually,” Magrini said in an interview broadcast on the RaiTre television channel.

On Monday, Walter Ricciardi, professor of hygiene at Rome’s Catholic University and an advisor to the health minister, told La Stampa that it is “likely” another booster “will be useful for everyone” by autumn.

Ricciardi stressed that certain health measures should be kept in place even if the government ends the current state of emergency on March 31st as expected.

“The state of emergency may end, but with the foresight to keep in place the pillars that support our current freedoms,” Ricciardi said.

He said existing rules on vaccination, boosters, the Italian ‘green pass’ health certificate and on wearing masks indoors “must remain in place.”

The Italian government is currently evaluating when and how to proceed with relaxing nationwide health measures after Prime Minister Mario Draghi promised in early February that a “timeline” for relaxing the rules would soon be announced.

So far, few changes to the current restrictions have been confirmed, with parliament set to examine proposals later this week.

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First batches of Novavax Covid vaccine to arrive in Italy

Italy will begin to administer the new anti-Covid vaccine in the coming days, as millions of doses are scheduled for dispatch across the country and in other EU nations.

First batches of Novavax Covid vaccine to arrive in Italy

People in Italy aged 18 and over are now eligible to get vaccinated against Covid-19 with ‘Nuvaxovid’ – the name of the new Covid vaccine from the company Novavax.

Around one million doses are initially due to arrive in Italy by the end of February, according to Italian media reports.

Some 100 million initial doses in total have been shipped to Italy and other EU countries from the company’s Dutch distribution centre, the US medical company announced in a statement.

It’s hoped that Novavax could offer a more attractive alternative for previously unvaccinated people who are sceptical about the mRNA and vector vaccines.

“It’s a protein vaccine, like the flu vaccines,” said Italian medicines agency director Nicola Magrini earlier in February. “It will be a small supplement compared to the other mRna vaccines. Some seem to prefer it.”

READ ALSO: When and how will Italy offer a fourth Covid-19 vaccine dose?

Some regions of Italy have already opened bookings for the new vaccine, noted Italian newspaper La Repubblica.

The Marche region and Lombardy, for example, have started accepting vaccine bookings for the new inoculation, while Emilia Romagna is set to offer vaccine hubs with the new jab.

Each regional healthcare system can decide how it will administer the shot, so people looking to book their dose will need to check their region of residence’s guidelines. Find links here.

On a national level, Italy’s Ministry of Health has published a circular with instructions on the vaccine’s use ahead of its delivery.

Novavax, whose trade name is ‘Nuvaxovid’, has so far only been approved for the primary cycle. The first and second doses are given three weeks apart, while approval is pending for the third dose.

READ ALSO: How to try to get a Covid-19 vaccine without a health card in your region of Italy

A medical worker prepares a dose of Novavax

A medical worker prepares a dose of Novavax’s Covid vaccine for vaccination during a trial at St George’s University Hospital in London. Photo: picture alliance/dpa/AP | Alastair Grant

Nuvaxovid is a so-called protein vaccine which contains coronavirus-like particles that stimulate the immune system to produce defence antibodies and T-cells against SARS-CoV-2 – that is, white blood cells specialised to fight the virus to protect against Covid-19.

The ministry’s circular states that, “the duration of protection offered by the vaccine is not known, as it is still being determined in ongoing clinical trials”.

“None of the components of this vaccine can cause Covid-19,” the circular reads.

READ ALSO: Reader question: Do I need to update my Italian green pass after a booster shot?

“Protection may not be complete until seven days after administration of the second dose. As with all vaccines, vaccination with Nuvaxovid may not protect all vaccinees,” it added.

Its efficacy, calculated during the trials, is 90 percent in preventing symptomatic disease, slightly lower than for the RNA vaccines, which reached 95 percent.

Tests were carried out before the arrival of the Omicron variant, however. It is possible that the protection of Novavax has dropped a little since then.

The vaccine rollout follows its approval by the Italian Medicines Agency (AIFA) in December, after the European Medicines Agency (EMA) gave the go-ahead just days before.

Find more information about Italy’s Covid-19 vaccination campaign on the Italian health ministry’s website (available in English).