For a Vaccination Campaign that Effectively Reaches All Members of the Population

The Immigration and Health Board writes to Minister Speranza of a strategic vaccination plan with the measures to reach the vulnerable and marginalized populations to guarantee everyone a vaccine.

letter sent on February 4, 2021



The Associations belonging to the Health & Immigration Board (TIS) wrote to the Minister of Health Roberto Speranza to propose solutions for the obstacles impeding equitable access to vaccines to those living in marginalized communities.


The exclusive registration setting through the national / regional platform for booking the vaccine at your general practitioner or elsewhere, could be a discriminating obstacle for the socially more fragile population, as has already happened in some Regions with the ‘compulsory dematerialized prescription and online booking”.


This is what a letter sent on February 4, 2021 by the Associazione Studi Giuridici Immigrazione (ASGI), Caritas Italiana, Centro Astalli, Emergency, Intersos, Médecins du Monde, Doctors against Torture, Doctors for Human Rights (MEDU), Doctors Without Borders (MSF), Frontier Health and the Italian Society of Migration Medicine (SIMM) read. These associations, gathered in the Immigration and Health Table (TIS), have listed a series of recommendations to the Ministry of Health to reach several hundred thousand people belonging to socially marginalized categories or living in situations that can create obstacles to access the vaccine.


The TIS has listed among these the people, Italian and foreign, welcomed in collective structures, those who are without documents or residence permits, EU citizens in a condition of administrative irregularity, asylum seekers who have not yet been able to access the public service and stateless persons, as well as socially fragile subjects who live in informal settlements or in any case those who do not have a general practitioner and have difficulty accessing the National Health Service. Among these there are also the hundreds of thousands of foreign workers in the process of regularization and awaiting the residency permit, for which access to the National Health Service has not always been given, even when they have the right.


One of the major difficulties reported to the Ministry of Health is the lack of documentation to be able to actually access the services offered by the public health service, including vaccination against COVID-19. The TIS reminds us that in the FAQ section on the AIFA website there are guidelines for vaccinating persons (Italian and foreign) in conditions of social exclusion by accepting: “any document (not necessarily valid) that shows the identity of the person to be vaccinated and in the absence of any document, the personal data declared by the person and the indication of any body / structure / association of reference will be recorded” as sanctioned by Article 32 of the Italian Constitution and provided for by Article 35 of the Consolidated Law on Immigration.


However, the requirement to book a vaccination appointment by mandatory registration through the national / regional platform, with one’s general practitioner, or otherwise through the tax code / health card, “could be a discriminating obstacle for the socially more fragile population, as is already happened in some Regions with the compulsory dematerialized recipe and online booking.”  In the letter, the Associations present to the Ministry a series of recommendations for including the categories currently at risk of exclusion in the vaccination plan. Among the proposals, TIS asks that:


  • specific procedures for the National Vaccination Plan are included in favor of vulnerable and marginalized communities, including: people living in informal settlements, those experiencing homelessness, migrant populations, asylum seekers, refugees and stateless persons regardless of their legal status, and of people housed in emergency or particularly crowded collective structures.


  • administrative “flexibility” is envisaged, as indicated by AIFA, possibly also mediated by local authorities and / or by associations and third sector organizations, to facilitate vaccination for those who are on the national territory even if they do not have valid proof-of-identity documents including health card, identity document, or taxes.


  • To enhance fundamental role of associations in the involvement of immigrant communities and cultural mediators in order to foster communication and identify people  experiencing social exclusion and health & social vulnerabilities and receive immediate access to vaccination, also providing in some cases an active vaccination offer  in specific places of aggregation, taking into account the need to ensure vaccination in a population that is difficult to trace.


“These measures can favor a better and widespread distribution of the vaccine among the entire population present on the national territory with greater coverage for a real guarantee of public health and reduce the risk of differentiation between Regions and Local Health Authorities regarding procedures, methods and processes to protect the more fragile and hard-to-reach population,” conclude the Associations, asking the Ministry (which has not yet replied to the letter) for a discussion and active involvement of the Immigration and Health and Asylum Board on these relevant issues, and avoid the Organizational “solitude” of the various reception structures, which have often had to define their own paths and procedures for safe reception and management.

Flavia Melillo
Flavia Melillo