The question of what has gone wrong in Italy now confuses a hard-hit nation that had thought it was over the worst. There are many factors at play. Italy, the second grayest country on earth, has more elderly people to vaccinate than most. In February, according to mobility data, it was slightly more open than other major European countries, leading to a higher spread of the virus; it has since been squeezed back. At the same time, the more deadly variant first discovered in Britain has gained dominance here and elsewhere across the continent.
But some researchers and data analysts say Italy’s vaccination campaign also deserves the blame. The country, they say, has vaccinated too many of the wrong people, over-prioritized young workers and left the elderly vulnerable.
“Things have not been done properly in the last three months, that much is clear,” said Sergio Abrignani, an immunologist and a new member of a scientific committee advising the government. “Otherwise we would not have 300, 400 deaths every day, as we have done now.”
Italy’s difficulties have lessons for other countries facing their own tough decisions on who to prioritize with a limited vaccine supply. European countries, including Italy, have mostly been adapted to devote the first doses to frontline healthcare professionals and nursing home residents. But if the primary goal is to avert death, the pick-up from Italy seems to be: Once this work is done, continue to give doses to the elderly and be very selective as to which younger workers may be eligible.
That data shows why Italy remains so vulnerable: Among EU countries, it ranks at the very bottom of inoculation of people in the 70s – a group that is still very vulnerable to the vandalism of the virus. Only 2.2 percent of that age group are fully vaccinated. Every second age group in Italy – including people in their 20s and 30s – has received a higher proportion of full protection.
It also pays for an initial decision to devote its first phase exclusively to healthcare professionals – whether it is on the front lines or not – rather than vaccinating that group more slowly while targeting the elderly. Most people in the 80s had no protection in March, a pace that placed it behind other European countries. It has since run to catch up. But it is the people who became infected weeks ago who are now dying.
As a result, the profile of average victim has changed a bit. At the end of December, the victim had an average age of 81. Now the average age is 79.
“Every minute of these delays [in vaccinating the elderly], it leads to a dramatic loss of human life, ”said Piero Ragazzini, general secretary of a pensioners’ union.
The sharpest contrast to Italy comes from France, which has devoted the overwhelming majority of its doses to seniors and has given at least one dose to 50 percent of them in the 70s. Although France is known for its vaccine skepticism and got off to a slow start, in late February, Prime Minister Jean Castex insisted that the country was ahead of others in vaccinating “the right people”. Anyone in France aged 70 and over was eligible for a vaccine at the end of last month.
The countries make a good comparison because they have been pretty similar in terms of lockdown rules and mobility in recent months.
Over the past week, France has registered 1,900 covid-19 deaths. Italy has admitted 3,000.
“We need to continue vaccinating people over the age of 75 and increase the vaccination of people with comorbidity because statistics show us that they are more likely to be hospitalized or severely affected,” Castex said.
In assessing why Italy has gone off course, some experts point to a decentralized system of healthcare, where the country’s 20 regional governments have the breadth of breadth to decide who gets shot. Although the central government’s Ministry of Health set guidelines for who to prioritize at the start of the rollout – frontline health workers, nursing home residents, people over 80 and then key workers – some regions have opened their doors wide to midcarers barely starting to administer doses to 70 and older.
In recent weeks, Italian newspapers have been full of stories about vaccinations of chefs, models and judges. Several regional studies have been launched. Italian Prime Minister Mario Draghi, who took office in February two weeks ago, accused some regions of “neglecting” the elderly and instead favoring groups “who are likely to be given priority based on their contractual strength.”
For several weeks, Italy gave shots to middle-aged workers because it had no other choice. The national drug regulator had recommended that the Oxford-AstraZeneca vaccine be used only for those 55 years of age and younger. But officials say that even after the guidance was repealed – with AstraZeneca proven to the entire population – the regions were slow to adapt their strategies.
There are also questions about why certain young people got their shots. According to government data, around 250,000 people in their 20s and 30s have been given doses, even if they are not teachers, health workers or law enforcement members – the essential groups. The Ministry of Health did not answer a question about the rationale for vaccinating these people. In the government data, they are categorized as “other” or “altro”.
“In some regions, they vaccinated journalists. In others, they vaccinated lawyers, ”said Roberto Burioni, professor of microbiology and virology at Vita-Salute San Raffaele University in Milan. “University professors have been vaccinated now and they work externally. I do not see the reasoning behind this. It’s so foggy. ”
Abrignani said the situation in the wake of Draghi’s comments is gearing up for improvement. Doses given to people 70 years and older have accelerated over the last week.
But Matteo Villa, a fellow at the Italian Institute of International Political Studies, has done so followed Coronavirus said past failures – particularly the slowness of vaccinating those 80 and older – are still playing out at the moment.
Villa projects that Italy has so far saved 4,000 lives with its vaccine campaign, but that this could have been as high as 12,000 below the optimal model.
He said there is an argument for inoculating key workers in the subsequent stages, but that these doses should only be given to people over a certain age.
“I can tell you that they also vaccinated the wrong people because they also vaccinated me,” Villa said.
He is 37. He received his vaccination against weeks after a dose was given to his grandmother, who is 92. None of his parents, who are in their 60s, have been vaccinated.
“If you look at the mortality rate of the virus, I should not get a vaccine right now,” he said.
Noack reported from Berlin. Stefano Pitrelli contributed to this report.