As required by the decree which introduced the obligation, doctors and nurses who refuse can remain without pay until the end of the year
In recent days, the healthcare companies of many Italian regions have started the procedure that will lead to 
suspension of unvaccinated health workers. After having asked the professional orders, hospitals and RSA for the names of all doctors and nurses, and after having warned them of the consequences they would face by not being vaccinated, the health companies began to apply the rules set out in the decree which introduced the vaccination obligation, approved by the Council of Ministers on 1 April.
The regions have already granted more time than had been foreseen in the decree: the delivery of the lists of all health workers had been set by Tuesday 6 April and the verification of the vaccination status by 16 April. Subsequently, within a few days, the health authorities should have sent an invitation to provide documentation of the vaccination, confirmation of an appointment for administration or an explanation for the lack of vaccination.
Already at the time of verification by the health company, health workers must be exempt from jobs that involve interpersonal contacts or involve the risk of spreading the infection. When it is not possible to assign unvaccinated operators to non-risk tasks, the suspension of pay is envisaged.
The investigations lasted longer than expected and only in the last few weeks have the health companies sent formal reminders indicating the day and time of vaccination for the missing health workers. Many then did not show up for the appointments and in the last few days the first notices of suspension from service have been sent, as required by the decree, with the suspension of salary until 31 December 2021.
According to the weekly report published Saturday by the government, at the moment there are 45,753 health workers in Italy still waiting for the first dose of the vaccine. The data says that the Region with the most doctors and nurses not yet vaccinated is Emilia-Romagna, where 14,390 health workers are still missing, 7.8 percent of the total.
On an absolute level, Sicily also has quite high numbers, where 9,214 doctors and nurses have not yet been vaccinated, and Puglia with 9,099. In the autonomous province of Trento there are 2,205 unvaccinated people, but they represent 11 percent of the total. But although the report is official, these numbers are only partially confirmed by the Regions: in Lombardy, for example, according to government data, all healthcare workers are vaccinated even though many healthcare companies have announced that they have summoned late-comers doctors and nurses.
One of the regions that moved fastest was Puglia. At the end of May the Brindisi health company had suspended five employees - four nurses and a lab technician - because they had refused the vaccine twice. Also in Ragusa, Sicily, the local health authority had suspended 30 among doctors, nurses and health workers.
In the autonomous province of Bolzano, despite the government report showing that all health workers have been vaccinated, 3,926 employees have been recalled: 1,108 have decided to get vaccinated while all the others have been summoned to the vaccination points. Only three showed up for the first 28 appointments. They signed up low percentages also in the province of Modena, where only 8 of the 178 health workers summoned showed up. "Some of them will already be relocated to other departments and with other tasks in the next few days", he said the director general of the AUSL of Modena, Antonio Brambilla. "But for a hundred employees we will have to proceed with reporting to the respective professional associations". Estimates by the health agency say that the problem also affects about 5 percent of the 500 family doctors who work in the province. “If they are suspended it will really be a welfare problem. But the law requires us to report them to orders, just like our employees," said Brambilla.
In the province of Bergamo have been reported 3,788 unvaccinated operators: 1,640 people have already responded to the first invitation, while 280 have been reported as "subject to the sending of a second invitation for unsuitable or incomplete documentation". In Lazio, the invitation to get vaccinated within five days was sent to 300 doctors. According to the regional councilor for health, Alessio D'Amato, it is in any case a question of a small percentage of the staff who work in hospitals.
Alberto Cirio, the president of Piedmont – where they result 2,893 healthcare workers not yet vaccinated – he said not to consider excessive the possibility of dismissal for those who confirm their willingness not to get vaccinated. "Every job has obligations that must be respected," he explained. «These people will first be reported, then moved to other tasks, suspension as a last resort. The dismissal is not excessive if there are no alternatives. If one does not want to get vaccinated and does not accept the move to other jobs, there are no alternatives to being fired ». The president of the conference of the regions and president of Friuli Venezia Giulia, Massimiliano Fedriga is instead more cautious. Fedriga has explained that the path "is that of conviction, not of dismissal: we must make people understand the importance of protecting themselves mainly for the health professions".
What the law says
The Covid decree is law: penal shield and vaccination for healthcare workers
The Chamber of Deputies approved in second reading - and officially converted into law - the April Covid Decree (c. 3113),
Obligation to vaccinate healthcare workers: until the complete implementation of the strategic vaccination plan, and in any case no later than 31 December 2021, healthcare professionals and healthcare professionals who carry out activities in healthcare, social and healthcare facilities, pharmacies and professional offices are obliged to undergo vaccination against Covid-19 , unless specific documented clinical conditions. Vaccination is an essential requirement for the exercise of the profession and for the performance of the work services rendered by the obliged subjects. (Article 4, paragraphs 1 and 2)
Verification of the anti Covid-19 vaccination obligation:
- Transmission of data from Orders and employers: the territorial professional Orders and employers of health interest, within five days of the entry into force of this decree, respectively transmit the list of their members and of the employee health workers, complete with the data of residence, to the Region or Autonomous Province of competence. (Article 4, paragraph 3)
- Notification to the local ASL: the Regions and Autonomous Provinces, within ten days from the date of receipt of the lists, verify the vaccination status of health workers; subjects who are not vaccinated against Covid-19 are promptly reported to the reference ASL. (Article 4, paragraph 4)
- Request for documents: the ASL of reference invites interested parties to provide the requested documentation within five days, or the presentation of the vaccination request (in this case, the interested party must notify the ASL within three days of receipt of administration) or the document certifying the clinical conditions above. (Article 4, paragraph 5)
- Non-compliance and suspension: once the established deadlines have been exceeded, the ASL ascertains the non-compliance and communicates it to the person concerned, to the reference Order and to the employer. This act determines the suspension of the interested party from carrying out interpersonal contacts in the case of the Orders; the employer, on the other hand, is required to assign, if possible, the employee to tasks that do not involve the risk of diffusion. If this is not possible, no salary or other emoluments will be recognized for the period of suspension. The suspension remains effective until the possible administration of the vaccine, until the completion of the vaccination plan or in any case no later than 31 December 2021. (Art. 4, paragraphs 6 - 9)
Agenda Accepted: Specific compulsory vaccination of health personnel: the Government undertakes to evaluate the opportunity to have the regulatory initiatives useful to clarify the scope of application of the provision referred to in article 4 of the decree-law and, in particular, to define whether in the category of operators of health interest recipients of the The anti Sars-CoV-2 vaccination obligation should be considered to include all those who work in the presence of public and private health and social-health facilities. (9/3113/22 Mammì – M5S).
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