Italy's medicines regulator recommends fourth dose for immunocompromised people.

Italian health minister Roberto Speranza said on Sunday that a fourth covid vaccine dose for everyone after the summer is "to be considered likely".

In an interview with La Repubblica newspaper the minister invites people to "keep their feet on the ground: covid does not get on a plane and leave on 31 March", in reference to the date when Italy's state of emergency is due to expire.

Speranza added that the Green Pass "was and is a fundamental piece of our strategy" and "indoor masks are still important."

The minister's comments came after Italy's medicines agency AIFA recommended that people with severely compromised immune systems receive a fourth dose of the covid vaccine, starting in March, provided that at least 120 days have passed since their booster shot.

"But we will have to evaluate the recall for everyone after the summer" - Speranza told La Repubblica - "It is to be considered likely, because the virus will not shake our hands and go away forever. Unfortunately."

Fourth dose in the autumn

Walter Ricciardi, the coronavirus advisor to the health ministry, told La Stampa newspaper that "it is likely" a fourth dose "in the autumn will be useful for everyone."

"The state of emergency may cease, but the pillars that support our current freedom must remain with a relaxation of the rules" - Ricciardi told La Stampa - "The facilities for vaccination, boosters, the Green Pass and indoor masks must remain in place."

The comments from Speranza and Ricciardi came 10 days after AIFA head Nicola Magrini said that the Italian public would not be called on to have a fourth dose in the coming months but rather there would probably be an annual follow-up jab, describing it as a prospect "we will have to get used to".

State of emergency

Amid an improving covid situation in Italy, Speranza told La Repubblica on Sunday that if the curve continues to fall "we will work in the coming weeks to overcome the state of emergency."

Introduced more than two years ago to deal with the pandemic, these emergency powers are due to expire on 31 March, leading to speculation about how much longer the Green Pass system will stay in place.

Required to access most activities and services in Italy, there is currently a two-tiered system in place, with the "basic" version of the Green Pass available via a negative covid test, and the "Super" version which can only be obtained by people who are vaccinated or have recovered from covid.

Italy pays tribute to health workers

Speranza's interview with La Repubblica coincided with the second edition of a national day in honour of Italy's healthcare workers, dedicated to Emergency founder Gino Strada, with Pope Francis paying tribute to "heroic medical staff".

President Mattarella paid homage to Italy's doctors and nurses too, saying: "It is thanks to their professional preparation and their spirit of sacrifice that it was possible to stem the risk of even greater losses."

The date of the national day coincides with the detection of coronavirus in “Patient 1” on 20 February 2020 when doctors broke protocol by performing a covid test on a 38-year-old man, after he presented with a high fever, cough and shortness of breath.

Until then covid tests were only carried out on people who had been in China, where the virus was raging in the Wuhan province.

The doctors’ suspicions proved right, triggering a national emergency and leading to Codogno being locked down in what would become the first "red zone" or covid hotspot in Europe.

Easing of covid restrictions

The government recently made the Green Pass infinite for those with a third "booster" shot, and lifted an outdoor face mandate, with masks now only required in crowds and in indoor public places.

The quarantine system for schools has also been relaxed and the permitted capacity of sports stadiums are set to increase in the coming weeks.

From 10 March it will be possible again to consume food and drinks in Italy's theatres, cinemas, stadiums and live music venues.

Vaccine mandate

Italian premier Mario Draghi recently promised to move towards "reopening the country even more", however life remains difficult for the unvaccinated who are barred from accessing restaurants, cinemas and public transport.

On 15 February the government's controversial vaccine mandate came into force for workers aged 50 or over who will be suspended without pay unless they get vaccinated.

The vaccine mandate is scheduled to remain in force until 15 June however there is talk that the requirement could be extended beyond this date.

For official information about the covid-19 situation in Italy (in English) see the health ministry website. Photo credit: MikeDotta / Shutterstock.com.