Judgment No. 5 of 2018
Paolo GROSSI, President - Marta CARTABIA, Author of the Judgment
In this case, the Court considered two applications from the Veneto Region contesting a Decree-Law laying down urgent provisions concerning vaccinations. The provisions listed ten vaccines mandatory for all minor children under the age of sixteen residing in Italy (including unaccompanied minor aliens), four of which were already mandatory, and six of which were elevated from recommended to mandatory status. Under the decree-law, the mandatory vaccines are a requirement for access to early childhood educational services, making enrollment contingent upon the presentation of a certificate of vaccination, and noncompliance can also result in administrative fines. The Applicant claimed that these requirements unduly compressed both constitutionally guaranteed freedoms of individuals and regional autonomy. The Court disagreed, and held these allegations to be unfounded. After ruling that interventions by third parties were inadmissible, the Court first described the history of vaccine legislation in Italy, which was marked by a mixture of compulsory and recommended vaccines, all provided free of charge, and varying degrees of regional autonomy in the area of vaccine regulation, particularly when vaccine coverage peaked in the nineteen nineties. Then it noted the current epidemiological context in Italy, marked by a troubling decline in vaccine coverage to levels considered alarming by national and international health organizations and a measles outbreak that had caused four deaths. It also pointed out that there was no scientific basis for a trending popular opinion that considered vaccines to be futile or even dangerous. Then, recalling the Legislator?s discretion in carrying out a reasonable balancing of these factors with regional and individual autonomy, the Court drew several conclusions: first, that urgent provisions were appropriate given the preventive nature of vaccination and the critical level of coverage in Italy, and that the Applicant inappropriately conflated epidemic emergencies with the kind of urgent need that could justify legislative intervention. Second, it noted that in medical practice, recommendation and obligation are conjoined concepts, and, therefore, shifting six vaccinations from the recommended to the compulsory category did not represent a significant change in their status. Third, it stated that requiring a certificate to enroll in school and imposing fines were reasonable, not least of all because the Legislator had provided for initial steps that included one-on-one meetings with parents and guardians to inform them about vaccine efficacy. Finally, it noted that, under certain conditions, Regions may experiment with downgrading certain vaccines from mandatory to suggested status, and that the Legislator could, in the future, extend this flexibility to other vaccines as well, under changed epidemiological conditions.