Italy set a new bar on Friday for major Western democracies seeking to move beyond the pandemic by putting in place a sweeping law that requires the nation’s entire work force — public and private — to have government-issued health passes.
The measure requires workers to show proof of vaccination, a negative rapid swab test or recent recovery from Covid-19 before returning to offices, schools, hospitals or other work places.
Under the new rules, those who do not have a Green Pass, as Italy’s health pass is called, must take unpaid leave. Employers will be responsible for verifying the certificates, for the most part a cellphone app. Workers risk fines of up to 1,500 euros ($1,760) for not complying.
The law goes further than those in other European countries or the United States in pushing vaccination mandates, which have become central — and hotly contested — parts of government strategies to curb the spread of the coronavirus.
With the step, Italy — the first democracy to have quarantined towns and applied national lockdowns — is again first across a new threshold, making clear that it is willing to use the enormous leverage of the state to try to move beyond the pandemic.
President Biden has appealed to private companies to mandate coronavirus vaccinations for employees, asking them to take initiative as an effort that he announced in September to require 80 million U.S. workers to get the shot undergoes a lengthy rule-making process.
China, where more than one billion people are now fully vaccinated, has no qualms about pushing a more forceful stance on vaccines. In August, the authorities in at least 12 Chinese cities warned residents that unvaccinated people could be punished if they are found to be responsible for spreading outbreaks.
In Italy, where more than 80 percent of people over age 12 are now fully vaccinated against Covid, the sweeping national mandate has stirred protests among hard-core holdouts, and some workers around the country threatened to strike on Friday.
But the measure has faced no serious legal challenge, and Prime Minister Mario Draghi and his government say they are confident that the courts will not delay or reverse the law.
Italy has now taken the boldest position in Europe. In France, President Emmanuel Macron has tried to make life uncomfortable for unvaccinated people, requiring a health pass to enter restaurants and for long-distance train travel, for instance, but has mandated vaccines only for some essential workers.
Italy earlier put in place tough requirements for health workers and teachers, significantly increasing vaccination rates in those categories. But to reach the most reluctant unvaccinated workers — an estimated 3.5 million people — the government has now taken one of the Western world’s hardest lines.
Government officials say that the measure is already working, and that more than 500,000 previously reluctant people — much higher than expected — have gotten inoculated since the government announced its plan last month.
Italians have largely embraced the Green Pass, as they have rules about wearing masks on public transit and other closed public spaces, as a small sacrifice for a return to normalcy. But a small population of eligible people remain unvaccinated — a mix of vaccine skeptics, conspiracy theorists and other anti-establishment types.
“There are still 50 deaths a day,” said Col. Mario Renna, a spokesman for the Italian Army general in charge of Italy’s vaccination effort. “We want to get to zero.”
Port workers in the northeastern coastal city Trieste, one of Italy’s largest shipping and transport hubs, gathered on Friday to prevent trucks and workers from gaining access to the port in protest of Italy’s new health pass mandate for all workers.
“We are just here peacefully standing before the gate,” Sandi Volk, a union leader, said in a telephone interview. “There are few workers inside.”
Mr. Volk, who is vaccinated, said that more than 600 of the port’s 1,000 workers were protesting the Green Pass on Friday. About 40 percent of Trieste’s port workers are estimated to be unvaccinated, the highest of any port.
“Some companies have promised to pay us back for the swabs,” he said of coronavirus tests, which are now required every two days for unvaccinated workers. “We won’t give up until the government cancels it.”
There is no indication that the government will do any such thing.
Some logistics companies in Trieste negotiated with the port workers’ unions and offered to pay for the swab tests. But members of other smaller unions rejected the plan and decided not to show up for work, reducing the port’s activities.
Officials said the disruption was minimal, though.
“The port works,” Massimiliano Fedriga, the president of the Friuli Venezia Giulia region, told the Italian news channel SkyTg24. “Obviously in some areas there will be difficulties and a reduced capacity, but it works.”
About 200 workers also sought to cause disruptions on Friday in the port of Genoa, in northwestern Italy, where about 20 percent of the roughly 12,000 workers are unvaccinated. The protesters blocked trucks at two of the entrances.
“We are not against the Green Pass per se,” said José Nivoi, a leader for the USB autonomous union in Genoa. “But we want the companies to pay for testing for all the port workers and a testing hub inside the port.”
ROME — Nicola Andreuzzi was one of the first Italians to participate in what on Friday became one of the Western world’s most sweeping Covid vaccine mandates, as the Italian government required all workers, public and private, to show their health pass to go to work.
At 5:10 a.m. in a warehouse outside Rome, he showed his health pass to a manager, lowered his head so his boss could take his temperature and then headed to central Rome to repair walls marred by graffiti in Trilussa Square. He said he trusted the government’s decision to mandate the vaccine for workers.
“If they tell me to build a wall, I am going to tell them how to do it,” he said after sandblasting a wall clean. “But if the experts make vaccine obligatory, I trust them on that.”
Around the country, lines formed in front of office buildings and factories as workers and employees waited to have their so-called Green Pass checked. The morning shift began late for many workers of the ILVA steel works in Taranto, where unions complained that there were not enough entrances or controls to process the more than 8,000 employees.
In Turin, lines formed in front of the main court, where employees had to exhibit their Green Pass and fill out a form certifying that they had not been in recent contact with anyone who has Covid.
At I Dolci di Checco, a cafe in Rome, one of barista didn’t show up for work on Friday morning because she didn’t have a Green Pass.
Inside the cafe, arguments for and against vaccination echoed those taking place across the city.
“I think no one should not be forced to get a vaccine,” said Maxim Turcan, 31, another bartender, as he poured milk fluff in a cappuccino. His employer has known for a while that he is vaccinated and did not check his Green Pass on Friday. “In a democracy, everyone should have the freedom to decide for himself.”
Paola Marmo, 73, a psychotherapist, stood at the counter before heading to the office.
“What kind of freedom is that if I send other people to an intensive-care unit?” she asked. Ms. Marmo, like all medical workers, was required months ago to get vaccinated, and said she agreed with the mandate being expanded to everyone. “Everyone should get a vaccine.”
Matteo Talamini, a baker who was carrying pounds of butter to make morning pastries, agreed. “I don’t see another solution,” he said. “It’s for everyone’s good.”
For some presenting their Green Pass on Friday, the requirement came, if anything, too late.
Maria Tisalita, a cleaner whose employer asked to see her Green Pass, said that her sister, who was unvaccinated, had died from the coronavirus two weeks ago.
“I think if she was vaccinated she would have survived,” she said. Nevertheless, she said she thought inoculation should be a personal choice — “not something they force you to do.”
Frustrated that tens of millions of Americans remain unvaccinated despite broad access to vaccines, President Biden has used the full force of his presidency to push two-thirds of U.S. workers to be inoculated against the coronavirus, reaching into the private sector to mandate that all companies with more than 100 workers require vaccination or weekly testing.
The White House has also mandated shots for health care workers, federal contractors and most federal workers, who could face disciplinary measures if they refuse.
“We’ve been patient,” Mr. Biden said when he announced the measures in September. “But our patience is wearing thin. And your refusal has cost all of us.”
Before the mandates can come into full force, the measures must go through an interagency review process, which could take weeks.
In the meantime, vaccine mandates are facing growing resistance in states whose leaders oppose such requirements and other pandemic restrictions. Gov. Greg Abbott of Texas issued an executive order barring private employers from mandating coronavirus vaccines. And in Florida the state’s health department fined Leon County, which includes Tallahassee, for violating a state ban on “vaccine passports.”
Like so many other aspects of the pandemic, positions on mandates have been caught up in the swirl of bitter partisan politics, and approaches by states and localities vary wildly.
California’s governor issued the nation’s first statewide Covid-19 vaccine mandate for schoolchildren, saying they would be required as soon as next fall to be inoculated against the coronavirus to attend public and private schools in the state.
Gov. Gavin Newsom’s order adds the coronavirus vaccine to other inoculations, such as for measles and mumps, that are required for nearly seven million students to attend K-12 schools in person. The mandate will first apply to seventh through 12th grades, and then kindergarten through sixth grades, only after the Food and Drug Administration grants full approval to a vaccine for those age groups.
New York issued a vaccine mandate for more than 650,000 hospital and nursing home workers, prompting a flurry of lawsuits across the state, brought by nurses and others who are seeking exemptions.
The vaccination rate among home health workers in New York was about 86 percent as a deadline arrived last week, exceeding the expectations of some union and industry leaders and suggesting that thousands may have made a last-minute decision to be inoculated, according to preliminary state data.
But the state’s survey of agencies providing home health care also showed that at least 34,000 workers appeared to have missed the deadline to get vaccinated under the mandate, rendering them unable to work and deepening a labor shortage in the industry.
The new requirement that workers in Italy present a health pass to earn a salary threatened to set off protests across the country on Friday.
Last weekend, a demonstration of 10,000 opponents to the so-called Green Pass was hijacked by right-wing extremists and turned violent, prompting questions about lax policing and, more broadly, forcing Italy to once again reckon with its fascist legacy.
The violent post-fascist group Forza Nuova, partly inspired by the January assault on the U.S. Capitol building, sought to divert the march to attack the headquarters of the country’s largest worker union, which was ransacked.
Protesters clashed with police officers under clouds of tear gas and the spray of water cannons. Nearly 40 officers were injured, and about a dozen extremists were arrested.
One of the ransackers took off his shirt and exposed across his back an eagle tattoo associated with fascist movements. Others burst into an emergency room and assaulted a nurse. The protests grew worrisome enough to prompt the evacuation of House Speaker Nancy Pelosi, who was in Rome to meet Pope Francis, from a Mass at a nearby church.
A judge who signed arrest warrants for Forza Nuova members said that “they wanted to reach the institutions.” Roberto Fiore, a founder of the group, has called Ashli Babbitt, the woman killed in the assault on the U.S. Capitol, “the first heroine of the American people’s revolution.”
The images of fascists bashing police officers and smashing windows of a left-wing workers’ union were an unsettling echo of the fascist attacks on Communist groups that helped bring Mussolini to power a century ago. The acts prompted condemnation across the political spectrum.
A Telegram group, “No Green Pass, We’ll Win Together,” made up of about 30,000 members, has talked about a coming “war” and strikes and sickouts.
Italy’s interior minister has acknowledged that something went wrong last weekend, and Italian officials said that controls would be much tighter on Friday.
The Democratic Party filed a motion in Parliament to disband neofascist groups, saying that it was time to “end ambiguity about fascism” in Italy. Conservative politicians, worried about upcoming municipal elections across the country, also sought to distance themselves from the violence.
Mr. Draghi said on Tuesday that the government was looking into the possibility of disbanding Forza Nuova.
Ernesto Milani, a baker in the northern Italian city of Rovigo, is skeptical about the coronavirus vaccines. He thinks they are too experimental and worries about side effects. And he thinks the Italian government is infringing on his liberty by pressuring him to get vaccinated.
And so on Friday his bakery is closed.
Mr. Milani is shuttering his bakery in protest of the new requirement that people in Italy who want to work must have a health pass showing proof of vaccination, a negative coronavirus test or proof of recent recovery from Covid-19.
“Giving in to the Green Pass means giving in to blackmail,” he said.
But if Mr. Milani wants to work, give in he must. Prime Minister Mario Draghi is requiring all workers to get with the government program.
Some unions and labor associations warned that this could prove disastrous.
“We are naturally very worried, because almost a third of our work force does not have a Green Pass,” Ivano Russo, the director general at Italy’s largest association of truck drivers, couriers and logistics operators, said in a telephone interview.
Twenty-five to 30 percent of Italy’s logistics workers have not been vaccinated, and given that Italians have had plenty of opportunities to get a shot, they may have no intention of doing so, he said.
“We need to be pragmatic,” Mr. Russo said. “We agree that we have to protect people’s health, but truck drivers drive alone and could even avoid getting off their vans or trucks like they did during the first lockdown. Imagine Italian supermarkets with a third of the shelves empty. That could happen.”
Already, Milanese workers were planning to strike over the Green Passes. And in Rome the public transportation company, already in disarray, acknowledged that a large chunk of its workers are not vaccinated. In Trieste and Genoa, two of Italy’s major ports, workers have staged strikes to demand that the government pay for their swab tests.
José Nivoi, a union representative for Genoa’s port workers, said that about 20 percent were not vaccinated and that the Green Pass would create divisions among them.
“You are putting thousands of family in a condition of distress,” he said.
There is widespread belief in Asia that vaccines are the only way out of the pandemic. This month, when a vaccination center in Tokyo offered 200 walk-in shots for young people, hopefuls queued from the early morning hours, and the line extended for blocks.
In South Korea, when the authorities opened vaccinations to people in their 50s, roughly 10 million simultaneously logged on to a government website to sign up for shots. The system, which was designed to process up to 300,000 requests at a time, temporarily crashed.
And people in poorer nations whose lives were upended by extended lockdowns have felt they had no choice but to get vaccinated.
“If I get sick, I don’t get money,” said Arisman, 35, a motorcycle taxi driver in Jakarta, Indonesia, who got his second shot of the Chinese-made Sinovac vaccine in July because his job involved contact with many people. “If I don’t work, I don’t get money.”
Countries in the Asia-Pacific region, once lauded for their pandemic response, initially struggled to get their Covid vaccination programs off the ground as the United States and Europe ramped up theirs. Now, many of those laggards are speeding ahead, lifting hopes of a return to normality in nations resigned to repeated lockdowns and onerous restrictions.
Risks remain, since most of the countries do not manufacture their own vaccines and could face supply problems if their governments approve boosters. And in Southeast Asia the rollout has been slow and uneven. But for much of the region, the shift has been striking.
That has been in part because vaccines were never a polarizing issue in Asia-Pacific.
Although each country has had to contend with its own anti-vaccine movements, they have been relatively small. They have never benefited from an ecosystem — sympathetic media, advocacy groups and politicians — that has allowed misinformation to influence the populace.
Overall, most Asians have trusted their governments to do the right thing, and they were willing to put the needs of the community over their individual freedoms.
The lack of social safety nets in many Asian countries also motivated many governments to roll out the vaccines quickly, said Tikki Pangestu, a co-chair of the Asia-Pacific Immunization Coalition, a group that assesses Covid-19 vaccine preparedness.
“At the end of the day,” he said, “if they don’t do it, they’re going to end up with social unrest, which is the last thing they want.”