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A medical staffer takes a nasal swab for a COVID-19 rapid test in Rome, on Dec. 30, 2021.Andrew Medichini/The Associated Press

At a small coffee shop in central Rome on Monday morning, the door was wide open and the few patrons who chose to drink indoors to escape the cold had to show the masked baristas proof of vaccination for the first time.

The new restriction came into force after the Italian government made vaccination passes – not just a negative COVID-19 test – necessary to use public transportation and gain access to public spots such as gyms, hotels, restaurants and bars. Last week, the government also required everyone 50 or older to become fully vaccinated, making Italy one of only three European Union countries to mandate vaccines for an entire age group.

Italy’s vaccine mandate came as infection rates were setting records virtually every day since the Omicron variant began to sweep through the country in December. Italy is hoping that compulsory vaccination will protect the economy and take some pressure off hospitals. Health Minister Roberto Speranza said two-thirds of patients in ICUs are unvaccinated.

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But it’s far from certain that other EU countries will push through similar vaccination policies, even if many of them, such as France, are using tight restrictions to make life for the unvaccinated more difficult every month. Several European cities have been hit with large anti-vaccine protests. Right-wing parties are largely opposed to compulsory vaccination. And enforcement questions abound.

Still, the idea of vaccine mandates is no longer taboo, and many government leaders support them, even if some have yet to confront the “refuseniks” head on.

“I sense that we are seeing a change in views on vaccine mandates, as more people, and politicians, appreciate the consequences for society of significant numbers remaining unvaccinated,” Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, said in an interview. “Of course, there is much more to be done to encourage vaccinations, short of mandates, but there is growing evidence that they do work and those who are determined to hold out are a small minority.”

According to the Bloomberg Vaccine Tracker, almost 71 per cent of the eligible EU population is fully vaccinated and one in three has received a booster shot. The goal is to vaccinate everyone who is eligible while Omicron infections remain stubbornly high. The highly transmissible variant is straining public services as many doctors, ambulance drivers, police officers and civil servants become symptomatic.

Italy has been at the forefront of the campaign. Before it announced compulsory vaccination for those 50 or older, it had required all teachers and health workers to be vaccinated and all other employees, in both the public and private sectors, to be jabbed or test negative to enter the workplace. “These rules aim to keep hospitals functioning well and schools and business activities open,” Italian Prime Minister Mario Draghi said last week.

The two other EU countries that will soon require jabs for entire age groups, not just certain professions such as medics, are Greece and Austria.

Greece announced in late November that it would make vaccination compulsory from Jan. 16 for anyone 60 or older. The country had already banned the unvaccinated from indoor public spaces such as restaurants, cinemas and museums.

Austria plans to go a big step further than Italy and Greece. On Feb. 1, vaccinations for anyone over 14 are to become mandatory, though some politicians think the date will slip.

France is not requiring vaccination for certain age groups, just certain professions. But last week, French MPs passed a bill that will require proof of vaccination for adults to access public places such as restaurants and theatres. Voting on the bill was stalled for a few days after French President Emmanuel Macron triggered a political firestorm when he said he wanted to “piss off” the unvaccinated by making their lives unbearably complicated.

Other EU countries are talking about vaccine mandates, but some of them are delaying such a move because of political and popular resistance. Germany’s new Chancellor, Olaf Scholz, predicted in November that the country would have a general vaccine mandate by February or March. His goal now seems impossible, with some members of his ruling coalition opposed to any mandate. A few recent demonstrations in Germany against compulsory vaccination have turned violent.

There is also a feeling among some politicians in Germany and elsewhere in the EU that the vaccine mandates would come too late to stop, or even slow, the Omicron onslaught. Some big countries, such as Italy and France, have reported more than 150,000 cases a day and more than 250,000 on a few days (the French daily record was 332,000, achieved one day last week). Italy reopened its schools Monday after the holidays, triggering predictions of an even bigger Omicron wave in the coming weeks.

German Health Minister Karl Lauterbach appears to be changing his stand on compulsory vaccination. As Omicron was taking off in Germany, he said a vaccine mandate would not stop the Omicron surge. But on Sunday, as the cases and fatalities continued to rise, he told German newspaper Die Welt that gaining immunity through infection was not the solution.

“We need a vaccine mandate,” he said. “Otherwise Omicron is a dirty vaccination through the back door.” He added that “many people would become seriously ill with often permanent damage” if Omicron were left unchecked.

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