Italy’s 5Star Movement learns to love coronavirus vaccines

Italy, the first European country to see its hospitals overflow with coronavirus cases, is rolling out vaccines that many hope will mark the beginning of the end of the crushing pandemic.

But the country faces an uphill battle to immunize its population — one of the most vaccine-skeptical in Europe — especially given that one of its ruling parties has long expressed such doubts itself.

The populist 5Star Movement, which governs with the center-left Democratic Party, voiced vaccine skepticism as far back as 1998, when Beppe Grillo, the movement’s founder and its former leader, questioned the use of vaccines in a televised skit in front of a live audience.

That attitude continued to persist among the 5Stars’ leaders over the years.

“In some cases vaccines are useful,” said Paola Taverna, vice president of Italy’s upper house of parliament, in 2015. “But other times what we’ve found is that they’re entirely for the benefit of pharmaceutical companies, and not in citizens’ interest.”

In 2018, she struck an even more forceful tone, saying that “an unvaccinated child is a healthy one.” 

Some in the party have long maintained that mandatory jabs were a plot by Big Pharma, an argument reflective of the 5Stars’ opposition to establishment institutions they perceive to be corrupt and unscrupulous.  

But even before the coronavirus, this position had started to shift. One turning point was when Grillo signed an “alliance for science” put forward by prominent virologist Roberto Burioni. 

Taverna herself later said in 2018 she would stop talking about the issue, in an attempt to put the controversy to rest. 

This has now turned into full-throated support for a coronavirus vaccine from party representatives who see the jab as a solution to the ongoing health crisis: In December, Italy climbed to the top in rankings for coronavirus mortality in Europe. The perception that politicians fumbled in managing the second wave has weighed on the government’s popularity as well.

But the 5Star leadership’s change in tack has fueled resentment within party ranks. It also reflects a more general shift within the movement, which went from being a vessel of a scattershot — and at times contradictory — revolt against the establishment to a structured party that has had to make difficult decisions to govern. 

This could further complicate efforts to convince a reluctant population to roll up their sleeves: One in five Italians say they won’t get a coronavirus shot and of the remaining 80 percent, more than half would rather wait before receiving their dose.

Anti-politics and antibodies

On vaccines, this change of course has proved painful, prompting internal fights that pitted party members against each other.    

A good example is Elena Fattori, who in 2013 was elected as a senator for the 5Star Movement. Before that, she had worked as a researcher after getting a doctorate in molecular science. 

Fattori describes her own view of vaccines as nuanced.

“They each have their risks and benefits,” she told POLITICO. “It depends which one we’re talking about.”

“Of course, to say that we shouldn’t use them is crazy,” Fattori added.

In 2019, the senator left the 5Star Movement to become an independent, citing her position on vaccines — and the bad blood that this caused among her vaccine-skeptical colleagues — as a major reason.

“There were more anti-vaxxers than I had imagined,” said Fattori, who has written a book on the relationship between politics and science titled “The Middle Ages in Parliament.”

But as she sees it, not everyone who paid lip service to the issue is a true believer — and “political opportunism” among the leadership has also played a role, she said.

Even after a more pro-vaccine line prevailed among more of the movement’s leaders, “it was very difficult [for the party] to correct the course,” she said.

This shift was accompanied by a wider change in the party, she said: “The movement in many ways ceased to exist.”

Others remained burned by the topic. Party member and then-Health Minister Giulia Grillo, for example, found herself in the middle of a bitter row over the issue in 2018. The debate centered on the so-called Lorenzin law, inherited from the previous government, that increased the number of mandatory vaccinations for schoolchildren. The debate presaged current discussions about how to handle vaccine hesitancy.

At the time, Grillo found herself walking a tightrope, trying to accommodate activists within the movement while not deviating too much from the scientific mainstream. A persistent measles outbreak upped the ante to get the response right.

Despite pressure from her colleagues, Grillo held firm on the issue of obligatory vaccinations for schoolchildren while promising an easing of certain measures. Inside the party, though, there was a rupture.

“Certain powerful figures who were anti-vaxxers when I was minister went to war against me,” Grillo said in a newspaper interview last August. “A war that I ended up losing. One of the reasons, maybe, that I’m not minister anymore.” 

From a movement to a party

Over time, the most vehement vaccine skeptics have found themselves sidelined.

Sara Cunial, a former deputy in the country’s lower house of parliament, described mass immunization as a “gratuitous genocide” in 2018. She was subsequently expelled from the party.

Another example is Davide Barillari, a regional counselor of the Lazio region, who proposed a regional ordinance that would mandate a four- to six-month quarantine for children who were vaccinated. He was shown the door after setting up a website promoting health “counter-information” that closely resembled an official government site. 

There is also MEP Piernicola Pedicini, who recently left the movement to join the Greens. In his good-bye note to the party, Pedicini, who previously had said that it’s necessary to “vaccinate less” but do it better, argued the movement had abandoned its “brave position on vaccines.”

A trained medical physicist, Pedicini accused the movement of having changed — a shift that he traced back to when the current Italian Foreign Minister Luigi Di Maio became party leader in 2017. 

The MEP said that when he joined the movement, “it was an innovative force” willing to tackle the establishment.

“Before, it felt like a family,” Pedicini told POLITICO. “Wherever you went, everyone spoke the same language.”

But in the run-up to his re-election as MEP, he said he found hostility.

“That fluidity in the party, which should have created dynamism, showed itself to be a big problem,” he said. As a result, he argued the leadership was able to stage a takeover without any checks and balances.

Roberto Biorcio, a professor of political science at the University of Milano-Bicocca, believes the party has undergone a significant transformation since it began to govern in 2018.

At its start, Grillo was able to give a political voice to the tension between common people and the governing class in the political system, Biorcio explained. And the early shape of the movement reflected this ideal, with a charismatic leader on the one hand and an activist base on the other. 

But the reality of having to govern the third-biggest country in the EU meant that the party had to evolve. This change included setting up a defined party organization at both the national and local level, while lessening the importance of the activists.

“It’s an organizational structure more similar to traditional parties,” Biorcio said. 

This transformation came at a cost. As the movement made compromises to govern, and shed representatives from the more extreme positions on vaccines, it also finds itself diminished. Once the most popular party in Italy, it’s now fallen to fourth place in recent surveys. In trying to tread the line between populism and respectability, it wants to put distance between itself and any past associations with the anti-vaccine movement. 

In a written statement on behalf of the party, 5Star MEP Daniela Rondinelli said that while she had “a lot of respect” for the share of Italians who refuse the jab, getting a shot was “an act of love” for those most vulnerable.   

“I hope that in the vaccination campaign, the realization that a vaccine is the only tool we have to put an end to this pandemic prevails,” Rondinelli said. 

Deputy Health Minister Pierpaolo Sileri, also a 5Star, has gone as far as to say that the coronavirus vaccine should be mandatory, which many experts have advised against. That’s a major turnaround from 2019, when Sileri, along with two politicians from the far-right League, presented an amendment to relax the Lorenzin law.

Meanwhile, medical professionals tasked with administering the vaccine will have their work cut out for them. Alongside the French and Romanians, Italians have consistently ranked high for vaccine skepticism in Europe.  

But as the 5Stars moderate their position, a recent poll showed that vaccine skeptics now lean more to the right: the largest share of respondents who said they would not get vaccinated against the coronavirus supported the League and the Brothers of Italy.

With this sentiment still strong among many ordinary Italians, Fattori said she fears a resurgence of the anti-vax movement. 

“At the moment, the epidemic makes it difficult to say that it’s better not to vaccinate,” Fattori said. But once the contagion isn’t as pressing, the anti-vax movement could “once again reemerge as a powerful force.”

This article is part of POLITICO’s premium policy service: Pro HealthCare. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.

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