Mandatory Vaccinations for Children in Italy: What, When, and Where in Rome
10 vaccines required by law, all free. From birth to age 16: the schedule, the paperwork, and what happens if vaccinations are missing.
In a Nutshell
Since 2017, Legge 119 (the so-called Decreto Lorenzin) makes 10 vaccinations compulsory for all children aged 0–16 living in Italy. They are free, administered by your local ASL (Azienda Sanitaria Locale — your local public-health authority), and children under 6 who lack them cannot be enrolled in nursery or pre-school.
At a Glance
| Cost | Free (covered under the LEA — Italy's essential levels of care) |
| Timeline | First dose at 3 months; full cycle completed by age 16 |
| Where in Rome | Vaccination centres at ASL Roma 1–6, or your child's family paediatrician (Pediatra di Libera Scelta) |
| Documents | Child's Tessera Sanitaria (Italian health-insurance card), parent's ID, vaccination booklet |
| Appointment | ASL sends an automatic letter around the 60th day of life |
The 10 Mandatory Vaccines
By law, every child born from 2001 onwards must receive vaccines against:
- Polio
- Diphtheria
- Tetanus
- Hepatitis B
- Whooping cough (pertussis)
- Haemophilus influenzae type b (Hib)
- Measles
- Rubella
- Mumps
- Chickenpox (varicella) — for children born from 2017 onwards
In practice this is not 10 separate injections. The first six are combined in the hexavalent vaccine (a single shot covering diphtheria, tetanus, pertussis, polio, hepatitis B and Hib). The last four come in the MPRV vaccine (measles, mumps, rubella, varicella).
There are also recommended but not mandatory vaccines offered free by the ASL: meningococcal, pneumococcal, rotavirus, HPV, seasonal flu and COVID-19.
The Schedule: When Each Vaccine Is Given
| Vaccine | When |
|---|---|
| Hexavalent — 1st dose | 3rd month of life |
| Hexavalent — 2nd dose | 5th month of life |
| Hexavalent — 3rd dose | 11th–13th month |
| MPRV — 1st dose | 13th–15th month |
| MPRV — 2nd dose + DTP-polio booster | 6 years |
| Adolescent booster (dTpa-polio) | 12–18 years |
The full cycle follows the Piano Nazionale Prevenzione Vaccinale (PNPV) 2023–2025 (National Vaccination Prevention Plan), updated by the Ministry of Health.
For newborns in Rome, the ASL sends an automatic appointment letter to your registered address around the 60th day of life. You don't need to track down the clinic — they come to you.
Vaccinations and School Enrolment
The vaccination requirement is tied directly to school registration. Here is what happens in practice:
- By 10 July (for nurseries and pre-schools) you must present an ASL vaccination certificate or a self-declaration.
- The school cross-checks with the ASL via the Anagrafe Vaccinale Regionale (AVR) (Regional Vaccination Registry) of Lazio — if the vaccinations are already on record, you don't need to hand in paper documents.
- If vaccines are missing, the school contacts you and you have 10 days to get up to date.
The consequences depend on the child's age:
- Ages 0–6 (nursery and pre-school): without the required vaccines the child cannot be admitted.
- Ages 6–16 (compulsory schooling): the child attends as normal, but parents receive an administrative fine of €100–500.
Children Who Have Come from Abroad
If your child arrived from another country with a foreign vaccination booklet, they don't start from scratch. Bring the booklet (even in the original language) to an ASL vaccination centre and the doctor will assess the coverage already received and top up only what is missing — this is called recupero (catch-up), and it is free.
If there is no booklet, the doctor can order blood tests to check immunity or administer the missing doses.
The vaccination obligation applies to all children resident in Italy, regardless of their nationality or their parents' legal status. Children of asylum seekers and undocumented migrants are entitled to free vaccinations with no reporting to the authorities.
Mistakes to Avoid
- Thinking vaccines cost money. At an ASL vaccination centre they are completely free. If someone offers you the same vaccines for a fee at a private clinic, you are being charged for something you can get free of charge the same day at your local centre.
- Missing appointments without rebooking. The vaccination calendar is timed to maximise effectiveness. If you miss a slot, contact the ASL immediately to reschedule.
- Assuming these diseases no longer exist. Measles, whooping cough and diphtheria still cause serious hospital admissions every year in Italy. High vaccination coverage also protects people who cannot be vaccinated for medical reasons.
Special Cases
Medical exemption. Your child's paediatrician can grant a temporary or permanent exemption in cases of immunosuppression (e.g. during chemotherapy), a previous anaphylactic reaction to a vaccine component, or other conditions specified by the regulations. A medical exemption does not carry a fine and does not prevent school enrolment.
Internationally adopted children. The ASL runs a dedicated pathway with clinical and serological assessment on arrival. Any missing vaccinations are completed free of charge.
Children in foster care. Vaccination programme enrolment is managed jointly by the ASL and the Comune (city hall / municipality) social services.
HPV vaccine. Recommended (not mandatory) for both boys and girls from age 11, free up to age 18 (often extended to 26). It protects against cervical, anal and oropharyngeal cancers, as well as genital warts.
Official Sources
- Ministry of Health — Vaccinations
- Ministry of Health — Mandatory Vaccination Law 119/2017
- Legge 119/2017 — full text on Normattiva
- PNPV 2023–2025
- National Vaccination Schedule — Ministry of Health
- AIFA — Italian Medicines Agency
- Epicentro ISS — Vaccines
- Salute Lazio — Vaccinations
- Regione Lazio — Vaccination Registry
Legal references: Legge 31/07/2017 n. 119 (Decreto Lorenzin); DL 07/06/2017 n. 73; Circolare Ministero Salute 16/08/2017 prot. 25233; PNPV 2023–2025; DPCM 12/01/2017 (LEA).