Buonguerrieri’s words offer the anti-vaxxers an imaginary victory

The most revealing part of the statement in which Alice Buonguerrieri defended her amendment does not concern her implausible account of the measures adopted during the pandemic. It is her expression of gratitude to Fratelli d’Italia, of which the MP says she is proud because the party has acted as an ‘interpreter and spokesperson’ for those who have been subjected to a hate campaign. Here, at least, political communication becomes transparent: the aim is not to clarify how the provision approved in committee works, but rather to present FdI as the party offering a comeback to the anti-vaccine movement. The problem is that the promised comeback does not correspond to what the amendment actually provides for.

Buonguerrieri refers to doctors and nurses who are said to have lost their jobs for refusing vaccination, whilst the legislation she has tabled concerns professionals struck off the register following disciplinary proceedings. The difference is fundamental and decisive. Failure to comply with the vaccination requirement resulted in a temporary suspension from carrying out high-risk activities and, where it was not possible to assign the employee to other duties, from pay; striking off the register, on the other hand, constitutes the most serious disciplinary sanction, imposed by the Professional Body following an assessment of individual conduct deemed incompatible with continued practice of the profession. The Constitutional Court expressly noted that the consequence provided for by law was suspension, not the termination of the employment relationship. The amendment therefore does not overturn the suspensions of unvaccinated healthcare workers, does not restore their lost wages, and does not declare the obligation unlawful. It introduces a special procedure through which certain healthcare professionals struck off for ‘non-malicious acts related to the pandemic’ may apply for reinstatement within sixty days of the law coming into force, provided they still have an appeal pending before the Central Commission for Healthcare Professionals. The audience Buonguerrieri addresses in his statement and the group covered by the legislation are therefore different: the former includes suspended healthcare workers and, more generally, the entire community that regards the vaccination policy as persecutory; the latter consists of a presumably much smaller number of professionals struck off for conduct warranting disciplinary action.

Given that one of the lead signatories is also a lawyer, the suggestion of an accidental confusion between suspension and striking off does not offer a credible explanation. The statement is crafted to make the amendment appear as a redress for a wrong inflicted on all healthcare professionals opposed to vaccination, even though the legislation does not have that effect. A politically promised amnesty is far broader than that provided for by law, relying on the public concerned to recognise the signal and not read the text. The provision also presents its own problems, which Buonguerrieri carefully avoids addressing. Reinstatement of those struck off the register is already provided for by law after five years, provided that the person concerned has conducted themselves beyond reproach and has obtained rehabilitation where the striking off resulted from a criminal conviction. The amendment introduces a fast-track procedure for a category defined by an unspecified reference to acts “related to the pandemic”, without explaining why similar conduct should be treated differently depending on the period in which it was committed. The requirement that an appeal must still be pending also creates a paradox, because Article 53 of the professional regulations normally grants such an appeal suspensive effect. The provision therefore risks facilitating the re-registration of those who, precisely because of the ongoing appeal, may not have been definitively struck off the register. Added to this is the question of constitutional reasonableness arising from the preferential treatment accorded to those with a pending appeal compared to those whose appeal has already been decided or who have not lodged one. One need not be a constitutional law expert to understand that a derogation devised in response to the pandemic would require a more robust public justification than simply the desire to send a signal to the electorate.

Buonguerrieri does not address these objections and prefers to speak of a requirement introduced by an ‘obscure circular’ from the then Minister Roberto Speranza. This claim is also false. The vaccination requirement for healthcare workers was established by Article 4 of Decree-Law 44 of 1 April 2021, adopted by the Draghi government and converted by Parliament into Law 76 of 2021. A Member of Parliament may challenge that decision, propose a different assessment and argue that the balance between individual rights and public health was misguided; she cannot attribute to a ministerial circular an obligation introduced by a legislative act published in the Official Gazette. Replacing the law with an ‘obscure’ circular is not a mere lexical detail, because it serves to transform a decision taken by the government and confirmed by Parliament into the arbitrary act of a minister who has become the symbolic target of the anti-vaccine protest. A verifiable legislative matter is thus adapted to a narrative in which healthcare workers were allegedly deprived of their jobs by Speranza’s personal order, whilst FdI is now said to be setting them free. That narrative is politically effective precisely because it sidesteps the content of both the law and the amendment. The phrase ‘paracetamol and watchful waiting’ serves the same purpose. Buonguerrieri claims that this alleged protocol would have worsened patients’ conditions, often leading them to hospital with little hope of recovery, without providing any clinical data capable of supporting such a serious causal link. The ministerial guidelines provided for active monitoring of patients, the checking of vital signs and the use of paracetamol or non-steroidal anti-inflammatory drugs to manage symptoms; the Council of State also clarified that these were general recommendations, compatible with the doctor’s professional autonomy when exercised on the basis of evidence of efficacy and safety.

To demonstrate that those guidelines caused harm to patients, it would be necessary to identify an alternative treatment, show that it was effective during the period in question, and document worse outcomes amongst those who followed the ministerial recommendations. Buonguerrieri presents nothing of the sort, because the reference to home care does not serve to explain the amendment concerning those struck off the register: it serves to invoke the narrative through which a section of the public has interpreted the entire pandemic. The same approach is applied to vaccines, when the MP states that it is "now well known" that they do not prevent person-to-person transmission. This statement uses observations regarding subsequent variants and the decline in protection to retroactively invalidate the results available in 2021. Against the original virus and the first variants, the vaccines significantly reduced the risk of infection as well as protecting against severe disease. In the Israeli study of nearly 1.2 million people published in February 2021 by the New England Journal of Medicine, the estimated efficacy of the Pfizer vaccine against documented infection was 92 per cent from seven days after the second dose. Those data accurately reflected the epidemiological context at the time and were among the pieces of evidence on which public health decisions were based. Protection against infection declined over time and with the emergence of variants with greater immune evasion capacity, particularly Omicron, whilst protection against severe disease remained higher. This development does not invalidate the previous findings, as a vaccine’s efficacy is measured in relation to the circulating variant, the time elapsed since administration and the outcome under consideration. The Constitutional Court specifically referred to Omicron’s greater ability to evade immunity compared with previous variants, alongside the continued high level of protection against severe disease, and assessed the legislature’s decision in the light of the knowledge available at the time the obligation was introduced.

The data reported in the early stages of the campaign were therefore not a lie exposed by subsequent events. They were accurate figures for the virus and the time period under study, updated as conditions changed. This updating is part of the normal functioning of science, which does not promise immutable truths independent of the evolution of the object under observation. Using Omicron to argue that vaccines did not reduce infection in the preceding period amounts to distorting the timeline, as if an accurate weather forecast for Monday were to become incorrect simply because the weather changed on Friday. Furthermore, the reference to serious adverse effects is presented in isolation from any information on their frequency and from a comparison with the benefits of vaccination. Adverse events do occur, and pharmacovigilance serves to identify them; their detection has made it possible to revise the recommendations for certain vaccines and population groups. The Constitutional Court, citing AIFA’s assessments, noted that serious reactions occurred rarely or very rarely and that the risk they posed did not outweigh the overall benefits of vaccination. Merely raising the possibility of the most serious outcome instils fear, whilst preventing the public from assessing its probability and how it compares with the risk of infection.

At this point, the expression of gratitude directed at Fratelli d’Italia takes on an even more interesting significance, because the party for which Buonguerrieri celebrates his role as spokesperson for the anti-vaxxers is led by Giorgia Meloni herself, who in 2018 wrote that on the subject of vaccines, one should “rely on the scientific community”, avoiding an ideological approach to the issue and leaving the decision to those with the relevant expertise. In March 2021, Meloni also called for the European introduction of the ‘green certificate’, which she regarded as a tool to restore free movement and support the economy without turning it into an ‘immunity passport’. The contrast with Buonguerrieri is stark. Meloni argued that necessary and compulsory vaccines should be identified on the basis of scientific expertise; the FdI MP now describes the requirement for healthcare workers as a measure devoid of scientific basis, imposed by the ideological left through a non-existent circular. Meloni warned politicians not to turn vaccines into an ideological battle; Buonguerrieri builds his defence of the amendment by attributing every decision made during the pandemic to the ‘worst of the ideological left’. The party that at the time pointed to the scientific community as the arbiter now proclaims itself the spokesperson for those who reject the very conclusions that community had reached.

A change in political stance may be legitimate when motivated by new data or a different assessment of the interests at stake. Here, the new data is being used out of its temporal context, whilst legal categories are being superimposed in such a way as to promise those whose membership is suspended what the amendment may eventually grant to some who have been expelled. The party line has not evolved as a result of a scientific review; it has adapted to the emergence of a recognisable electoral base, to whom a narrative is now being offered that is the opposite of the one advocated by Meloni before the anti-vaccination movement became an organised political community. There are therefore two possibilities. Either the words with which Meloni entrusted the assessment of vaccines to science expressed a genuine principle, in which case Buonguerrieri is dragging FdI in the opposite direction, using the party’s name to lend credibility to regulatory and scientific falsehoods. Or that principle only held true until there was a section of the electorate to be won over through mistrust of vaccines and health institutions. In either case, the pride with which the MP thanks her party does not resolve the contradiction: it lays it bare.

Buonguerrieri’s statement does not defend the amendment, as it fails to address its ambiguous scope, the existing procedure for reinstatement and the paradox of the pending appeal. It defends a narrative in which suspended healthcare workers are struck off, a law becomes a circular and the correct data on the first variants are erased by what happened afterwards. Thanks to this rewriting, a regulation intended for a small number of professionals can be sold to the entire anti-vax movement as a collective rehabilitation. The amnesty promised to that audience does not exist, whilst the political advantage generated by the announcement does. Those who were suspended will derive no benefit from the amendment, but may come to see Fratelli d’Italia as the party that declares the pandemic measures to be unjust and adopts their rhetoric. The lead signatory, rather than explaining the legislation she had passed, offers voters an imaginary victory and thanks FdI for turning it into a cause. It is hard to find a clearer demonstration of how a political party can invoke science when it costs nothing and abandon it as soon as a solid bloc of votes appears available.