Italy is entering the part of the year when influenza begins to return to schools, offices, public transport and family homes.
Millions of people are affected by seasonal respiratory infections every winter, and health authorities are now rolling out the country’s 2026-2027 flu vaccination campaign as cases of flu-like illness begin to rise.
Vaccination remains a particularly sensitive subject in Italy. The country was one of the first Western nations to be hit hard by Covid-19 in 2020, and the pandemic was followed by years of intense public debate over vaccines, health passes and compulsory measures.
So one question inevitably comes back every autumn: do you actually have to get the flu vaccine?
The short answer is no.
In Italy, the seasonal influenza vaccine is not compulsory for the general population. It is, however, strongly recommended — and offered free of charge — to a wide range of people considered more vulnerable to severe complications or more likely to transmit the virus to vulnerable people.
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Who Should Get the Flu Vaccine in Italy?
Italy’s Ministry of Health says the influenza vaccine can be used from six months of age, provided there are no specific contraindications.
The strongest recommendation applies to groups considered at greater risk.
These include people aged 60 and over, pregnant women and women in the postpartum period, residents of long-term care facilities and people with chronic illnesses that can make influenza more dangerous.
Those conditions include, among others, diabetes, cardiovascular disease, chronic respiratory illnesses and disorders affecting the immune system.
The vaccine is also recommended for healthcare and social-care workers, police officers, firefighters, blood donors and some people whose jobs involve regular contact with animals.
Another important group is children.
For the 2026-2027 season, Italy recommends and actively offers vaccination to children between six months and six years of age, even when they do not have an underlying medical condition.
For these priority groups, vaccination is generally offered actively and free of charge through the public health system.
When Should You Get Vaccinated?
The Ministry of Health recommends beginning seasonal vaccination campaigns from the start of October.
There is a reason for the timing.
Protection does not begin immediately after the injection. It generally takes around two weeks for the immune response to develop, while protection gradually declines over the following months.
The goal is therefore to be protected when influenza circulation becomes strongest during the winter.
But missing the October window does not mean it is too late.
Italian health authorities recommend continuing to offer the vaccine throughout the influenza season to eligible people who have not yet received it.
The exact launch date, however, depends on where you live.
Italy Does Not Have One Single Vaccination Start Date
Italy’s health system is managed regionally, so the practical vaccination calendar varies across the country.
As of October 12, vaccinations are opening to the general population in Emilia-Romagna, Sicily, Calabria and Campania.
Lombardy began vaccinating priority groups on October 1 and expanded access more widely from October 12.
Piemonte is scheduled to expand its campaign from October 13, followed by Friuli-Venezia Giulia on October 14.
Other regions are following different timetables.
Umbria began earlier in October, while Tuscany has scheduled the start of its campaign for October 21.
Liguria has adopted an even more gradual system. Vaccinations for some children began on September 28, followed by older and vulnerable residents, while vaccination for the wider population is expected to open from November 15.
That means someone living in Milan may be able to book the vaccine before somebody of the same age living in another part of Italy.
Expats should therefore check the website of their Region or local health authority rather than assuming that the same booking rules apply everywhere.
Where Can You Get the Vaccine?
The answer also varies by region, but vaccination in Italy is normally available through a combination of family doctors, paediatricians, public vaccination centres and participating pharmacies.
Some regions allow online booking through their health portal, while others rely more heavily on GPs or local health authorities.
People who are not included in one of the groups entitled to free vaccination may still be able to receive a flu vaccine, depending on regional arrangements and vaccine availability, but may need to obtain it privately.
For most adults, one seasonal dose is sufficient.
Some younger children who have never previously been vaccinated against influenza may need two doses separated by at least four weeks, so parents should follow the advice of their paediatrician.
Italy is using updated trivalent vaccines for the 2026-2027 season, designed around the influenza strains expected to circulate in the Northern Hemisphere this winter.
And flu vaccination can generally be given alongside other indicated vaccines, although individual medical circumstances should always be discussed with a healthcare professional.
What Happens in the UK?
The British approach is slightly different.
In England, flu vaccination is also not compulsory for the general population, but the NHS provides it free to defined groups.
The 2026-2027 programme began on September 1 for pregnant women and children.
From October 1, free NHS vaccination expanded to people aged 65 and over, adults under 65 with certain medical conditions, care-home residents, carers and other vulnerable groups.
Frontline health and social-care workers can also receive vaccination through workplace programmes.
Children are a particularly important part of the British strategy. The programme covers two- and three-year-olds as well as school-age children through Year 11, with many receiving a nasal-spray vaccine rather than an injection.
British health authorities deliberately start most adult vaccination in October rather than very early in the autumn because protection can decline over time and flu activity commonly peaks around December or January.
The aim is to have most eligible adults vaccinated by the end of November.
The United States Goes Much Further With Its Recommendation
The United States takes a broader approach.
The CDC recommends an annual influenza vaccine for virtually everyone aged six months and older, apart from people with specific medical contraindications.
That is much wider than Italy’s emphasis on actively targeting particular risk groups.
For most Americans, September and October are considered the ideal months to receive the vaccine, with the CDC recommending vaccination by the end of October where possible.
Vaccination can still be useful later in the season while influenza viruses continue to circulate.
The American vaccines have also been updated for 2026-2027. All seasonal flu vaccines available in the US are trivalent, and their composition has been changed from the previous season, including an update designed to target the H3N2 strain that circulated widely during 2025-2026.
Again, however, a public-health recommendation does not mean that every American is legally required to receive the vaccine.
France and Germany Follow the European Risk-Based Model
Across continental Europe, policy generally looks more like Italy than the United States.
France begins its joint seasonal flu and Covid vaccination campaign on October 13, 2026.
Its priority groups include people aged 65 and over, pregnant women, immunocompromised people and those with conditions that increase their risk of severe disease.
Germany follows a similar model.
The country’s STIKO vaccination committee recommends seasonal influenza vaccination particularly for everyone aged 60 and above, pregnant women and people with chronic medical conditions, as well as certain occupational and household risk groups.
The pattern is therefore fairly clear.
European countries generally concentrate public programmes on people most likely to experience severe influenza or transmit it to vulnerable groups, while the United States recommends annual vaccination much more broadly.
But in none of these examples does the existence of a recommendation mean that every member of the general public is automatically subject to a compulsory vaccination requirement.
For expats living in Italy, the most important practical point is to check the rules in your own Region. Our guide to how healthcare works in Italy for foreigners explains how the SSN, family doctors and regional health services work, while the Italian Ministry of Health’s influenza portal provides the official national guidance.
So, is the flu vaccine mandatory for everyone? No. But for older adults, pregnant women, young children and people with health conditions that increase the risk of complications, health authorities are making a much stronger recommendation: get protected before the winter flu season reaches its peak.
