Booster vaccination with COVID-19 bivalent vaccines


With the Circular of 7 September 2022, the Ministry recommends the bivalent formulation of m-RNA vaccines (Comirnaty Original / Omicron BA.1 and Spikevax Original / Omicron BA.1) as a booster dose, in subjects over 12 years of age, who have at least completed a primary course of SARS-CoV-2 / COVID-19 vaccination.

The circular follows the AIFA green light of 5 September for the two bivalent vaccines Comirnaty and Spikevax, approved by the EMA as booster doses for all subjects over the age of twelve.

  • These vaccines, the CTS motivated, have shown the ability to induce an antibody response greater than that of the original monovalent vaccine against both the Omicron BA.1 variant and the BA.4 and BA.5 variants.
  • In terms of safety, the available data show no differences from the original monovalent vaccine.

Second booster dose

Bivalent vaccination is therefore recommended, as a priority, to those who are still waiting to receive the second booster dose:

  • people aged 60 and over
  • health workers
  • operators and guests of residential facilities for the elderly
  • pregnant women
  • people (from 12 years old) with high frailty motivated by concomitant / pre-existing pathologies (see attachment 2 Circular 11 July 2022)

First booster dose

Bivalent vaccination is also recommended for: all people 12 years of age and older still waiting to receive the first booster dose regardless of the vaccine used to complete the primary course

  • Laws
  • Circular 7 September 2022
    Circular 11 July 2022
  • Look
  • Fourth dose over 60, the video with the Nobel laureate Giorgio Parisi
  • to know more
  • FAQ – Questions and answers fourth dose
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Guidelines descending from the circular of the Ministry of Health “extension of the vaccine audience receiving the second booster dose as part of the anti-SARS-CoV-2 / COVID-19 vaccination campaign” of the Presidency of the Council of Ministers.

Vaccination obligations

Vaccination obligationsThe vaccination obligation extended to 31 December 2022 for:

  • operators, health professions and health professionals
  • all workers employed in social-health and social-welfare residential structures
    personnel who carry out their work in any capacity in the structures referred to in art. 8-ter of the Legislative Decree December 30, 1992, n. 502 (for example hospitals, assisted healthcare residences, clinics, medical and dental offices, diagnostic centers), excluding external contracts
  • students of degree courses engaged in internships for the qualification to exercise the health professions.

(Law Decree 24 March 2022, n.24)

Unit for completing the vaccination campaign

From 1 April 2022 (Decree-law 24 March 2022, n.24 Urgent measures to overcome the measures to combat the spread of the COVID-19 epidemic, as a result of the cessation of the state of emergency) the emergency powers of the Head of Civil Protection and those of the Extraordinary Commissioner.

In its place, a Unit was set up for the completion of the vaccination campaign and for the adoption of other measures to combat the pandemic, which is coordinated with the Ministry of Health.


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