Italy – Health Risks, Inoculations, Vaccinations, and Health Certificates

What are the main health risks for expats living in Italy?

As a high-income country with well-developed public health systems, Italy presents a health landscape broadly similar to other Western European nations. Nevertheless, a number of specific concerns deserve attention — and several of these vary considerably depending on which region of Italy you choose to call home.

Vector-borne diseases

West Nile virus (WNV) is endemic across parts of Italy. By 2025, hundreds of confirmed human cases had been recorded within a single season. The bulk of reported cases originate from the Lazio region (covering Latina, Roma, and Frosinone) and Campania (including Napoli, Caserta, Salerno, and Avellino). Because no human vaccine exists for West Nile virus, the best defence remains personal mosquito avoidance — using repellents, wearing covering clothing, and fitting window screens — particularly throughout the summer season.

Italy has also seen locally acquired cases of chikungunya fever, a viral illness spread by infected mosquitoes. These cases have been concentrated mainly in the Emilia-Romagna and Veneto regions. Additional vector-borne diseases including leishmaniasis, Lyme disease, murine typhus, and West Nile virus may present a risk in certain areas, underscoring the importance of consistent personal protective measures.

Tick-borne encephalitis

Within Europe, Italy is considered a low-incidence country for tick-borne encephalitis (TBE), though the risk is not negligible in specific locations. Infection foci are concentrated in forested and mountainous territory across the north-east, with confirmed cases documented since 1967 in provinces such as Trento, Belluno, and Gorizia.

Food, water, and other risks

The risks associated with food and water consumption in Italy are minimal and broadly comparable to those in other industrialised nations. National standards for sanitation and food safety are generally strong. Seasonal risk of viral gastroenteritis — such as norovirus — may increase depending on time of year and the level of community transmission in a given area.

Environmental and climate risks

Intense summer heatwaves are a recurring feature of Italian life, particularly in the south. Urban air pollution — most pronounced in cities like Milan and Rome during winter, when atmospheric inversions concentrate particulate matter — is an additional concern. Hepatitis C, leptospirosis, and sexually transmitted infections also warrant awareness. Anyone with a pre-existing respiratory condition should research local air quality data before deciding where to live.

Measles outbreaks

Between January and April 2025, health authorities investigated 42 suspected measles cases in and around the Metropolitan City of Milan. This followed a measles epidemic in the same area in 2024 driven by multiple introductions of distinct viral genotypes. Ensuring MMR vaccination is fully up to date before relocating to Italy is therefore especially important.

Are any vaccinations or inoculations required before entering Italy?

As of 2025, Italy imposes no compulsory vaccination requirements on arriving travellers. All COVID-19 entry restrictions were lifted in June 2022, and a COVID-19 vaccination certificate is no longer required for entry. That said, keeping routine vaccinations current remains sound practice regardless of destination.

The principal exception concerns travellers who are arriving directly from countries where yellow fever is endemic. In such cases, Italian authorities may ask to see a valid International Certificate of Vaccination or Prophylaxis (ICVP) — commonly referred to as the “yellow card.” This is standard practice across much of Europe and is not a policy unique to Italy. Travellers not coming from an endemic zone have no yellow fever certificate requirement to satisfy.

The US Department of State has no record of HIV or AIDS-related entry restrictions for visitors to Italy or for foreign nationals residing there. Travellers are not required to declare pre-existing health conditions at the border under standard entry procedures.

Those applying for a long-stay visa — whether for work, study, or elective residency — may find that health-related documentation, such as proof of adequate health insurance coverage, forms part of the broader visa application requirements. This is a visa administration consideration rather than a vaccination mandate; the health certificate section below covers this in greater detail.

It is always advisable to verify the current requirements of the Italian consulate or embassy in your home country ahead of travel, as conditions can evolve. Consular offices remain the definitive reference point for documentation requirements at the time of your application.

Which vaccinations are recommended for expats moving to Italy?

Although no immunisations are obligatory for entry into Italy, health authorities recommend a series of vaccinations for those planning to relocate. These fall into two broad groups: routine immunisations that should be kept current, and destination-specific vaccines worth exploring with a travel health professional.

Routine vaccinations to keep up to date

• MMR (Measles, Mumps, Rubella): The CDC recommends that all international travellers be fully vaccinated against measles in line with its guidance on MMR vaccination for international travel. In light of recent outbreaks in northern Italy, verifying that your MMR status is complete before departing is particularly advisable.
• Tdap (Tetanus, Diphtheria, Pertussis): The Tdap vaccine provides protection against tetanus, diphtheria, and pertussis; only a single adult booster for pertussis is required. Confirm that your booster is current before you move.
• Influenza: The CDC recommends annual influenza vaccination for all international travellers aged six months and over. Italy’s flu season generally spans from late autumn through to late winter.
• Polio: Polio vaccination is part of the standard routine immunisation programme for most travel itineraries, with a single adult booster dose recommended.
• Chickenpox (Varicella): The varicella vaccine is recommended for those who have neither been vaccinated nor had chickenpox. Italy includes varicella in its national childhood immunisation schedule; compare your personal vaccination history against Italian requirements.

Hepatitis A and B

Italy, like several other European countries, carries a moderate risk of hepatitis A — a liver infection transmitted through contaminated food or water. The hepatitis A vaccine delivers reliable protection and is usually administered in two doses across a six-month period. Hepatitis B can be a relevant risk in both social and occupational contexts. Whether you work in healthcare, education, or another sector that brings you into regular contact with others, ensuring your hepatitis B vaccination is current provides an important layer of protection.

Destination-specific vaccines worth considering

• Tick-borne encephalitis (TBE): Those who expect to spend time in rural or forested areas — particularly in northern Italy — should seriously consider the TBE vaccine. The risk is concentrated in these regions and is greatest during the warmer months when ticks are most active.
• Chikungunya: Given documented outbreaks in central and northern Italy, vaccination against chikungunya is worth discussing with your healthcare provider, especially if you plan to spend significant time outdoors in affected regions. A vaccine is now available.
• Rabies: Those who anticipate frequent contact with animals or who plan to pursue outdoor activities in rural or wilderness settings may wish to consider pre-exposure rabies vaccination. While urban environments carry minimal risk, the Italian countryside presents a different exposure profile.
• Meningitis: The meningococcal vaccine is recommended for unvaccinated individuals and those at elevated risk — students in shared accommodation in particular. Anyone moving to Italy to study should factor this into their pre-departure health planning.

The CDC advises scheduling a consultation with a travel health specialist at least six to eight weeks before departure to receive personalised immunisation advice. If your country of origin follows a different national immunisation schedule from Italy’s, a travel health clinic can help identify any gaps — for example, hepatitis A and varicella are not included in all countries’ childhood programmes, though Italy does include both.

Do you need a health certificate to move to or work in Italy?

For most visa categories, Italy does not require a general medical certificate or health examination as a standard condition of entry. However, certain long-stay visa pathways and residency routes carry health-related documentation requirements that expats should factor into their planning.

Health insurance as a visa requirement

When applying for long-stay visas such as the Elective Residency Visa (Visto per Residenza Elettiva), a student visa, or a self-employment visa, applicants are typically required to demonstrate that they have health insurance coverage that is valid in Italy and provides comprehensive protection for the full duration of their stay. Italian consulates usually ask for either proof of private health insurance or evidence that the applicant will be eligible to access the Italian public healthcare system. Exact requirements differ according to visa type and the individual consulate handling the application.

Work-related health assessments

Employees working in particular sectors in Italy — notably healthcare, food handling, education, and construction — may be subject to a mandatory pre-employment medical evaluation (visita medica) conducted by a company-appointed occupational health physician (medico competente). These assessments focus on health aspects relevant to the specific role and working conditions involved. They are obligations under Italian workplace safety legislation (Legislative Decree 81/2008) and are organised by the employer — they are not immigration or visa requirements.

Tuberculosis screening

Certain Italian consulates — typically in cases involving specific visa types or applicants from countries with elevated tuberculosis rates — may ask for a chest X-ray or tuberculosis test as part of the visa medical documentation package. This is not a universal requirement; it depends on the applicant’s country of habitual residence and the procedures operated by the individual consulate. Always confirm requirements with the Italian consulate or embassy in your country of residence well before submitting your application, as procedures and fees are subject to change.

Where to obtain a medical assessment

Where a medical assessment is part of the visa process, the consulate managing your application will direct you to approved physicians or clinics — typically designated panel doctors (medici di fiducia) affiliated with that consulate. Timelines for obtaining results and associated costs vary; consult the relevant Italian consulate directly for up-to-date figures, as these cannot be reliably generalised.

Once you are resident in Italy, no medical examination is required to maintain your residency status, though making use of regular health checks available through the SSN is actively encouraged.

How does healthcare in Italy compare to what expats may be used to?

Italy’s national health service, the Servizio Sanitario Nazionale (SSN), operates as a universal system making medical services available to both citizens and legal residents. It guarantees essential care largely without charge at the point of delivery, with modest co-payments (ticket) applying to certain services such as specialist consultations, diagnostic tests, and some medications. Rather than functioning as an insurance-based arrangement where the scope of coverage depends on a purchased plan, the SSN is financed through general taxation and is open to all legal residents — a model comparable to the UK’s NHS or Australia’s Medicare.

Quality and infrastructure

The 2024 CEOWORLD Health Care Index places Italy 22nd out of 110 countries. Particularly notable is Italy’s score of 98.3 out of 100 for Medical Infrastructure and Professionals — a figure that places it first in Europe in that category. Major hospitals in cities such as Milan, Rome, Bologna, and Turin provide a high level of specialist care, though both quality and waiting times can differ substantially between regions.

Regional variation

Healthcare delivery in Italy is decentralised, with each region overseeing its own Sistemi Sanitari Regionali (SSR). This means that the quality of services, waiting times, and available resources can vary considerably. Northern regions — including Lombardy, Emilia-Romagna, and Trentino-Alto Adige — are widely regarded as having the most robust public healthcare infrastructure. Some southern regions, by contrast, face longer delays and comparatively fewer resources.

Registering with the SSN

To gain access to public healthcare, you must enrol with the SSN through your region’s SSR at the local Azienda Sanitaria Locale (ASL). The process requires a tax identification number (codice fiscale), which is obtained from the Agenzia delle Entrate, and a visit to your local ASL office with your residence permit, codice fiscale, proof of address, and a valid identity document. Once registered, you will be able to select a general practitioner (medico di base).

If you are employed in Italy and making tax contributions, you are entitled to public healthcare at no additional charge. Those who do not pay taxes in Italy — such as retirees, students, or dependants — may be required to pay an annual fee in order to access the SSR.

Public and private care

Despite its considerable advantages in terms of affordability and breadth of coverage, the public system does struggle with lengthy wait times in certain areas and specialties. Many expats find that combining public and private healthcare gives the best overall result. Private hospitals and clinics (cliniche private) operate alongside the SSN, typically offering reduced waiting times, more modern facilities, and a higher proportion of English-speaking staff — at a cost that falls to the patient unless covered by supplemental private insurance.

Language

In larger cities, private healthcare settings, and areas with sizable expat populations, English-speaking medical professionals are relatively easy to find. In public facilities — especially in smaller towns and rural communities — English proficiency is more variable. Familiarity with basic medical Italian, or access to a reliable translation tool, can make a meaningful difference when using public services away from the main urban centres.

Emergencies

Anyone requiring urgent medical attention can present at the emergency department (pronto soccorso) of the nearest public hospital without prior registration. The national emergency number is 112 (the EU-wide general emergency line), while 118 is the dedicated number for medical emergencies and ambulance services.

What are the risks of travel within Italy, and are there regional health differences?

Italy encompasses a remarkable range of landscapes — from the Alpine peaks of the north to the semi-arid terrain of Puglia and the volcanic environments of Sicily — and health risks shift meaningfully according to geography. Expats who travel extensively within the country, or who settle in rural or mountainous localities, should be aware of conditions specific to those areas.

West Nile virus — central and southern regions

In 2025, Italy recorded 500 confirmed human West Nile virus infections and 32 deaths — the highest number of human WNV infections the country had reported at that point in the year. The majority of cases were concentrated in the Lazio region (Latina, Roma, and Frosinone) and Campania (Napoli, Caserta, Salerno, and Avellino). With no human vaccine currently available, preventing mosquito bites — especially during dawn and dusk hours — is the most effective strategy. Expats living in or regularly passing through these areas during warmer months should treat this risk seriously.

Tick-borne encephalitis — northern and forested regions

TBE risk in Italy is concentrated in the forested and mountainous north-east, including the provinces of Trento, Belluno, and Gorizia. The virus is transmitted through the bite of infected Ixodes ticks, with the European subtype predominating in these areas. Anyone spending time outdoors in forested northern territory — whether hiking, working, or simply living nearby — should wear protective clothing, apply tick repellent, and carefully check for ticks afterwards. Vaccination against TBE is a sensible precaution for those who live in or frequently visit these localities.

Chikungunya — Emilia-Romagna and Veneto

Locally acquired chikungunya infections have been confirmed in Italy, including cases in the Veronese area. By 2025, indigenous cases in northern Italy were being linked to strains connected to circulation from Réunion Island. The vector responsible is the tiger mosquito (Aedes albopictus), which is now well established across much of northern and central Italy, making this a concern for a broad swathe of the country.

Altitude and mountain regions

Expats who ski, trek, or take up residence in Alpine communities at elevations above 2,500 metres may be susceptible to altitude sickness (acute mountain sickness). The Italian Alps and the Dolomites draw enormous numbers of outdoor enthusiasts each year. To reduce risk, ascend gradually, maintain good hydration, and seek prompt medical advice if symptoms such as headache, dizziness, or nausea develop at altitude.

Heat and air quality — urban centres and the south

Central Italy tends to enjoy relatively mild temperatures throughout much of the year, while southern Italy is warm in winter and considerably hotter in summer. Heatwaves — occurring with increasing frequency and severity — pose the greatest danger to the elderly, young children, and anyone with cardiovascular or respiratory conditions. The Po Valley cities of Milan, Turin, and Bologna suffer from significant air pollution, most acutely in winter. Those with asthma or other respiratory conditions should consult regional air quality indices when deciding where to settle.

Where can expats get reliable and up-to-date health advice for Italy?

Health guidance, disease alerts, and vaccination recommendations can shift — sometimes rapidly. The authoritative sources listed below should be your primary reference points. Always verify specific requirements directly with the relevant authority before travelling or lodging a visa application.

• Italian Ministry of Health (Ministero della Salute)
  Italy’s official national health authority, offering vaccination schedules, disease surveillance data, and public health guidance.
  www.salute.gov.it
• Istituto Superiore di Sanità (ISS)
  Italy’s National Institute of Health — the scientific and technical body responsible for monitoring infectious disease, publishing epidemiological bulletins, and advising on public health policy.
  www.iss.it
• World Health Organization (WHO) — Italy
  The WHO Europe office tracks health developments across the region, including Italy, and publishes country health profiles and disease outbreak notifications.
  www.who.int/europe
• US Centers for Disease Control and Prevention (CDC) — Italy traveller health page
  The CDC’s dedicated Italy page provides current vaccine recommendations, health notices, and travel health advice, updated on a regular basis.
  wwwnc.cdc.gov/travel/destinations/traveler/none/italy
• UK Travel Health Pro (NaTHNaC) — Italy
  Compiled by the National Travel Health Network and Centre (NaTHNaC) and reviewed by travel health specialists, this is among the most thorough and regularly updated resources for Italy-specific health risks and vaccination recommendations.
  travelhealthpro.org.uk/country/112/italy
• Fit for Travel (NHS Scotland) — Italy
  A clinically reviewed, concise source of Italy health and vaccination guidance maintained by NHS Scotland.
  www.fitfortravel.nhs.uk/destinations/europe-russia/italy
• Italian Ministry of Foreign Affairs and International Cooperation — visa and residency requirements
  The authoritative reference for visa categories, required documentation (including any health-related paperwork), and consular contact details.
  vistoperitalia.esteri.it
• European Centre for Disease Prevention and Control (ECDC)
  Monitors infectious disease trends across Europe, including Italy, and publishes regular surveillance bulletins covering West Nile virus, chikungunya, measles, and other conditions.
  www.ecdc.europa.eu

Treat online resources — including this article — as a foundation for further enquiry rather than a definitive authority. Before relocating, speak with a travel health clinic or your own physician, and consult current official sources for requirements specific to your situation, country of origin, and visa category, as these are subject to change at any time.

Frequently Asked Questions

Do I need any vaccinations before moving to Italy?

No vaccinations are legally mandated for entry into Italy — with the caveat that travellers arriving directly from a yellow-fever-endemic country may be asked to present a yellow fever certificate. Health authorities do, however, strongly recommend that routine immunisations be current before you relocate, including MMR, Tdap, polio, and influenza. Depending on where in Italy you intend to settle, additional vaccines such as hepatitis A and B, tick-borne encephalitis, or chikungunya may also be advisable. Book a consultation with a travel health clinic at least six to eight weeks before your move.

Will my vaccinations from home be accepted in Italy?

Italy, in common with most EU member states, recognises vaccination records issued in other countries, especially where these are presented in a recognised format such as a World Health Organization International Certificate of Vaccination or Prophylaxis (ICVP) or an EU Digital COVID Certificate-compatible document. Records not in Italian or English are best accompanied by a translation. When you enrol with the SSN and attend your local ASL office, staff will review your vaccination history and advise on any outstanding gaps.

Is private health insurance required to live in Italy?

Once enrolled with the SSN, private health insurance is not a requirement of everyday residence. That said, several long-stay visa categories — including the Elective Residency Visa and student visa — require applicants to demonstrate at the visa application stage that they hold comprehensive health insurance valid in Italy. After obtaining legal residency and a permesso di soggiorno, you can register with the SSN and access public healthcare. Residents who do not pay Italian taxes and are not automatically covered may be required to pay an annual voluntary SSN contribution. Verify current requirements with the relevant Italian consulate.

What happens if I develop a serious illness in Italy?

For medical emergencies, dial 118 (dedicated to medical emergencies and ambulances) or 112 (the general EU emergency number) and proceed to the nearest hospital’s emergency department (pronto soccorso). Emergency treatment is provided to everyone in Italy regardless of insurance status or SSN registration. For serious but non-emergency conditions, SSN-registered patients are referred to specialists through their assigned GP (medico di base). Private hospitals and clinics offer faster access but involve out-of-pocket costs unless you hold supplemental private insurance.

How do I find an English-speaking doctor in Italy?

English-speaking doctors are readily found in major cities such as Rome, Milan, Florence, and Bologna, particularly within private clinics and some larger public hospitals. Many embassies and consulates maintain lists of English-speaking physicians and specialists for use by their nationals. The International Association for Medical Assistance to Travellers (IAMAT) also provides directories of English-speaking practitioners. In smaller towns and rural areas, English proficiency among public healthcare staff is more variable; acquiring a working knowledge of basic medical Italian — or having access to a reliable interpreter — is therefore a practical investment.

Is there a malaria risk in Italy?

No. Italy has been free of malaria transmission since the disease was officially eradicated in 1970. Any malaria cases that arise in Italy today are classified as imported — contracted by individuals prior to their arrival in the country. No malaria prophylaxis is required for living in or travelling through Italy.

What are the main mosquito-borne risks in Italy, and how can I protect myself?

The two principal mosquito-borne concerns in Italy are West Nile virus — spread by Culex mosquitoes, with the highest risk in central and southern regions — and chikungunya, transmitted by the tiger mosquito (Aedes albopictus), which is now established across much of northern and central Italy. No human vaccine exists for West Nile virus. A chikungunya vaccine is available; ask your healthcare provider whether it is appropriate for you. Practical protective measures include applying DEET-based repellent, wearing long sleeves and trousers during peak mosquito activity at dawn and dusk, using mosquito screens on windows and doors, and removing any standing water in and around your home.

How do I register with Italy’s public healthcare system (SSN) as an expat?

SSN registration requires a valid residence permit (permesso di soggiorno), a codice fiscale (Italian tax identification number, issued by the Agenzia delle Entrate), and proof of address. Bring these documents to your local Azienda Sanitaria Locale (ASL) office, where you will complete registration and select a general practitioner (medico di base). If you are employed in Italy and making social security contributions, registration carries no additional cost. Non-taxpaying residents — such as retirees or students — may be required to pay an annual voluntary fee. EU residents holding an S1 form from their home country’s social security authority can register without charge, with costs reimbursed to Italy.