Exemption from the vaccination requirement: the Council of State ‘safeguards’ the right to choose one’s own paediatrician
Where there is a proven risk to the child’s health, vaccinations may be omitted or deferred only with a certificate from a specialist
Compulsory vaccinations may be omitted or deferred in the event of a proven risk to the child’s health only upon certification by a private paediatrician. Any other approach would be contrary to the relevant legislation (Article 1, paragraph 3, of Decree-Law No. 73 of 2017; Article 24 of Presidential Decree No. 272 of 28 July 2000) and with the Ministry of Health Circular No. 25233 of 16 August 2017, setting out operational guidelines for the implementation of the vaccination campaign. This was established by the Council of State (judgement No. 6671 of 2026), which upheld the judgement of the Lazio Regional Administrative Court No. 927 of 2026.
The background
The parents of a two-year-old girl challenged the refusal by the Bologna Local Health Authority (ASL) to recognise the certificate of exemption from compulsory vaccination issued by a general practitioner from the Palermo Provincial Health Authority. The Lazio Regional Administrative Court dismissed the appeal, pointing out that the girl’s medical condition had not been certified by the freely chosen paediatrician (PLS) as required by Article 1, paragraph 3, of Decree-Law No. 76 of 2017.
The Council of State’s ruling
In their appeal, the parents argued that if the legislature had intended to restrict the authority to grant vaccine exemptions solely to paediatricians of the patient’s choice, it would have expressly provided for this. For this reason, in the absence of such a provision, the court of first instance should have recognised the primacy of the minor’s right to individual health over the public interest in vaccination coverage. This argument fell short of the mark. The Council of State, on the one hand, referred to the relevant legislation, which states that:
- for children aged 0 to 6, healthcare is provided exclusively by the PLS;
- for children aged between 7 and 14, parents may choose whether healthcare should continue to be provided by the PLS or by a general practitioner;
