The death of a four-year-old girl in Palermo from diphtheria has renewed discussions on vaccine safety and the importance of immunisation, highlighting the disease’s resurgence in rare cases despite Italy’s successful vaccination programme.
The Istituto Superiore di Sanità has confirmed that a four-year-old girl who died in Palermo had diphtheria, after laboratory tests on samples from the Arnas Civico Di Cristina Benfratelli found Corynebacterium diphtheriae and the gene for the toxin that causes the most severe respiratory form of the disease. The case has put a rare but dangerous infection back into the public debate in Italy, where childhood vaccination has made diphtheria exceptionally uncommon. According to the World Health Organisation, the illness spreads through respiratory droplets and can lead to serious complications if the toxin reaches the bloodstream.
In its updated guidance, the Italian health institute stressed that the greatest risk falls on people who are unvaccinated or who have missed booster doses. The diphtheria vaccine is part of the routine childhood schedule in the hexavalent shot, which protects against six diseases, with further boosters recommended in childhood, adolescence and every ten years in adulthood. The institute also said the disease remains present in some parts of the world, including areas of south-east Asia, Africa and Brazil, which means imported cases remain a concern.
The public-health value of vaccination is clear in the Italian data cited by the institute and Istat. Before widespread immunisation, diphtheria killed about 2,000 children a year in Italy; by the late 1970s, and continuing through 2015, there were no recorded deaths from the disease. The institute says a study from Italy suggests vaccination may have prevented about two million cases a year between 1939 and 2015, underlining how dramatically the programme reduced both illness and death.
The Palermo case also revived discussion of a claim that vaccines cause autism, a theory the institute rejected outright. It cited a World Health Organisation review of 57 studies published between 2010 and 2025, which found no causal link. That conclusion fits with the wider scientific record: research cited by the U.S. National Center for Biotechnology Information and studies indexed by PubMed have found insufficient evidence for a connection, while the 1998 paper that helped fuel the myth was later withdrawn by The Lancet after its findings were discredited.
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