Italy made COVID-19 vaccination mandatory for people aged 50 and over on Wednesday (January 6).
The measure is immediately effective and will run until June 15.
It’s one of very few European countries to take similar steps, in an attempt to ease pressure on its health service and reduce fatalities.
Italy has the second-highest death toll on the continent after Britain.
They've registered more than 138,000 coronavirus deaths since February 2020.
Prime Minister Mario Draghi's government had already made vaccination mandatory for teachers and health workers.
And since October last year, all employees have had to be vaccinated or show a negative test before entering the workplace.
Refusal results in suspension from work without pay, but not dismissal.
Wednesday's decree toughens this up for workers over the age of 50 by removing the option of taking a test rather than vaccination.
Ministers from the right-wing League issued a statement distancing themselves from the over-50 vaccine rule.
They called it "without scientific foundation, considering that the absolute majority of those hospitalized with COVID are well over 60."
Italy was hit later than several northern European countries by the highly contagious Omicron variant, but its cases have steadily risen, with growing pressure on hospitals and intensive care units.
It has seen an average of more than 150 deaths per day over the last two weeks.
Around 74% of Italians have received at least two vaccination shots and 6% have had just one jab, according to Our World in Data.