ROME — For months, Marta Pacholczak has been fretting about getting vaccinated.
Originally from Poland, she has lived in Rome for 25 years, but for many of those, Ms. Pacholczak has been homeless. She is not registered with Italy’s national health service, and without an official residence or a social security number, she has had no access to the country’s coronavirus vaccination campaign.
But over the weekend, she was one of nearly 900 people who tried to take advantage of an overnight vaccination drive, called Open Night, organized by the health authorities in the Lazio region, which includes Rome.
“I can’t do anything without a vaccine,” said Ms. Pacholczak, 65, clutching her ticket — No. 850 — while craning her neck to hear numbers being called out on Sunday morning. “I can’t work or travel in this moment.”
The initiative, organized in a cloister of the Santo Spirito hospital, near the Vatican, was targeted at “people on the margins of society, the most fragile,” said Angelo Tanese, the director general of ASL Roma 1, the region’s largest local health unit.
To help draw in the crowds, a jazz pianist serenaded those present on Saturday night, while free espresso and cornetti — the Italian croissant — were offered on Sunday morning.
Doctors and nurses administered the Johnson & Johnson vaccine to homeless people, undocumented migrants, foreign students and foreigners who legally work in Rome but are not registered with the national health service.
Johnson & Johnson’s vaccine, which requires only one dose — unlike the two-shot regimens made by AstraZeneca, Moderna and Pfizer-BioNTech — is especially useful for inoculating people who might be harder to reach or might not return for a second dose. About 80 percent of the people at the Santo Spirito clinic were undocumented migrants, Mr. Tanese said.
Santo Spirito, a 12th-century hospital and one of the oldest in Europe, has seen its fair share of plagues, epidemics and wars, Mr. Tanese said. “It’s the vocation of this hospital,” brought into the 21st century, he noted.
Gianfranco Costanzo, the health director of the National Institute for Health, Migration and Poverty, estimates that there are at least 700,000 people in Italy who are not registered with the national health service, which is managed by regional governments.
“Those are serious numbers, especially in a pandemic,” he said in a telephone interview. “But it’s also a question of rights, because our health service ensures that everyone has a right to be vaccinated, regardless of your administrative status.”
With coronavirus variants driving case numbers up again worldwide, it is critical to vaccinate as many people as possible, as quickly as possible, Mr. Costanzo said. Several regions in Italy have begun to make inroads, but others lagged behind, he added.
Antonio Mumolo, the president of Avvocato di Strada, an association that assists homeless people, said, “Today there is Covid, but yesterday there was tuberculosis.”
“Infectious diseases have always existed,” he added, “and if people aren’t cared for,” public health is at risk.
The pandemic has highlighted the constraints of regional health care services, said Dr. Alessandro Verona, who works for INTERSOS, a charity that aids vulnerable members of society. “This created administrative chaos for people who are outside the system,” he said, especially for those who moved between regions, like foreign agricultural workers. “The world has changed, people move, and the marginalized have to be seen as people that have to be protected.”
“We have to pass from the concept of a population that is hard to reach to a national health system that is easy to reach,” Dr. Verona added.
ASL Roma 1, which organized the vaccination drive at the Santo Spirito hospital, is also working with volunteer aid organizations to increase inoculation rates among marginalized groups. They are visiting Roma settlements and occupied buildings, and are offering shots to homeless people via a camper that crisscrosses Rome, Mr. Tanese said. Two centers catering to homeless people will open this week.
Dr. Paolo Parente, who is responsible for innovative models of primary health care for ASL Roma 1, said, “We felt the responsibility that part of the community was not vaccinated,” adding, “Now that the national vaccination drive is on the way, it’s time to start with the most vulnerable.”
As of Sunday, nearly 20 million people in Italy had been fully vaccinated — about 32 percent of the total population.
It was a varied crowd at Santo Spirito: There was a Peruvian employee of a United Nations agency in Rome who had arrived in the city only three weeks ago; a Chinese couple transfixed by their cellphones; two 20-somethings from Kazakhstan studying in Cassino, about 90 miles south of Rome, who were uncertain about the Sputnik vaccine given back home; a Rwandan woman studying business at one of Rome’s main universities; and a Brazilian caregiver who had been worried about not being vaccinated while the person she looked after was.
Wearing a pink rubber bracelet that read #IAmVaccinated, Rose Marie Magada, a nun from the Philippines who moved to Italy in January, said that she was overjoyed to receive the shot after months of uncertainty. “It’s good to be protected,” she said.
Laura Morettoni, a nurse at Santo Spirito who had pulled an all-night shift, said she was tired but glad to have been part of the initiative. “I think that the homeless and the marginalized felt welcome and looked after,” she said.
The Open Night was publicized through the health unit’s social media accounts, but many who attended said that they had heard about it through volunteer associations or acquaintances, like Ms. Pacholczak, who has found lodging with a generous friend.
In the end, Ms. Pacholczak did not get vaccinated. She has a heart condition, so the medical staff at Santo Spirito decided that a different vaccine would be better for her and put her on a waiting list.
Mr. Tanese, who had been on his feet for more than 24 hours, said that his unit would almost certainly repeat the vaccination initiative.
“Except not at night,” he laughed. “It’s a little tiring.”