When alarm over potential adverse reactions halted immunization across Europe this month, many people worried it would undermine public confidence in AstraZeneca's vaccine.
The court process in Italy further complicates the confusion that has arisen.
A prosecutor in the Sicilian city of Syracuse opened an investigation against two doctors and a nurse for possible manslaughter after the sudden death of a naval officer just hours after receiving a vaccine from a British-Swedish company, Reuters writes.
Prosecutor Gaetano Bono also ordered tens of thousands of doses of that vaccine to be confiscated across the country.
He told Reuters that this was done as a precaution.
His move, however, has angered health workers who say they see no need for it.
Italy's initiative to immunize the vast majority of its 60 million citizens by September got off to a shaky start due to slow delivery and poor publicity for AstraZeneca's product, which is considered key in the pandemic because its transport is easier and cheaper than other vaccines.
Days after the Syracuse case, a judge in northern Italy ordered police to seize nearly 400.000 vaccines from a separate AstraZeneca contingent over a second sudden death after immunization, Reuters reported.
The court actions in Italy precede a decision by more than a dozen European countries, including Germany, France and Italy, to suspend use of the vaccine after it was linked to blood clotting in a very small number of people.
The European Medicines Agency said last week that preliminary testing showed the vaccine was not associated with an increased overall risk of blood clots, so most governments continued to use it.
A rise in mistrust
But doctors in Italy say the prosecutors have contributed to growing distrust in a country with a strong anti-vaccination movement.
Only 62 percent of Italians answered that they plan to get vaccinated against covid-19, according to a survey by the British company Opsos MORI published in December.
"How can we be expected to vaccinate millions of people under such conditions?" said Massimo Gali, head of the department of infectious diseases at the Saco Hospital in Milan.
"The medical professionals I know are absolutely furious about this absurd situation."
The World Medical Association (WMA), which represents doctors from 115 countries, said doctors and nurses elsewhere in Europe did not face the same kind of legal threat.
"In any other country in the European Union, it would not be considered manslaughter," said Dr. Frank Montgomery, chairman of the WMA council.
"Possible side effects of vaccination should never lead to the prosecution of a doctor."
AstraZeneca said it is ready to cooperate in the investigation and has confidence in the justice system.
Tests have shown that its vaccine is up to 79 percent effective, and the company said on Sunday that additional testing does not give any cause for concern about its safety.
Legal experts say there is nothing doctors and the government can do to influence the judges' decision.
According to the Italian constitution, writes Reuters, prosecutors are completely independent and cannot be exposed to any external pressure.
In addition, the law obliges them to investigate every case brought to their attention.
"An investigation must be conducted and public opinion cannot be taken into account," prosecutor Bono told Reuters, rejecting suggestions of an overreaction to the death of the naval officer.
Stressing that he has no fear of AstraZeneca's vaccine, Bono said he received it hours after speaking with the family of the deceased.
Autopsy
The naval officer, 43-year-old Stefano Paterno, had no health problems when he went to be vaccinated at the Augusta military hospital on the east coast of Sicily on March 8, his wife told La7 television.
After a few hours, he developed a slight fever, but it subsided by the time he went to sleep.
Around two o'clock after midnight, he had a seizure and soon died, even though an ambulance arrived immediately.
His wife asked the local prosecutor to determine if there was a connection between the death and the immunization.
Bono immediately opened an investigation into possible manslaughter and named a nurse and two doctors as possible suspects, as well as the head of AstraZeneca in Italy. The names of the doctors have not been released.
Bono said that by flagging them so early, it allowed the suspects to hire lawyers to monitor the autopsy.
"It is a guarantee for them. It gives them the right to participate in the process and have their say," he told Reuters.
Medical unions say such investigations are deeply disturbing for their staff.
“It's a simple intramuscular injection. You cannot be held responsible for any possible side effects," says Karlo Palermo, head of the ANAAO-ASSOMED physician union.
“Can you imagine the negative personal consequences for any doctor who finds himself in such a situation? They have to find a lawyer, a technician to attend the autopsy... it's very disturbing”.
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