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Salvatore Giuffrida, the director of the hospital, Europe’s fourth largest, said he favored a vaccination requirement because it would also keep medical workers healthy and would strengthen defensive lines as a brutal third wave spreads through northern Italy.

“We cannot afford not having them on the job,” he said. “The objective is not to lose soldiers during a war in a nation that complains about not having health care workers.”

He estimated that 15 percent of his nursing staff, about 400 nurses, was unvaccinated. Simply removing those nurses from the wards, or redirecting them to switchboards as some have proposed, would be “a cure worse than the disease,” he said, because it would result in the reduction of 250 beds.

He and other directors said that Italy’s strict privacy laws kept the hospitals from knowing which doctors and nurses were unvaccinated.

Paolo Petralia, the director general of the Lavagna hospital in Chiavari, the site of another outbreak this month, said 90 percent of his doctors were vaccinated, along with about 80 percent of nurses and aides.

“They are protected by privacy laws,” he said, citing a recent pronouncement by Italy’s data protection authority that the vaccination status of health workers should be unknown. “But this right exists until it does not limit another person’s right,” Mr. Petralia said.