The Italian anti-mafia commission is probing whether crime syndicates are intervening in the country's vaccine distribution.
Fifty people were put under criminal investigation, with 13 arrests and 35 house arrests for the Ndrangheta mafia scam in Italy's poorest region, Calabria.
More than 200 police, including officers from the US Federal Bureau of Investigation (FBI), have been carrying out 19 arrest warrants since dawn targeting the Inzerillo clan in Sicily's capital Palermo and the New York-based Gambino family.
Public anger sparked over the court decision to free Salvatore Riina to "die in dignity."
The Lucchese crime family were suspected of pulling off the notorious 1978 airport heist that inspired Martin Scorsese's 1990 Academy Award-winning film "Goodfellas." 19 were arrested for crimes ranging from murder to the illegal sale of cigarettes.
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