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An avowed anti-vaxxer, Pepe vocally opposed the mandatory vaccination of schoolchildren in Italy, supported the idea of a link between vaccines and autism, and spread a number of conspiracy theories, such as the ones regarding chemtrails. After the outbreak of the COVID-19 pandemic, he called the media coverage and containment measures "ridiculous hysteria" and opposed the subsequent vaccination campaign. He died from COVID-19 on 23 December 2021, at the age of 59.