Pope Benedict XVI gestures to faithful during the Urbi et Orbi message in St. Peter's Square at the Vatican. (Gregorio Borgia/ Associated Press)

The Vatican will review security procedures after a woman jumped a barrier and rushed at Pope Benedict for the second time in two years, managing to knock him down before being pulled away by security, a spokesman said Friday.

While Benedict, 82, was unhurt in the fall, a retired Vatican diplomat, Cardinal Roger Etchegaray, 87, suffered a broken hip in the commotion.

The incident in St. Peter's Basilica raised fresh questions about security for the pontiff after officials said the woman involved had jumped the barrier at the 2008 midnight mass in a failed bid to get to the pontiff. She even wore the same red-hooded sweatshirt.

Vatican officials said the woman, identified as Susanna Maiolo, 25, is a Swiss-Italian national with psychiatric problems.

Just hours after the incident, Benedict delivered his traditional Christmas Day greetings in 65 languages from the loggia overlooking St. Peter's Square.

Preparing to deliver his speech, the Pope seemed a bit shaky but showed no signs of any problems once he began speaking. He did not mention the incident.

Instead, he spoke on a number of themes, saying humanity has been affected by the "grave financial crisis," but even more by a moral crisis and "the wounds of wars and conflicts."

The 82-year-old Pope also spoke about the troubles in the Middle East and the "little flock" of Christians who live in the region.

"At times it is subject to violence and injustice, but it remains determined to make its own contribution to the building of a society opposed to the logic of conflict and the rejection of one's neighbour," he said.

He spoke of the Roman Catholic Church’s role active role in imploring an end to injustice in the Democratic Republic of Congo, and called on those in Madagascar to overcome their divisions.

Turning his attention to North America and Europe, he said the church has been urging people to leave behind their "selfish" mentality, "to advance the common good and to show respect for the persons who are most defenceless, starting with the unborn.”

Attacker taken for treatment

Susanna Maiolo is identified by the Vatican as the woman who jumped a barrier inside St. Peter's Basilica and rushed at Pope Benedict XVI. (Italian Ministry Handout/Associated Press)His alleged attacker was taken to a clinic for treatment.

In 2008, she had also attempted to jump the barricade but was tackled by security before she could reach the Pope.

On Thursday night, the Pope was attacked while walking down the main aisle to begin Christmas Eve mass. The Pope was dragged down, after which Maiolo, who was not armed, was swarmed by bodyguards.

Benedict lost his miter and his staff in the fall. He remained on the floor for a few seconds before being helped back up by attendants. At that point, a few shouts of "Viva il papa!" (Long live the Pope!) rang out, followed by cheers from the faithful.

After the incident, Benedict, flanked by tense bodyguards, resumed his walk to the main altar. He appeared somewhat shaken, and leaned heavily on aides and an armrest as he sat down in his chair.

Pope Benedict XVI is helped to his seat after being knocked down by a woman who jumped barriers as he was arriving for Christmas Eve mass in St. Peter's Basilica on Thursday. (Gregorio Borgia/Associated Press)

It was the first time a potential attacker came into direct contact with Benedict during his nearly five-year papacy.

Virtually anyone can get into a papal mass: tickets are required but are easy to get if requested in advance. Identification cards are not necessary to gain entrance, although visitors must pass through a metal detector.

Spokesman Rev. Federico Lombardi said it's not realistic to think the Vatican can ensure 100 per cent security for the Pope considering he is regularly surrounded by tens of thousands of people for his weekly audiences, masses, papal greetings and other events.

The Pope is protected by a combination of Swiss Guards, Vatican police and Italian police. When he moves around St. Peter's Square during his weekly Wednesday audience, he does so in an uncovered white jeep; when he travels overseas or outside the Vatican, he usually uses one outfitted with bulletproof glass.

There have been other security breaches at the Vatican.

In 2007, during an open-air audience in St. Peter's Square, a mentally unstable German man jumped a security barrier and grabbed the back of the pope's open car before being swarmed by security guards.

In 1981, Pope John Paul II was shot in the abdomen by a Turkish gunman as he rode in an open jeep at the start of his weekly audience in the Vatican piazza.

With files from The Associated Press