Nicolini, who hails from the ruling centre-left Democratic Party, gained 24.28 percent of votes in Sunday's polls, losing to the civic list of party rival Salvatore Martello who won with 40.30 percent of votes.
In second place was grassroots Five Star party candidate Filippo Mannino with 29.39 percent of ballots, while Nicolini came third.
The only mainstream candidate who did worse than Nicolini was the anti-immigrant Northern League party's Angela Maraventano, who got 6.03 percent of votes, the results showed.
Turnout was 79 percent on Lampedusa, home to 4,000 islanders and where many thousands of migrants arrived by boat across the Mediterranean from North Africa and were welcomed by Nicolini in recent years, a policy that looks set to change under Martello, a hotel owner and leader of Lampedusa's fishermen.
"Our arms remain outstretched but first and foremost we want to know what the rules are: how many people can land here, how long they should stay for and where they stay...we can't have migrants swarming all over the place," Martello said on Monday.
In April this year, Nicolini was the joint recipient of the UNESCO's prestigious peace prize together with migrant rescue association SOS Mediterranee.
Nicolini was recognised for "her boundless humanity and unwavering commitment to refugee crisis management and integration in response to the arrival of thousands of refugees on the shores of Lampedusa and elsewhere in Italy," UNESCO said.
Democratic Party leader Matteo Renzi made Nicolini a member of its national secretariat in May and took her with him in October to the last formal dinner of Barack Obama's presidency, along with Oscar winning Roberto Benigni, film director Paolo Sorrentino and fashion designer Giorgio Armani.
Nicolini also met Pope Francis when he travelled to Lampedusa on his first official trip outside Rome in July 2013.
(This story has not been edited by Social News XYZ staff and is auto-generated from a syndicated feed.)
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