The Vatican will review security procedures after a woman jumped a barrier and rushed at Pope Benedict XVI for the second time in two years, this time managing to knock him down before being pulled away by guards, the Vatican spokesman said on Friday. Benedict, 82, wasn't hurt and delivered his traditional Christmas Day greetings in 65 languages from the loggia overlooking St. Peter's Square. While a bit unsteady at first, he also delivered a short speech about the world's trouble spots without problem. The incident in St. Peter's Basilica raised fresh questions about security for the pontiff, however, after officials said the woman involved had jumped the barrier at the 2008 Midnight Mass in a failed bid to get to the pope. She even wore the same red-hooded sweat shirt. The Vatican said the 82-year-old Benedict was unhurt in the fall and that his busy Christmas schedule would remain unchanged. French Cardinal Roger Etchegaray, an 87-year-old Vatican diplomat, fractured his hip in the commotion and will be operated on at Rome's Gemelli hospital, Vatican spokesman the Rev. Federico Lombardi said. Benedict appeared a bit unsteady as he approached his chair on the loggia overlooking St. Peter's Square to deliver his traditional Christmas blessing and was steadied by an attendant. But he then spread open his arms, blessed the crowd and delivered his "Urbi et Orbi" speech, Latin for "To the city and the world," without any problem. He followed with Christmas greetings in 65 different languages that drew sustained cheers and chants from the crowd. In the speech, the pope decried the effects of the world financial crisis, conflicts in the Holy Land and Africa, and the plight of the "tiny flock" of Christians in Iraq. "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 neighbor," he said. Lombardi identified the woman who toppled Benedict as Susanna Maiolo, 25, a Swiss-Italian national with psychiatric problems. He said Maiolo, who was not armed, was taken to a clinic for necessary treatment. She was the same woman involved in a similar incident at last year's Midnight Mass, Vatican officials said. In that case, Maiolo jumped the barricade but never managed to reach the pope and was quietly tackled by security. In both cases she wore a red sweat shirt. During Thursday night's service, Maiolo jumped the barricade and lunged for the pope as he processed down the aisle toward the altar. As security guards brought her down, she grabbed Benedict's vestments and pulled him down with her, according to witness video obtained by The Associated Press. After a few seconds on the floor, Benedict stood up with the help of attendants, put back on his miter and took hold of his staff, and continued to process down the aisle to the cheers of "Viva il Papa!" ("Long live the pope"). He continued to celebrate the Mass without incident. It was the first time a potential attacker came into direct contact with Benedict during his nearly five-year papacy. Security analysts have frequently warned the pope is too exposed in his public appearances. After getting up, Benedict, flanked by tense bodyguards, reached the basilica's main altar to start the Mass. The pope, who broke his right wrist in a fall this summer, appeared unharmed but somewhat shaken and leaned heavily on aides and an armrest as he sat down in his chair. Benedict made no reference to the disturbance after the service started or on Friday. 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. Then there was the assassination attempt against Pope John Paul II by Turkish gunman Mehmet Ali Agca in 1981. John Paul suffered a severe abdominal wound as he rode in an open jeep at the start of his weekly audience in the Vatican piazza. The pope is protected by a combination of Swiss Guards, Vatican police and Italian police. Since the Sept. 11, 2001 attacks on the US, the Vatican has tightened security at events where the pope is present. All visitors must pass by police to get into the square, with those entering the basilica going through metal detectors or being scanned by metal-detecting wands. However, Sister Samira, an Indian aide to Vatican officials who attended the service and saw the incident, said she is never searched by security when she attends papal Masses, and said the same holds true for other people in religious garb. In a similar incident, Italian Premier Silvio Berlusconi was attacked as he was greeting the crowd at a political rally earlier this month. A man with a history of psychological problems hurled a souvenir statuette at the politician, fracturing his nose and breaking two of his teeth. Benedict celebrated this year's Christmas Eve Mass two hours earlier than the usual midnight starting time in a move by the Vatican to ease the pontiff's busy holiday schedule. Benedict has been remarkably healthy during his pontificate, keeping to a busy schedule and traveling around the world. But in July, he broke his wrist during a late-night fall while vacationing in an Alpine chalet and had to have minor surgery and wear a cast for a month - an episode that highlights the risk he ran in Thursday's tumble. His next major appearance is scheduled for Sunday, when he joins homeless people at a Rome soup kitchen for lunch. In addition, he is due to preside over a vespers service on Dec. 31, celebrate Mass on New Year's Day and another one to mark Epiphany on Jan. 6, and then baptize babies in the Sistine Chapel on Jan. 10. Thousands of pilgrims from around the world descended on the traditional birthplace of Jesus in Bethlehem for the most upbeat Christmas celebrations the Palestinian town has seen in years. Hundreds of worshippers packed St. Catherine's Church on Manger Square for morning mass. Most were local Palestinian Christians, and the mass was celebrated in Arabic. Some 47,000 Filipinos who fled their homes in anticipation of the eruption of the Mayon volcano shared rations of noodles, fried fish and fruit to celebrate Christmas in evacuation centers. Children opened donated presents and clowns entertained the crowds, as the government tried to keep the evacuees from slipping back to their homes.