An Iranian medical personnel wearing protective suit works in a COVID-19 section of the Rasoul-e-Akram hospital in western Tehran at midnight on December 14, 2020. (Photo by Morteza Nikoubazl/NurPhoto)

As nations worldwide jockey to secure access to the newly authorized Pfizer-BioNTech Covid-19  vaccine, Iranian authorities continue to issue contradictory statements about how and whether inoculations will be made available in the country.

Iran, the Middle East’s hardest pandemic-hit country, is by all accounts lagging in the global race to obtain the shots, sparking new criticism of President Hassan Rouhani’s perceived as lacking pandemic response. Iran’s Covid-19 death toll surpassed 53,000 on Thursday.  

Iran is one of 94 countries that have inked commitment agreements with the COVAX facility co-led by Gavi, the Vaccine Alliance; the Coalition for Epidemic Preparedness Innovations (CEPI); and the World Health Organization (WHO).

The COVAX facility is one of the three main components of the Access to Covid-19 Tools (ACT) accelerator founded under the auspices of the WHO, European Commission and the French government to ensure that all countries, including low-income ones, can acquire coronavirus diagnostics, treatment and vaccines.

But politics and ideology are clouding Iran’s receptiveness to outside vaccines, analysts and observers say.

Iran’s vaccine hopes took a hit when Abdolnaser Hemmati, the governor of the Central Bank of Iran, wrote on his Instagram page on December 7 that Iran’s attempts to purchase vaccination through the COVAX arrangement were “stalled” due to US sanctions.

“Since the purchase of Covid-19 vaccine should be dealt with through the official World Health Organization channels, any effort so far to remit and transfer the needed foreign currency has been obstructed due to the inhumane sanctions of the US government and the necessity of obtaining permits by OFAC,” Hemmati wrote in his post.

Central Bank of Iran governor Iran Abdolnaser Hemmati says US sanctions are blocking access to Covid-19 vaccines. Image: Twitter

Office of Foreign Assets Control (OFAC) is the financial intelligence arm of the US Department of Treasury that oversees and implements economic sanctions. In order to engage in financial, banking and business relationships with Iran, nations need to obtain OFAC permits or they will be targeted with US secondary sanctions if their Iran transactions are detected.

US sanctions have impinged on nearly every aspect of life in Iran, including the government’s ability to provide essential goods. But Iran still has instruments at its disposal to keep humanitarian trade and aid up and running, and other countries have indicated a willingness to help.

The US State Department tweeted on in its Persian language handle on Thursday that the US has “never sanctioned Iran’s health and medical sectors, humanitarian assistance and medicine and will not do so.”

The Ministry of Health, claiming that sanctions are impacting Iran’s access to foreign vaccines, has announced that Iran is working on a domestic vaccine that will most likely be unveiled in June 2021.

Payam Tabarsi, the head of the infectious diseases department at Tehran’s Masih Daneshvari Hospital and one of the researchers involved in the Iranian Covid vaccine project, told Hamshahri newspaper that some officials “make unnecessary noises” by wrongly claiming they have purchased vaccination from overseas while Iran cannot transact in US dollars.

“Even to acquire the flu vaccine, we were unable to transfer money… We should accept that we are under sanctions and we cannot move money abroad, so we cannot purchase vaccines. This is very simple. We need to develop a vaccine ourselves,” he said.

Iranian officials, however, continue to refute each other and confuse Iranians who have struggled and suffered from the pandemic for nearly a year with overstretched hospitals and highly fatigued medical workers.

On December 8, Kianoush Jahanpour, the spokesman of the Iran Food and Drug Administration (IFDA), told the Islamic Republic News Agency that a total of 42 million doses of Covid-19 vaccine will be purchased for 21 million Iranians, of which nearly 17 million will be supplied through the COVAX facility, 21 million will be imported from foreign manufacturing firms directly and the rest would be produced through joint ventures with other countries.

Iran Food and Drug Administration spokesman Kianoush Jahanpour says vaccines are on the way. Image: Twitter

Yet four days after Jahanpour’s promising announcement, Mostafa Ghanei, the head of the scientific committee of the national coronavirus taskforce, appeared on state TV to pour cold water on the idea of importing vaccines via the COVAX mechanism.

He said Iran has notified COVAX that it does not need the Pfizer-BioNTech vaccine because, according to him, Iran does not have the well-equipped aircraft to air transport the jabs in extremely cold temperatures and also lacks the specialized fridges to store the vaccines at temperatures of -70 degrees Celsius, which is required to ensure the vaccine’s effectiveness.

Further complicating the situation, Iran’s Minister of Roads and Urban Development Mohammad Eslami retorted on December 17 that there is no difficulty in terms of air transporting the vaccines, and as soon as the Ministry of Health specifies the country of origin, Iranian planes will be able to take delivery of batches.

The Head of the Civil Aviation Organization of Iran Touraj Dehghani also confirmed that there are two airline companies, namely Iran Air and Mahan Air, that are ready to help with the delivery of vaccines and have the “necessary conditions” to do so.

Logistics and sanctions aside, conspiracy theories are circulating by anti-science hardliners in Iran, who since the beginning of the outbreak have defied social distancing and other health protocols and pilloried the WHO for being an irreligious organization.

On December 7, Zahra Sheikhi, a conservative member of Iran’s parliament, misquoted the billionaire philanthropist Bill Gates in a string of tweets as reputedly saying he intends to eliminate 15% of the world’s population through the coronavirus vaccine. That falsely attributed statement was taken from a doctored video.

Sheikhi also accused the WHO of being a “promoter of abortion”, insinuating that Iran should thus not order vaccines through the COVAX framework.

MP Zahra Sheikhi thinks Bill Gates wants to use Covid-19 vaccines to kill 15% of the world population. Image: Twitter

Experts say if the Islamic Republic is determined to import internationally-verified vaccines and prioritize public health, the sanctions and perceived logistical intricacies that apply to all countries should not prevent it from serving and saving its citizens.

“In his recent interviews, the WHO representative in Iran, Dr Christoph Hamelmann, has assured Iranians that sanction rules and regulations are not going to be applied when purchasing vaccines from COVAX and that Iranians can have their fair share as long as they pay the vaccine costs to the COVAX facility,” said Mahan Ghafari, an epidemiology scholar at the University of Oxford.

Ghafari warns the pandemic’s toll could intensify if Iran drags its feet and fails to purchase vaccination in quantities needed to immunize a population that remains highly vulnerable to infection: “I think not purchasing vaccines from COVAX is going to delay appropriate public health response. We have to remember that we are still in the middle of a pandemic and a large fraction of the Iranian population is still susceptible to contracting Covid-19.”

“Therefore, such delays can have serious public health consequences and may result in a potentially higher death toll in the coming months while the Iranians still wait for their domestic vaccines to bear fruitful results in the clinical trials,” he told Asia Times.

While Iranian authorities dispense often conflicting comments about being ready to import internationally approved vaccines, while at the same time persuading the public to trust a domestic vaccine, experts say politics and ideology underpin Iran’s apparent resistance to foreign vaccines.

“Given my limited awareness, it is quite hard to say what are the main reasons Iran may not be willing to import and use the Pfizer-BioNTech vaccine, but I would not be shocked if someone says both political and ideological reasons can somehow explain these drastic decisions being made by Iran,” said Mostafa Shokoohi, an epidemiologist and CIHR postdoctoral fellow at the University of Toronto.

“Iran is right that some vaccines require special facilities to keep the vaccine safe, especially the one from Pfizer-BioNTech, but what about the vaccine created by Moderna which does not require such facilities? We know that Moderna’s vaccine remains stable at 2 to 8 degrees Celsius,” he told Asia Times.

“As you see, it is not a matter of buying some other facilities or materials. It is a matter of something else that we are not fully aware of it, or if we are aware, we have no clear explanation for them.”

US pharmaceutical giant Pfizer and its German partner BioNTech are shipping their vaccine worldwide. Photo: AFP

A spokesperson with the Geneva-based Gavi, the Vaccine Alliance, told Asia Times that “an OFAC license has been secured, so there is no legal barrier to Iran procuring vaccines through the COVAX facility.”

Gavi, a public-private global health partnership striving to expand the umbrella of immunization over poorer countries has so far “secured up to 200 million doses of a vaccine for lower-income countries with the support of the Bill & Melinda Gates Foundation, under their tech transfer agreements with AstraZeneca and Novavax.”

“The vaccines produced will be either Novavax or AstraZeneca’s candidate vaccines, depending on which attains licensure or prequalification. This deal also includes substantial options for further doses,” the spokesperson added.