Coronavirus Pandemic: An Iranian Chronology, August 2021

July 30 – August 5, 2021

Vast quantities of Iran’s domestically-made Covid-19 vaccine were thrown away because of contamination, probably with live coronavirus, a source has told IranWire.

CovIran-Barekat was developed last year by Setad, a massive parastatal holdings company under the control of the Iranian Supreme Leader. It received an emergency permit for use in Iran earlier this year despite a lack of published data around its efficacy, and is being produced by state-owned firm Shifa Pharmed.  

In early July 2021, a spokesman for Setad reported that some 1.2 million doses had been “lost”. The firm later blamed the loss on potential spillage at Shifa’s manufacturing plant, stating: “Given that this is a new production line, it is quite plausible that there will be problems in filling the vials; a batch of 1.2 million doses could get spoiled.”

But this week an informed source told IranWire that in fact, it was Setad that jettisoned the vaccines. “At first the reason [publicly] given was mistakes made in vialing, which, by itself, is a disaster,” they said.

“But what really paralyzed the project, and deprived the Health Ministry of the doses it had been promised, was the tests Shifa Pharmed conducted on the vaccines.

“This has not been publicly disclosed, and we can rest assured it will not be. But there’s a strong possibility that they found live viruses in the vaccines.”

Unlike other Covid-19 vaccines like Pfizer and Moderna, which use new mRNA technology, CovIran-Barekat is a traditional vaccine that uses a dead or deactivated form of the virus to trigger an immune response.  the very beginning, Shifafarmed’s method has been to use dead or deactivated viruses to make the vaccine.

“Importantly,” IranWire’s source said, “a number of people who were injected with Barekat showed severe [Covid-19] symptoms – more like those caused by the live virus. Some others showed light symptoms. We’re talking about coronavirus infections here, not vaccine side-effects.

“This, of course, doesn’t mean the whole product is useless. It applies only to that portion that was thrown away.”

Conflicting Lines on CovIran-Barekat Production

On Wednesday, August 4, Alireza Vahabzadeh, an advisor to outgoing Health Minister Saeed Namaki, said that as of now five million doses of CovIran-Barekat vaccine had been made up and 1.8 delivered to the Health Ministry.

But the remarks fell just one day after, Mohammad Hossein Fallah Mehrabadi, vice president of Iran’s Razi Vaccine and Serum Research Institute, had said: “So far less than a million doses has been made domestically.”

For nine months now, Iranian officials have issued contradictory statements about the state of Iran’s domestic vaccine drive. On July 29, Minoo Mohraz, supervisor of the CovIran-Barekat research team, said that starting on July 30, production would reach several million doses per week.

This does not appear to have happened. In the meantime, the production of CovIran-Barekat has clearly been hampered by serious issues. For the time being CovIran-Barekat is being produced by Shifa Pharmed at just one facility. On August 1, Setad president Mohammad Mokhber said the groundwork had been laid for a second production line to get up and running by August 9.

Meanwhile Kianoush Jahanpour, spokesman for Iran’s Food and Drug Administration, said that 861,372 doses of the Barekat vaccine had been administered to Iranians as of Wednesday, August 4.

Iranians Having to Make Do With Sinopharm

With record numbers of new Covid-19 cases being reported every day, officials are no longer shying away from acknowledging the dire situation in Iranian hospitals. Shortages of beds are being compounded by a lack of IV fluids to support the sickest patients.

Iranian state media has described this latest phase of the pandemic as “explosive” while health officials believe the fifth “peak” of infections is a while away yet. The official daily number of Covid-19 fatalities reached 434 at noon on Thursday, August 6, but this only covers those people who managed to take a coronavirus test. Of the around 260,000 tests being conducted each day, around 40,000 have come back positive, putting Iran among the current worst-afflicted countries.

On July 30, Iran also received a second shipment of 1,098,300 AstraZeneca vaccines from Japan, which were secured through Covax: the global facility launched by the World Health Organization (WHO) aiming to provide equitable access to vaccines worldwide. Iran previously received close to two million doses from Japan on July 23.

This has sped up the inoculation drive somewhat, with 500,000 jabs now being administered But it has also added to the confusion for Iranians waiting for their first or second dose.

“They texted my mum and told her to go to a vaccination center in east Tehran,” a Tehran resident told IranWire. “When we got there, we found out they only had the Barekat vaccine. We refused and went to the Iran Mall shopping center, which is bigger. I wanted her to have AstraZeneca. But in Iran Mall, they said they only had [Chinese-made vaccine] Sinopharm.”

A resident of Rasht, the capital of Gilan Province, had a similar story to tell on trying to secure a dose for his father. “We’re on the fifth day of this week. For two days of it, there were no vaccines left in Rasht. On the other days, the clinics we went to said they only had the Barekat vaccine. After a few days of going back and forth, we found out we could get vaccinated in other, nearby cities as well. So I took my father to Someh Sara, an hour from Rasht, and he got Sinopharm.”

According to the Health Ministry, as of Thursday, August 5, Iran had acknowledged delivery of 13 separate shipments of foreign-made vaccine, comprising 12.63 million doses. The total number of vaccine doses administered to Iranians up to the time of writing was 14,438,861.

Official Coronavirus Statistics

According to the Health Ministry’s weekly statistics, a total of 2,554 patients are known to have lost their lives to Covid-19 in the week ending August 5: an increase of 543 over the preceding week. With 434 deaths, August 5, the last day, had the highest officially-recorded number of fatalities for the week.

At the week’s end, 6,170 Covid-19 patients in Iran were being treated in ICUs. According to the Health Ministry, at the time of writing 2,933,866 Iranians had received both doses of vaccine.

There are currently 285 Iranian cities on red alert for coronavirus transmission. Another 110 are rated orange and 53 are yellow. No city in Iran is currently on “blue” alert.

August 6

The fifth wave of coronavirus infections in Iran has yet to reach its projected peak. But deaths from Covid-19 are already at record heights, with the number of officially-recorded deaths standing at around 400 every day.

Hospitals are at capacity, and provincial officials say that there is no more room for new patients – not even in the corridors. Pictures posted on social media show some patients being vaccinated or connected to IV drips outside the entrances.

Dr. Alireza Zali, the director of Tehran Coronavirus Taskforce, broke rank on Friday, August 6 to tell Iranian Students’ News Agency (ISNA) that he and colleagues had requested a total lockdown, but it had been rejected by higher-ups.

Dr. Zali said he didn’t believe the significance of this “had really been understood.” He added: “We believe that an effective lockdown is a total one. Anything temporary or partial will not work.”

The Tehran Coronavirus Taskforce wants to see social activities drastically pared back, with only essential activities like the provision of food, medicine and emergency services allowed. “Even public transport must stop,” he said.

Dr. Zali also called for the government to improve contact tracing of Covid-19 patients, and to speed up its sluggish Covid-19 vaccination drive.

Meanwhile Dr. Masoud Mardani, member of the National Coronavirus Taskforce, said the situation of Iran’s hospitals was “deplorable”. He, too, demanded a nationwide lockdown. “If it’s going to be something like the recent six-day measures, it’s not going to be worth a penny,” he said.

According to the latest figures announced by the Health Ministry, in the 24 hours before noon on Thursday, August 5, a total of 434 people were recorded as having lost their lives to Covid-19.

Health experts, statisticians and government officials have repeatedly stated over the past 12 months that the real Covid-19 death toll for Iran is likely to be around 1.5 times to double the official figure.  

No Lessons Learned After Last Year’s Muharram Disaster

The Persian calendar month of Muharram, when Shia Muslims attend vast mourning gatherings for the martyrdom of Husayn ibn Ali, the third Shia imam in 680 AD, is set to get under way on August 10.

Last year strict health protocols were imposed on the biggest public events. But despite the fact that Iran’s Covid-19 figures are worse than this time last year, a multitude of officials are adamant that the ceremonies must still go ahead.

“In such conditions,” Dr. Mardani reported, “mourning ceremonies and processions must not take place. People should take part virtually, or watch it on TV, so that this disease will not spread.”

Nevertheless on Friday, August 6, the National Coronavirus Taskforce was duty-bound to announce the state “guidelines” for 2021’s Muharram mourning events.

The rules stated that closed event spaces must not be filled to more than a quarter capacity, ceremonies must not continue past 2am, and participants should use hand sanitizer or disinfectants before attending.

In fact, these were exactly the same guidelines that were put in place last year, when pictures and videos showed people flouting the rules at tightly-packed ceremonies all over Iran. In the weeks that followed, new coronavirus infections surged.

Ominously, this week Saeed Mahdavi, director-general of the Islamic Development Bureau in Gilan, echoed the exact sentiments disastrously voiced by President Hassan Rouhani last year. “Muharram ceremonies must not be shut down,” he said – adding the “enemy” was trying to create a dichotomy between health and religion.

August 6 – August 12

On Wednesday, August 11, Dr. Alireza Zali, the director of the Tehran Coronavirus Taskforce, revealed that the Islamic Republic had lied to the World Health Organization (WHO) about Covid-19 fatalities and exposed the failures of a number of government officials in the fight against the pandemic.

The revelations come amid rising infections and deaths across the country from the Delta variant, and as Iran’s already-fragile health system continues to buckle under the strain. According to the health ministry’s statistics, a total of 3,587 people lost their lives to Covid-19 in the week ending August 12. A hospital boss in Isfahan has also warned that potentially fatal cases of black fungus infection in children, linked to Covid-19, are on the rise.

Zali’s statements revealed some important lies and shortcomings but left many questions, especially about vaccines, unanswered.

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Since the coronavirus pandemic started in Iran, Dr. Alireza Zali, president of Shahid Beheshti University of Medical Sciences, has been the director of the Tehran Coronavirus Taskforce. During Iran's five coronavirus outbreaks, Zali repeatedly asked the National Coronavirus Taskforce for Tehran to be quarantined or locked down, regarding it as a key center of the contagion, but each time his request was rejected.

Dr. Zali keeps the Covid-19 situation in greater Tehran under close supervision, being sure to provide the media with updates. However, on August 11, in a change to his usual briefings, he attacked the policies of the Islamic Republic regarding the fight against coronavirus, and specifically regarding the importation of Covid-19 vaccines. He revealed that Iran had concealed the true number of Covid fatalities from WHO and, instead, had asked the organization to praise Iran’s health system when speaking to the media. “We turned international aid back from the airport – and Doctors without Borders,” he said.

In particular, Zali highlighted the failure of Iran’s foreign ministry regarding vaccines.

Shirking Responsibility?

“Mr. Zali should have said these things much earlier,” Mohammad Reza Mahboubfar, a health expert and analyst in Tehran, tells IranWire. “It is too late to say these things at a time when, sadly, Iran has turned into the coronavirus slaughterhouse of the Middle East, and perhaps the world. I believe that such statements by Dr. Zali about the situation of the pandemic in Iran and across the country does not clear him of responsibility because he is a key figure within the National Coronavirus Taskforce.”

“Our ambassadors to foreign countries weren’t trying to get hold of vaccines,” said Dr. Zali. “I talked to the Japanese ambassador and he said that the Iranian ambassador never asked for vaccines. What kind of diplomacy is this?”

“Mr. Zali is addressing Mohammad Javad Zarif and his ambassadors to various countries in the world,” says Mahboubfar. “And Mr. Zarif responded that any vaccine that had been imported had been the result of the foreign ministry’s efforts. It would appear that Dr. Zali lacks adequate information about imported vaccines. I consider him a spent force at the National Coronavirus Taskforce. I have even heard that, contrary to what has been said, he has never attended National Coronavirus Taskforce meetings and he has not been given much of the information about the process of importing vaccines.”

Mahboubfar says it seems evident that these are Dr. Zali’s final days with the Tehran Coronavirus Taskforce, and he is trying to clear himself from the charge of “murdering” his fellow Iranians. People died as a result of failures by various ministries and government agencies, and Zali was part of this official management, or mismanagement, of the pandemic.

The Ban on Importing American and British Vaccines

On August 11, a few hours after a huge number of media outlets reported Dr. Zali’s statements, Mohammad Javad Zarif responded on Instagram. He dismissed Zali’s statements as “libel”, “slander” and “attacks” against the diplomatic service of the Islamic Republic. He instead pointed the finger at various other institutions and at the ban on importing American and British vaccines. He then put forth his own list of questions: “Who first brought up the issue of coronavirus within the government?...Which minister got  the Sputnik vaccine from Russia?...Which government agency arranged for the acquisition and the gift of more than 24 million foreign vaccines and has arranged for the massive and continuous imports for the coming weeks?…On the other hand, who was it that rejected the plan to import 20 million doses of vaccines from Europe?”

“I believe that powers beyond the Ministry of Health denied permission to import 20 million doses under [the World Health Organization’s program] Covax,” says Mahboubfar. “They were the same people who made promises about a domestically-produced vaccine and said they would produce tens of millions of doses by the end of the summer. The 20 million doses mentioned by Mr. Zarif was from Covax’s supply and Covax wanted to provide Iran with reputable brands of foreign vaccines including Pfizer, Moderna and Johnson and Johnson, but unfortunately, thanks to a letter signed by a number of professors at the universities of medical sciences, they banned American and British vaccines from Iran.

“In February, the foreign ministry and the health ministry were ready to import vaccines. The plan was to import 12 million doses in the first phase and six million doses in the second phase, but institutions with higher authority than the health ministry prevented, claiming that the development of domestic vaccines had reached an acceptable stage, that clinical trials had been completed and that they were able to produce the vaccine within the country.”

It was in January that the Supreme Leader Khamenei banned the import of American and British Covid-19 vaccines. Following this announcement, 2,500 doctors and health professionals asked in a letter for a ban on the import of Covid-19 vaccines. The names of 194 of the signatories to the letter have been published. One of them was Bahram Einollahi, President Raisi’s choice to head the Ministry of Health.

“Isn’t it naïve to trust the lives and the health of our dear people as laboratory test subjects...to American and British vaccine makers, to the same governments that, in the past few decades have proven in different ways that they place no value on the health and the lives of Iranians?,” read the letter.

Supreme Leader’s “Revolutionary” About-Turn

On August 11, following the most recent uncontrolled surge of Covid-19 in Iran, the Supreme Leader described securing vaccines as “the country’s first and foremost urgent issue”. Kianoush Jahanpour, the spokesman for Iran’s Food and Drug Administration, announced that that importing American and British vaccines was permitted, provided they have not been manufactured in these two countries — a strange condition that can only have been an attempt to save face on Khamenei’s behalf.

Many criticized this reversal in policy, saying it was too late. Tens of thousands of Iranians had lost their lives due to a lack of the vaccine, they said.

In addition to the fiasco of refusing to import vaccines, the production of domestic vaccines has not been a shining success either. Tens of millions of doses of the CovIran-Barekat vaccine, produced by the Executive Headquarters of Imam's Directive (known as “Setad”), a foundation controlled by the office of Iran’s Supreme Leader, had been promised, but on August 10 the newly-inaugurated President Ebrahim Raisi announced: “Our domestic production is not enough and we must import between 30 and 40 million doses.” Kianoush Jahanpour announced that by the early autumn, 40 million doses will have been imported.

Fatemeh Karimkhan, a journalist based in Iran, tweeted: “Jahanpour said that within the next three months 40 million doses of foreign vaccines will be imported. There has been no change in sanctions, no change in currency reserves, no change in the enmity or the friendship of countries that make the vaccines. Why was the decision to import vaccines not taken six months ago? Three months ago? One month ago?”

“The Covid-19 crisis that has engulfed the country is a self-inflicted one and is primarily the result of self-imposed sanctions by the Islamic Republic regarding the ban on importing American and British vaccines,” says Mohammad Reza Mahboubfar. “In the past few days promises about importing 40 or even 120 million doses have been made but it is unlikely that these promises are true because, in a sense, Iran has no government. We only have a president and the ministers who are currently in the cabinet have a record of failures.”

The Fiasco of Domestic Vaccine Production

Mahboubfar says the domestic Covid-19 vaccines are a “montage” of Chinese and Cuban originals: “No innovation, no creativity and no new discovery has taken place in the development of domestic vaccines. As a result of sanctions and broken promises, even China, Cuba and Russia would not allow Iran to access the raw ingredients to produce vaccines domestically. That is why Iran has only managed to produce 1.3 million doses of the vaccine.”

According to Mahboubfar, in the past few months at least six pharmaceutical companies have informed the health ministry that the mass production of vaccines to fulfill the promises Iranian officials have made is impossible: “Unfortunately, instead of listening to domestic vaccine makers, the health ministry has even refused to permit private companies, inside and outside Iran, to import vaccines.”

He believes that the health ministry is unwilling to pay a price that it believes is too high.

Early this spring “we laid the groundwork to import six million doses of vaccine but the health ministry did not allow it,” reported Masoud Khansari, president of the Tehran Chamber of Commerce on August 12.

This is yet further evidence that the health ministry is opposed to importing vaccines. However, on July 25, health minister Saeed Namaki claimed his ministry “is not responsible for importing vaccines. Its job is to manage the contagion and administer the vaccines.” He reasserted this position and defended the performance of the health ministry on August 12 during a visit to Mashhad: “Our duty was not to acquire vaccines. Others had to import it and we organized the injections. But they broke their promises and those who had claimed to be our friends left us alone in the middle of a slaughterhouse.”

Dr. Zali’s revelations show that the officials of the Islamic Republic were willing to spend money on items like medicine for treating symptoms of Covid-19 but not only refused to spend it on importing vaccines, they even prevented others from doing so.

“We mustn’t obsess over the price of vaccines and buy them even at twice the price to protect people,” said Dr. Zali. “We spent €720 million on Remdesivir [a drug used to treat severe Covid-19] but we should have spent that on vaccines. How come, under sanctions, we can buy petroleum equipment at three times the price but not do the same for vaccines?”

Isfahan Hospital Boss Warns Black Fungus Spreading Among Children

Behrouz Kalidari, the deputy director of treatment at Isfahan University of Medical Sciences, reported that local hospitals have  seen an outbreak of black fungus among patients with Covid-19.

The rare but serious infection affects the sinuses and facial bones and can cause sight loss or brain damage. When untreated, it kills 50 percent of sufferers.

On Friday, August 13, Kalidari told the Iranian Metropolis News Agency (IMNA) that more than 40 children had come down with the disease, mucormycetes, at Imam Hossein Hospital and three at the university’s hospital in Isfahan.

One of the cases, he said, was an eight-year-old child. Doctors had to remove parts of his cheek and eye in order to save his life. "The more people we have with immunodeficiency conditions,” Kalidari warned, “the more that opportunistic viruses such as black fungi are likely to spread."

Black fungus infection was first observed spreading among Covid-19 patients in India in May. Hospitals have since had to set up special units to treat thousands of affected people after they had recovered from Covid-19. 

The US Center for Disease Control and Prevention has warned the infection is “highly aggressive” and should always be treated immediately.

In June this year, Massoud Mardani, a member of the National Coronavirus Headquarters’ scientific committee, had also said cases of black fungus had been observed in Tehran.

Official Coronavirus Statistics

According to the health ministry’s weekly statistics, a total of 3,587 patients are known to have lost their lives to Covid-19 in the week ending August 12: an increase of 1,033 over the preceding week’s death toll of 2,554. With 588 deaths, August 9 had the highest officially-recorded number of fatalities for the week.

At the week’s end, 7,048 Covid-19 patients in Iran were being treated in ICUs. At the time of writing, according to the health ministry, 3,531,142 Iranians had received both doses of the vaccine.

There are currently 336 Iranian cities on red alert for coronavirus transmission. Another 84 are rated orange and 28 are yellow. No city in Iran is currently on “blue” alert.

August 11

Ayatollah Khamenei appeared on Wednesday to have changed his position on the need to import Covid-19 vaccines to Iran. In a televised speech, the Supreme Leader of the Islamic Republic called on the authorities to secure vaccines for coronavirus-racked Iran by any means necessary, calling it “the country’s first and foremost, urgent issue”.

Iran is now recording record numbers of new Covid-19 cases spurred in part by the Delta variant, with more than 500 citizens dying every day according to official figures. The true death toll is likely to be significantly higher than reported, due to a lack of testing and manipulation of the figures at the outset of the pandemic.

Last March, Khamenei repeatedly told people not to allow Iran’s “enemies” to overestimate the threat posed by SARS-CoV-2. In a speech on March 3, he said: "Do not make the coronavirus a big issue. This will exist for a short time, and then it will disappear." 

Despite all evidence to the contrary that emerged over the next 10 months, Khamenei then used an address on January 8, 2021 to ban the importation of American and British-made Covid-19 vaccines. "If the Pfizer factory can make a vaccine, they should use it on themselves first," he said, adding that the two countries were not “trustworthy”.

Officials at the Health Ministry and the Food and Drug administration scrambled to clarify that Pfizer-BioNTech, Moderna and Oxford-AstraZeneca vaccines, all of which were developed or part-developed in the US and Britain, could still be used in Iran as long as they were manufactured somewhere else. The Islamic Republic has since procured doses of AstraZeneca from other countries such as India.

A reported 21 million doses of the Russian-made Sputnik vaccine, the Chinese vaccine Sinopharm, the Indian-made vaccine Bharat and others have also found their way into Iran as of August 9. By itself, this would be sufficient to fully inoculate one quarter of the population.

The Islamic Republic has also unveiled its own domestically-produced jab, CovIran-Barekat, and at least five others that have yet to be rolled out. But progress has been glacial and no official data has been published on their safety or efficacy. Recently, some 1.2 million doses of CovIran-Barekat were “lost” by the manufacturing plant; an informed source told IranWire they were believed to be contaminated with live virus.

August 12

“We concealed the figures on fatalities from the World Health Organization,” said Dr. Alireza Zali, director of Tehran Coronavirus Taskforce on Wednesday, August 11. “When the WHO experts came to Iran, we constantly asked them to praise Iran’s health system to the media instead of consulting with them.”

The senior physician made the disclosure on Wednesday, August 11 during a conversation with Islamic Republic Radio and Television News Agency. In the same interview, Zali claimed Iran had just a five-day stock of vaccines left.

“When the first case of coronavirus was observed in Qom,” he said, “I asked for Qom to be quarantined and said [parliamentary] elections must not be held in that city. But some people ridiculed me, said that this disease could be easily controlled.

“We turned international aid back from the airport – and Doctors without Borders, even though we didn’t know much about this virus and hadn’t taken advantage of international consultations.”

Worse news, he said, was on the way to Iran. “The Delta [variant] lasted three months in India and they vaccinated everybody quickly. We mustn’t obsess over the price of vaccines and buy them even at twice the price to protect people.

“Our ambassadors to foreign countries weren’t trying to get hold of vaccines. I talked to the Japanese ambassador and he said that the Iranian ambassador never asked for vaccines. What kind of diplomacy is this?”

“We spent €720 million on Remdesivir [a drug used to treat severe Covid-19] but we should have spent that on vaccines. How come, under sanctions, we can buy petroleum equipment at three times the price but not do the same for vaccines?”

The only way to save the country, Dr. Zali said, was to implement a two-week nationwide lockdown, starting immediately.

Iran is in the throes of a devastating “fifth wave” of coronavirus infections spurred by the arrival of the Delta variant some months ago.

Hospitals are overwhelmed, with many patients sleeping in corridors, and Covid-19 has been claiming the lives of at least 500 Iranians every day.

The true figure is likely to be higher. Of the 260,000 coronavirus tests administered every day around 40,000 are coming back positive.

August 13

The Director-General of Islamic Propaganda in Khorasan Razavi province has said religious authorities cannot afford to host Shia mourning ceremonies in the open air despite a fifth surge of coronavirus in Iran.

Hadi Sahebgharani told Iranian media on Friday that due to high inflation, it would be too costly to erect scaffolding and lay carpets outside during the holy month of Muharram. The month sees believers attend thousands-strong ceremonies to mourn the death of Imam Hussein in 680AD.

“Scaffolding cannot currently be found in Mashhad,” Sahebgharani said, “and this has become a problem. Also, rent of a carpet… amounts to 10 million tomans ($378) for ten nights. At this price, how many carpets would we be able to rent to hold ceremonies outdoors for 10 nights? In this situation, we should thank the mourners for agreeing to go into the open spaces and enduring the hardships."

He cited recent remarks by the Supreme Leader of the Islamic Republic, Ali Khamenei, on the importance of holding mourning ceremonies despite the pandemic.

“A lot of information and explanations issue from the pulpits and shrines on maintaining health and hygiene,” he said. “Also, in addition to the fact that we must observe hygienic matters, we must supplicate to God and seek help from the Infallibles [the 12 Shia Imams, the Prophet Muhammad and his daughter Fatima].

“Our people believe that if they go to the shrine of Imam Reza, they will drink water with the intention of healing. And we cannot abandon our beliefs."

Earlier this week videos circulated online showing large crowds led by Mashhad’s Al-Reza Alamdar delegation packed at close quarters at an indoor Moharram event, violating Covid-19 restrictions. Sahebgharani said members of the board had been "severely dealt with" over the incident.

Mehdi Akbari, the eulogist of this delegation, said in his last public statement on Friday, August 13: "I believe that there is no disease in the shrine of the martyrs. The people have been healed so far, and no-one has fallen ill. This is my belief, and no-one has the right to mock our beliefs."

He then proclaimed that if the Iranian authorities were genuinely concerned about people’s health they should be delivering them with Covid-19 vaccines.

After videos of unsafe mourning ceremonies emerged in both Tehran and Mashhad, Iran’s Minister of Interior banned all indoor events and street processions.

Mashhad Covid Lead: City is ‘Surrounded’

Dr. Alireza Sedaghat, head of the special coronavirus ward at Mashhad’s Imam Reza Hospital, compared coronavirus to a “zombie” that would infect anyone who stepped into the street.

Mashhad “is now like a surrounded army,” he said. “What different does it make whether the mistake was made by the commander, by the soldiers or by me? The situation is bad and the medical team is squeezed. The cure for Covid-19 is not in the hospital but in prevention. We need just two weeks [of lockdown] to put this situation behind us.”

“While the official number of Covid fatalities announced by Mashhad University of Medical Sciences is 80,” he added, “we have to multiply this three or 3.5 times over. The [daily] number of people being buried at Behesht-e Reza, one of the two cemeteries in Mashhad, is 200 to 210.”

The problem, he said, was that Covid-19 patients were only going to hospital when they were already in a grave condition. Up to 40 percent of those admitted to Ghaem and Imam Reza hospitals in Mashhad die within 24 to 36 hours.

Earlier, Dr. Sedaghat had also called for a total ban on religious gatherings  - especially the Muharram mourning ceremonies. These events tend to be bigger and more crowded in Mashhad than elsewhere.

August 13 – August 19

At least 2,000 Iranians who received two doses of vaccine have since died, more than half after testing positive for Covid-19.

According to a letter sent to Health Minister Saeed Namaki by the ministry’s Center for Statistics and Technology, of the around 2.75 million Iranians who have so far received both doses of vaccine, 17,000 were then hospitalized with Covid-19 symptoms.

“Of these 2,000 who died,” Dr. Mohammad Reza Mahboubfar, a viral epidemiologist and a former member of the National Coronavirus Taskforce, told IranWire, “57 percent had tested positive. Most of them were aged over 70, meaning they’d had priority for vaccination.

“According to figures from around the world, the mortality rate among those who have received both doses of vaccine is about 10 per million. Based on the Health Ministry’s letter, the rate in Iran is 753 per million. In other words, the mortality rate in Iran after receiving both doses is more than 75 times the international average.”

The figures caused widespread consternation on being published, with many pointing fingers at the already-beleaguered Saeed Namaki and the person of Ayatollah Khamenei; in  early January the Supreme Leader banned American and British vaccines from Iran.

Health experts and lay observers alike believe the fourth and fifth waves of coronavirus infections in Iran, which respectively in spring and summer 2021, were made drastically worse by a lack of availability of vaccines. Imports have been repeatedly delayed while Iran has struggled to mass-produce the necessary quantity of domestic vaccines such as CovIran-Barekat.

According to official statistics, every day around 600 people who have tested positive for Covid-19 die in hospitals around the country. The Iranian Medical Council estimates that the real number of fatalities is as much as three or four times the official figure.

Iranian Vaccine Hesitancy Stands at 40 Percent

So far around the world, Covid-19 vaccination drives have generally progressed in age order, with the oldest citizens inoculated first followed by those in high-risk professions. The Islamic Republic has designated people in certain public-facing roles, such as government employees, teachers, journalists, bus and taxi drivers and health workers, as among the priority groups for vaccination.

However, according to Dr. Mahboubfar, some 40 percent of people who have so far been named as eligible have not gone to vaccination centers when called on. “People say they don’t trust either imported vaccines or domestic ones,” he said. “This is one of the main factors behind the increase of fatalities in the country.”

To compound the confusion, ever since the initial outbreak of coronavirus in Iran, promoters of so-called “Islamic” and “traditional” herbal medicines have been spreading misinformation about how to treat Covid-19. The strange remedies touted included placing cotton soaked with violet oil in the anal cavity, consuming alcohol or using camel urine; their promotion has not ceased even after the development of domestic Covid-19 vaccines. Belief in herbal remedies permeates all strata of Iranian society and could be a contributing factor to people’s reluctance to get vaccinated.

Vaccination Against International Guidelines

The Health Ministry has invited a number of people aged 25 and over and working in the designated professions to get their first jab. In some cases this will be the the AstraZeneca vaccine, which has been designated for use only in the over-40s, 50s and 60s by some European nations and other countries due to blood clotting being a rare possible side effect.

“The vaccine basket currently available to various age groups in Iran includes AstraZeneca, Sputnik V, Sinopharm and [the Iranian-made] Barekat,” Dr. Mahboubfar said. “They’re injecting individuals aged over 25 or 30 with AstraZeneca whereas in European Union countries, Canada, the United States, Australia and a number of Middle Eastern countries using AstraZeneca in individuals aged under 40 or 50 is banned.

“In Iran young people are being inoculated with this vaccine. Some have later died after being hospitalized while suffering from extreme convulsions.”

So far, Iran has imported around three million doses of AstraZeneca made in Japan, 315,000 doses manufactured in Russia and more than two million doses of this vaccine made in Italy and South Korea through Covax, the World Health Organization (WHO)’s equitable vaccine access program.

The Efficacy of Available Vaccines against the Delta Variant

Since the first recorded outbreak of coronavirus in the city of Wuhan, China, a number of variants of SARS-Cov-2 have emerged in different parts of the world and spread rapidly. In each instance, vaccine developers have communicated their findings about the efficacy of their products against the new variants to the World Health Organization.

Iran has so far failed to provide data to the public about either the efficacy of CovIran-Barekat against the original strain, or any of the variants. Meanwhile, Dr. Mahboubfar notes, a recent study conducted in Hungary on the efficacy of the Chinese-made Sinopharm and Russian-made Sputnik V vaccines found “these two are 50 to 60 percent effective against the original coronavirus that started in Wuhan – but their efficacy against the Delta and Lambda variants is very low.”

Recently the UK’s Oxford University estimated the efficacy of Pfizer and AstraZeneca vaccines against the Delta variant would fall to around 65 percent three months after receipt of the jab. To improve their efficacy a third, booster shot is recommended three months after the second dose.

“The number of second AstraZeneca shots administered in Iran has not been considerable and definitely there are not enough doses of this vaccine in Iran for a third shot,” Dr. Mahboubfar said. “The makers of Sinopharm, Sputnik V and Barekat have not said anything about the need for a third shot. In this situation, how are we going to know whether or not vaccinations have been sufficient?”

The vaccination process in Iran so far, he said, had been “chaotic”, with long lines forming outside out-of-stock health centers. Health Ministry officials recently announced that Iran had enough doses of vaccine at its disposal to last two weeks – in contrast to a claim by Tehran’s coronavirus chief that stocks would only last for five days. Local centers in some Iranian cities closed due to shortages in the past few days, even as residents continued to receive text messages for the Health Ministry instructing them to go for their first jab.

Previously shortages saw vaccinations in some areas suspended for as long as four weeks, meaning people who had received their first dose of Covid-19 jab were left waiting for a much longer interval between doses than recommended. This can affect vaccine efficacy to the point that if patients go for too long without receiving their second dose, they have to start over. For a while health officials considered mixing and matching imported jabs with CovIran-Barekat; whether this ended up happening at some clinics remains unclear.

Dr. Mahboubfar said he believes one of the reasons for the high mortality rate among patients who received both Covid-19 jabs was the extended delay between the first and second shots.

Infections Are Ahead of Vaccinations

The very slow pace of vaccinations in Iran, and the spread of the Delta variant, have caused the number of new infections to rapidly outstrip the number of people vaccinated. Other major problems include shortages of medical necessities such as oxygen capsules, drugs to treats Covid-19 symptoms and IV fluids.

According to the Health Ministry, as of now more than 16 million Iranians have received at least the first dose of the vaccine. But Dr. Mahboubfar points out that the number of those who have received the second dose is much lower. “For as long as the number of vaccinated people remains low, and the infection rate high, given the low efficacy of these vaccines against the Delta variant there is a high degree of probability that even those who have received both shots are going to get infected.”

Many people who have received both jabs in Iran assume they are immune to coronavirus and stop following health protocols. According to the Health Ministry, compliance with guidelines such as mask-wearing and social distancing across Iran has fallen to below 40 percent.

“The only way to fight the virus is to comply with health guidelines, because vaccination does not make you invulnerable,” warned Health Minister Saeed Namaki on August 18. “There will be many mutations of the virus in future and it’s likely these future variants will also raise questions about the efficacy of vaccines.”

Police: We Can’t Stop Muharram Processions

Nowhere is the delusion of invulnerability more manifest than in the mass gatherings and processions taking place in venues across Iran for Muharram: the Shia holy month that commemorates the martyrdom of Husayn ibn Ali, the third Shia Imam, in 680 AD.

The National Coronavirus Taskforce officially banned mourning ceremonies in closed spaces and street processions, but just like last year, the rule has been openly and repeatedly violated from the get-go. Religious Iranians have been documented packing into small spaces, shouting and crying without wearing masks, in a plethora of images and videos that have since found their way online.

On Wednesday, August 18, Mohammad Reza Farahbakhsh, the deputy commander for social affairs of Qom police for social affairs, bluntly stated that the police cannot stop Muharram processions by force; only religious associations and the Islamic Propaganda Organization have the power to stop the organizers from flouting the rules. In response, the director-general of the Islamic Propaganda Organization in Qom province shifted the blame back to the police.

Earlier this month on August 10, Deputy Health Minister Iraj Harirchi had warned that even without mourning ceremonies the number of Covid-19 fatalities in Iran was going to surge.

Regardless of who is responsible for the lax or non-existent enforcement of restrictions, the five-day lockdown that started on August 17 only contributed to an increase in inter-provincial travel and as a result, to the spread of coronavirus.

The National Coronavirus Taskforce had announced that private sector would be locked down as well as the public sector. But a resident of Tehran told IranWire this wasn’t true in practice: “It’s just empty talk. They issue sham orders that they themselves cannot enforce. For the last five days our business, like always, has only shut at the weekend. The metro is crowded and there’s the same amount of traffic in the streets as usual.”

Official Coronavirus Statistics

According to the Health Ministry’s weekly statistics, a total of 4,040 patients are known to have lost their lives to Covid-19 in the week ending August 19: an increase of 453 over the preceding week’s death toll of 3,587. With 655 deaths, August 16, the last day, had the highest officially-recorded number of fatalities for the week.

At the week’s end, 7,538 Covid-19 patients in Iran were being treated in ICUs. According to the Health Ministry, at the time of writing 5,236,423 Iranians had received both doses of vaccine.

There are currently 359 Iranian cities on red alert for coronavirus transmission. Another 59 are rated orange and 30 are yellow. No city in Iran is currently on “blue” alert.

August 20 – August 26

Concerns over the efficacy of Iran’s Covid-19 vaccination drive – relying in large part on imports of the Chinese Sinopharm vaccine – are rising as the country records instances of a higher death toll among vaccinated people than the world average.

The Chinese city of Wuhan is reportedly where the coronavirus pandemic started: now Iranians are hearing about China and Wuhan again but not for the same reason. More than 60 percent of covid vaccines imported to Iran are by the Chinese firm Sinopharm. Iran’s Red Crescent Society began importing this vaccine in May and recently announced that it was planning to accelerate imports.

Reports indicated that China has sold Iran two types of vaccine: one made in Beijing in 0.5ml vials and the other made in Wuhan in 1ml vials. Both the Red Crescent Society and Iran’s Food and Drug Administration have categorically denied these reports. But Red Crescent is refusing to divulge details about the imports, which has led to worries about the efficacy of these vaccines, especially after it was reported that at least 2,000 Iranians who had received both Sinopharm doses had lost their lives to Covid-19.

The worries began after the Health Ministry’s Center for Statistics and Technology reported that more than 2,000 fully-vaccinated Iranians have died – which is 75 times the international average for people who have received both doses of vaccine. Experts offered various analyses to account for this differential; some speculated that, considering the slow pace of vaccination in Iran, the Health Ministry published this figure to deter some Iranians from demanding to be vaccinated.

Others have meanwhile claimed that some or all vials of Sinopharm are being used to vaccinate two people – though these reports are difficult to verify. But guidelines issued by the World Health Organization (WHO) and even Iran’s own Health Ministry stipulate that each vial containing 0.5ml is to be used for one person; meaning that Iran’s program, if these reports are accurate, is leaving people only half-vaccinated.

The newspaper Mardom Salari also reported a similar experience shared by a member of its Telegram channel: “This morning, August 21, some of my friends and I went to the [vaccination center] but we were surprised when we saw that they were using one dose for two people. When we objected, the vaccination supervisor said ‘They have told us to do this because of the vaccine shortage.’”

A pharmacologist in Iran, who asked not to be named, told IranWire: “After the deaths of many vaccinated people were reported, my pharmacologist colleagues said that those who were given Sinopharm are not really vaccinated against coronavirus because the dose was inadequate. But … the problem went much further than what we imagined.”

Health professionals who work at vaccination centers have also said that, previously, they used 1ml Sinopharm vaccine vials to dose individuals; recent deliveries, though, have come in only 0.5ml vials.

A further complication came on August 26 when the newspaper Jahan-e Sanat reported that Iran has imported two kinds of Sinopharm vaccines: “The first is from Wuhan, is of lower quality, and sells for $10 per dose. The second is made in Beijing, is of higher quality, and costs $25 per dose. The rumor is that the efficacy of the Wuhan vaccine is much lower than the original [Beijing] Sinopharm and perhaps this has been the cause of increasing fatalities among Iranians who have been vaccinated.”

Kianoush Jahanpour, spokesman for the Food and Drug Administration, denied that Iran had imported “low quality” vaccines from China. He told Jahan-e Sanat that Sinopharm did sell two versions of its vaccine, “but the Wuhan Sinopharm is not licensed for use in Iran. The only Chinese vaccine that is permitted to be imported and used in Iran is the Beijing Sinopharm. It is iimpossible that the Red Crescent has imported the Wuhan vaccine because it is cheaper… In any case, the Red Crescent Society does not import, it just acts as an intermediary. The number of fatalities among covid patients has nothing to do with the vaccine. Contrary to all the negative propaganda, we have been transparent in offering information to the people. The name of the vaccine that we have acquired is Sinopharm (Beijing): BBIBP-CorV. Around 1.55 million doses of this vaccine were donated and we paid for the rest.”

Jahanpour added that the private sector intends to buy the Wuhan vaccine but that so far it has been unsuccessful in this effort.

“Mr. Jahanpour has never issued a ‘mea culpa’ so it is only natural for him to deny these reports,” IranWire’s pharmacologist source said. “The important point is that the Beijing and Wuhan vaccines are made using different methods. When we say they have different efficacies, it means that their IgG [Immunoglobulin G] antibodies are different and that the slightest shortfall in the level of antibodies in a dose means that the second dose does not boost the first dose. The resulting immunity is much lower and the chances that the person will be infected by coronavirus is therefore higher – especially with the Delta variant which is now the dominant variant in Iran.”

Reports published by the Iranian media have also confirmed that these two versions of Sinopharm’s vaccine have different levels of efficacy. The WHO has also not so far endorsed the Wuhan version. “Although both vaccines are made by the same company, they are very different,” wrote Khabar Online. “The Beijing vaccine is 79 percent effective and has been endorsed by the WHO, but the Wuhan vaccine has an efficacy of 72.5 percent and has not yet been endorsed by WHO.”

Health experts are worried about the efficacy of the vaccination program if people receive a first dose of Beijing and a second dose of Wuhan – given the differentials in antibodies described by IranWire’s source. Iranian health authorities have yet to conduct studies on he efficacy of the vaccines they are using and the Islamic Republic has given priority to quantity over quality.

Iran has imported a total of 29 million doses of vaccine to date.

Official Coronavirus Statistics

The number of Covid-19 infections, hospitalizations and fatalities has risen over the past few weeks. According to the Health Ministry’s weekly statistics, a total of 4,462 patients are known to have lost their lives to Covid-19 in the week ending August 26: an increase of 421 people over the preceding week’s death toll of 4,040. With 709 deaths, August 24 had the highest level of officially-recorded number of fatalities during that week.

XX

At the week’s end, 7,788 Covid-19 patients in Iran were being treated in ICUs. According to the Health Ministry, at the time of writing the total number of vaccine doses injected, both first and second shots, had reached 24,922,555.

There are currently 359 Iranian cities on red alert for coronavirus transmission. Another 59 are rated orange and 30 are yellow. No city in Iran is currently on “blue” alert.

This article is part of IranWire’s coronavirus chronology. Read the full chronology