Iran was heavily affected by COVID-19 and faced a delayed, uneven vaccine rollout. While global vaccine hoarding constrained access, the delay also reflected an immunitarian decision by the Supreme Leader to ban US- and UK-produced vaccines. Using Walt and Gilson's Health Policy Analysis (HPA), I examine Iran's early COVID-19 response, tracing how context, content, process, and actors shaped vaccine governance and outcomes. I compare deaths per 100,000 from the World Health Organization (WHO) with eight peer countries benchmarked by income group and vaccine portfolio. Adjusting for GDP per capita, the share aged 65 and over, and a Health Resources score, I identify excess mortality beyond expectations. Drawing on Esposito's immunity and Agamben's homo sacer, I read Iran alongside Global North policies prioritizing economic continuity and invoking 'natural herd immunity.' In both settings, protection is pursued through selective exposure, edging toward autoimmunity. In the Global North, sacrifice fell along the lines of unequal welfare and labour regimes and unequal vaccine markets; in Iran, martyrdom and purification moralized immunitary sovereignty as resistance to 'Western arrogance,' casting dissent as impurity and tending toward 'disinfestation,' where defence turns against the life it claims to secure.
Saeid Safari (Sat,) studied this question.