While governments worldwide are negotiating to acquire more vaccines or accelerating the delivery of existing orders, Lebanon only signed its first deal for 2.1 million doses of the Pfizer-BioNtech vaccine on Sunday.
According to the Ministry of Health, the vaccine doses are due to start arriving in batches, beginning February.
Lebanon finalized the agreement amid an uncontrollable surge in cases, overwhelming the country’s health care system beyond its capacity.
Parliament approved a law last week to protect Pfizer-BioNtech and other companies that will provide vaccines to Lebanon from any future liability claims for two years.
Given the economic crisis, how will Lebanon buy vaccines?
According to caretaker Health Minister Hamad Hassan, the World Bank gave Lebanon credit to buy the doses developed by the US and German companies and, thus, "be distributed in a free and fair manner."
Head Parliament’s Health Committee, MP Assem Araji, said that Lebanon had secured a price of $18 per dose, which means that vaccinations, which require two doses per person, will cost the country $37.8 million in total.
What is the vaccination strategy going to be?
Lebanon's national health authority unveiled its plan for vaccinating the public, with a first phase prioritizing healthcare workers and those over the age of 75.
The second phase will target people over the age of 50, health practitioners, and those who have asthma, diabetes, chronic heart diseases, cancer and other critical health issues.
The final stage will open for all citizens and residents wanting to take the vaccine.
Will Lebanon rely on one vaccine?
Lebanon's president approved a payment to reserve 2.73 million doses of COVID vaccine under the COVAX program, enough for 1,365,000 people. Along with the 2.1 million doses from Pfizer (enough for 1,050,000 people), this would cover 2,415,000 people out of a population of approximately 6 million, including at least 1 million refugees.
The Health Ministry said that another 2 million doses were being discussed with the private sector in Lebanon and other multinational pharmaceutical companies that manufacture vaccines, suggesting Oxford-Astrazeneca and China's Sinopharm.
The Ministry has also reserved vaccines from US company Johnson & Johnson, awaiting its global approval. Lebanon is currently considering more vaccines from US-based Moderna and Russia’s Sputnik, with the private sector's aid.
Could the decrepit electricity grid pose challenges for storage requirements?
The Pfizer-BioNTech vaccine is highly sensitive and can only be stored at -70 degrees Celsius (-94 degrees Fahrenheit). Once thawed, it must be administered within five days, and each individual must receive two shots.
During a recent interview, Hassan said Lebanon had 12 specialized freezers, each with a storage capacity of 35,000 doses.
But the country's limited electricity - where even government-run hospitals rely on donations to buy fuel for their generators to back up the unreliable state grid - has raised citizens' concerns about how the government will handle availability, distribution and storage.
Lebanese residents took to Twitter to question how citizens could trust the government's plan to store the vaccine.
So we are supposed to trust a government that cannot store bags of flour safely with a vaccine that needs -70 degrees fridges? We need to see the fridges 🇱🇧 #Lebanon— Joseph El-Khoury (@JEK_Psych) January 18, 2021
“Possessing the vaccine is one thing, but administering it is the real bottleneck," Fouad Naccache, a citizen who is anxiously waiting to get vaccinated, told Al Arabiya English.
What about herd immunity?
Heiko Wimmen, project director of the Iraq, Syria, Lebanon International Crisis Group, said that Lebanon could become the first country in the world to achieve herd immunity due to the rapid pace at which people were contracting the coronavirus.
Wimmen predicted that around 500,000 people would have contracted the virus by February when the first vaccinations begin in the country.
“Then the question is how fast they can scale it up, as they may find it challenging to handle the logistics of it. With the cooling requirements and the unreliable electricity supplies, it may not be possible to do it in a decentralized fashion,” Wimmen told Al Arabiya English.
According to Wimmen, although no one knows how much a country needs to reach herd immunity, 40 percent could slow down the spread significantly.
As the total number of coronavirus cases hit 255,956 cases at the start of the week, Lebanon, one of the hardest-hit countries in the Middle East, may face an even more dire situation in the weeks and months ahead.
Deaths in the county have continued to climb as the national death toll passed 2,000 deaths on Tuesday.
Hospitals have run out of room in intensive care units, though new cases and hospitalizations appear to have rolled back in recent days.
The county records a coronavirus-related death roughly every hour, and last week was its highest recorded ever for coronavirus-related fatalities.
The increasing toll has added a new level of urgency to the rollout of vaccines, which has already been criticized as slow.