vaccines

The United States and Israel have carried out multiple attacks on medical facilities in the course of their war on Iran.

On Thursday, Iranian President Masoud Pezeshkian appealed to international health organisations to respond to attacks on medical facilities in Iran, including the Pasteur Institute in capital Tehran, a key centre that Iranian officials said had been targeted that day.

At least 2,076 people have been killed and 26,500 have been wounded in Iran since the US and Israel first launched strikes on the country on February 28.

Here is a closer look at how the US and Israel have hit healthcare facilities in Iran.

What has the Iranian president said about attacks on healthcare?

On Thursday, Pezeshkian wrote in an X post: “What message does attacking hospitals, pharmaceutical companies and the Pasteur Institute as a medical research center in Iran convey?”

The Iranian president, 71, a heart surgeon by profession, continued: “As a specialist physician, I urge WHO [the World Health Organization], the Red Cross, Doctors Without Borders and physicians worldwide to respond to this crime against humanity.”

What is the Pasteur Institute, which has been targeted?

On Thursday, Iranian Foreign Ministry spokesman Esmaeil Baghaei wrote in an X post: “The American-Israeli aggressors have attacked the Pasteur Institute of Iran – the oldest and most prestigious research and public health centre in Iran and the entire Middle East, founded in 1920 through an agreement between the Pasteur Institute of Paris and the Iranian government.”

Baghaei deemed the attack “heartbreaking, cruel, despicable, and utterly outrageous”.

He did not specify whether there were casualties from the attack.

The institute was founded more than 100 years ago in collaboration with the Institut Pasteur in Paris, an internationally renowned centre for biomedical research, which itself was founded in 1887.

The institute in Iran conducts research on infectious diseases, produces vaccines and biological products and provides advanced diagnostics.

The centre has played a central role in fighting endemic diseases such as smallpox and cholera. It also supports Iran’s national immunisation programme by developing and producing vaccines and related biologicals – including those used against diseases such as tetanus, hepatitis B and measles.

Tedros Adhanom Ghebreyesus, the director general of the WHO, wrote in an X post on Friday that two departments of the Pasteur Institute of Iran have also been working closely with the WHO.

“The conflict in Iran, and the region, is impacting the delivery of health services and the safety of health workers, patients, and civilians present at health facilities,” Ghebreyesus wrote.

Which other healthcare facilities have been hit in Iran?

“Since 1 March, WHO has verified over 20 attacks on health care in Iran, resulting in at least nine deaths, including that of an infectious diseases health worker and a member of the Iranian Red Crescent Society,” Ghebreyesus wrote in his X post.

Some of the facilities hit include:

Red Crescent warehouse

On Friday morning, a drone strike hit a Red Crescent relief warehouse in Iran’s Bushehr province.

While no casualties were reported, the attack destroyed two relief containers, two buses and emergency vehicles, Fars news agency reported.

Tofigh Daru

On March 31, Israeli-US strikes hit one of Iran’s largest pharmaceutical companies in Tehran, the Iranian government said in a post on X.

The company was later identified as Tofigh Daru Research and Engineering Company, which is owned by the Social Security Investment Company, a state-run holding firm. On LinkedIn, Tofigh Daru states that it develops and produces active pharmaceutical ingredients “in the anticancer, narcotics, cardiovascular to immunomodulatory segments”.

No confirmed casualty numbers were reported from that strike.

Delaram Sina Psychiatric Hospital

This newly constructed hospital in Tehran was significantly damaged during an attack on the capital on March 29, according to the state-run Islamic Republic News Agency (IRNA).

About 30 patients were in the hospital at the time of the strike late on Monday, the hospital’s director told IRNA. No specific casualty figures for the hospital have been reported.

Ali Hospital

The hospital in Andimeshk in Iran’s Khuzestan province sustained damage from an explosion on March 21, according to the Mehr and Fars news agencies.

In his post on Friday, Ghebreyesus confirmed this attack and said the facility had been forced to evacuate staff and cease services.

Reports about the attack do not mention casualties at the hospital.

Gandhi Hospital

On March 2, Gandhi Hospital in Tehran was damaged during attacks on a television communications tower nearby.

No confirmed casualty figures were reported for the hospital itself.

What does international law say about attacks on healthcare?

International humanitarian law states that health establishments and units, including hospitals, should not be attacked, according to the International Committee of the Red Cross.

These protections also apply to the sick and wounded, to medical staff and to means of transport such as ambulances.

In 2016, the United Nations Security Council resolution 2286 was adopted unanimously. This condemns attacks on healthcare and calls on nations to respect international law.

However, last year record attacks on healthcare during armed conflict were recorded, according to the WHO’s Surveillance System for Attacks on Health Care (SSA).

The SSA said that in armed conflicts worldwide, 1,348 attacks on medical facilities resulted in the killing of 1,981 people. The majority of these deaths were in Sudan, where 1,620 people were killed, followed by Myanmar, where 148 people were killed.

This was a sharp uptick from 2024, when 944 patients and medical personnel were killed in armed conflict.

Where else has Israel targeted medical staff and facilities?

Lebanon

Besides Iran, Israeli attacks have also targeted healthcare facilities in Lebanon.

A month into its latest bombardment of Lebanon, Israel has killed 53 medical workers, destroyed 87 ambulances or medical centres, and forced the closure of five hospitals, according to Lebanon’s Ministry of Public Health.

“Israeli strikes and blanket evacuation orders are cutting people off from care and shrinking the space for health services to function,” Luna Hammad, the Lebanon medical coordinator for Doctors Without Borders (MSF), told Al Jazeera, adding that MSF has seen “a documented pattern of attacks affecting healthcare”.

Gaza

Throughout its genocidal war in Gaza, Israel has also attacked healthcare facilities in the Palestinian enclave.

In October 2023, hundreds of people sheltering in the car park of Gaza’s al-Ahli Hospital were killed in an Israeli attack, according to Palestinian health officials.

Israel attributed the explosion at the facility to a misfired rocket launched by the Palestinian Islamic Jihad, an allegation denied by the armed group.

In March 2024, the Israeli military said it killed 90 people in its raid on al-Shifa Hospital during a siege, as displaced Palestinians sheltering in the facility described long detentions and abuse.

In December 2024, the Israeli army arrested Dr Hussam Abu Safia, the director of Kamal Adwan Hospital, after refusing to follow orders to abandon one of the last functioning hospitals in northern Gaza. His arrest came a day after the military killed approximately 20 Palestinians and apprehended about 240 in a raid inside the hospital, which was one of the “largest operations” conducted in the territory until that time.

In March 2025, Israeli forces reportedly shot dead 15 Palestinian medics for the Palestine Red Crescent Society and inside clearly identifiable PRCS ambulances, during a rescue mission in Rafah’s Tal as-Sultan neighbourhood.

One day at an Idaho hospital, half the newborns Dr. Tom Patterson saw didn’t get the vitamin K shots that have been given to babies for decades to prevent potentially deadly bleeding. On another recent day, more than a quarter didn’t get the shot. Their parents wouldn’t allow it.

“When you look at a child who’s innocent and vulnerable — and a simple intervention that’s been done since 1961 is refused — knowing that baby’s going out into the world is super worrisome to me,” said Patterson, who’s been a pediatrician for nearly three decades.

Doctors across the nation are alarmed that skepticism fueled by rising anti-science sentiment and medical mistrust is increasingly reaching beyond vaccines to other proven, routine preventive care for babies.

A recent study in the Journal of the American Medical Assn., which analyzed more than 5 million births nationwide, found that refusals of vitamin K shots nearly doubled between 2017 and 2024, from 2.9% to 5.2%. Other research suggests that parents who decline vitamin K shots are much more likely to refuse getting their newborns the hepatitis B vaccine and an eye ointment to prevent potentially blinding infections. Rates for that vaccination at birth dropped in recent years, and doctors confirm that more parents are refusing the eye medication.

“I do think these families care deeply about their infants,” said Dr. Kelly Wade, a Philadelphia neonatologist. “But I hear from families that it’s hard to make decisions right now because they’re hearing conflicting information.”

Innumerable social media posts question doctors’ advice on safe and effective measures like vitamin K and eye ointment. And the Trump administration has repeatedly undermined established science. A federal advisory committee whose members were appointed by Health Secretary Robert F. Kennedy Jr. — a leading anti-vaccine activist before joining the administration — voted to end the long-standing recommendation to immunize all babies against hepatitis B right after birth. On Monday a federal judge temporarily blocked all decisions made by the reconfigured committee.

One common thread that ties together anti-vaccine views and growing sentiments against other protective measures for newborns is the fallacy that natural is always better than artificial, said Dr. David Hill, a Seattle pediatrician and researcher.

“Nature will allow 1 in 5 human infants to die in the first year of life,” Hill said, “which is why generations of scientists and doctors have worked to bring that number way, way down.”

Vitamin K’s importance

Babies are born with low levels of vitamin K, leaving them vulnerable because their intestines can’t produce enough until they start eating solid foods at around 6 months old.

“Vitamin K is important for helping the blood clot and preventing dangerous bleeding in babies, like bleeding into the brain,” said Dr. Kristan Scott of the Children’s Hospital of Philadelphia, lead author of the JAMA study.

Before injections became routine, up to about 1 in 60 babies suffered vitamin K deficiency bleeding, which can also affect the gastrointestinal tract. Today the condition is rare, but research shows that newborns who don’t get a vitamin K shot are 81 times more likely to develop severe bleeding than those who do.

Hill has seen what can happen.

“I cared for a toddler whose parents had chosen that risk,” the Seattle doctor said. The child essentially had a stroke as a newborn and wound up with severe developmental delays and ongoing seizures.

At a February meeting of the Idaho chapter of the American Academy of Pediatrics, doctors said they knew of eight deaths from vitamin K deficiency bleeding in the state over the preceding 13 months, said Patterson, who is president of the chapter.

Infections prevented by other newborn measures can also have grave consequences. Erythromycin eye ointment protects against gonorrhea that can be contracted during birth and potentially cause blindness if untreated. The hepatitis B vaccine prevents a disease that can lead to liver failure, liver cancer or cirrhosis.

Even if a pregnant woman is tested for gonorrhea and hepatitis B, no test is perfect, and she may get infected after testing, said Dr. Susan Sirota, a pediatrician in Highland Park, Ill. Either way, she risks passing the infection to her child.

Why are parents refusing routine care?

Parents give many reasons for turning down preventive measures, including fear that they might cause problems and not wanting newborns to feel pain.

“Some will just say they want more of a natural birth philosophy,” said Dr. Steven Abelowitz, founder of Ocean Pediatrics, which has three clinics in Orange County. “Then there’s a ton of misinformation. … There are outside influences, friends, celebrities, nonprofessionals and political agendas.”

Abelowitz practices in an area of the county with about an equal mix of Republicans and Democrats.

“There’s more mistrust from the conservative side, but there’s plenty on the more liberal side as well,” he said, “It’s across-the-board mistrust.”

Social media provides ample fuel, spreading myths and pushing unregulated vitamin K drops that doctors warn babies can’t absorb well.

Doctors in numerous states say parents refusing vitamin K shots often also decline other measures. Sirota, in Illinois, encountered a family that refused a heel stick to monitor glucose for a baby at high risk for having potentially life-threatening low blood sugar.

Care refusals aren’t a new phenomenon. Wade, in Philadelphia, said she’s seen them for 20 years. But until recently, they were rare.

Twelve years ago, Dana Morrison, now a Minnesota doula, declined the vitamin K shot for her newborn son, giving him oral drops instead.

“It came from a space of really wanting to protect the bonding time with my baby,” she said. “I was trying to eliminate more pokes.”

Her daughter’s birth a couple of years later was less straightforward, leaving the infant with a bruised leg. Morrison got the vitamin K shot for her.

Knowing what she does now, Morrison said, she would have gotten it for her son, too.

Efforts to persuade

Doctors hope to change minds, one parent at a time. And that begins with respect.

“If I walk into the room with judgment, we are going to have a really useless conversation,” Hill said. “Every parent I serve wants the best for their children.”

When parents question the need for the vitamin K shot, Dr. Heather Felton tries to address their specific concerns. She explains why it’s given and the risks of not getting it. Most families decide to get it, said Felton, who has seen no uptick in refusals.

“It really helps that you can take that time and really listen and be able to provide some education,” said Felton, a pediatrician at Norton Children’s in Louisville, Ky.

In Idaho, Patterson sometimes finds himself clearing up misconceptions. Some parents will agree to a vitamin K shot when they find out it’s not a vaccine, for example.

These conversations can take time, especially since the parents doctors see in hospitals usually aren’t people they know through their practices.

But doctors are happy to invest that time if it might save babies.

“I end every discussion with parents with this: ‘Please understand at the end of the day, I’m passionate about this because I have the best interest of children in my mind and heart,’” Patterson said. “I understand this is a hot topic, and I don’t want to disrespect anybody. But at the same time, I’m desperately saddened that we’re losing babies for no reason.”

Ungar writes for the Associated Press.