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Seychelles is 60% vaccinated but infections continue to increase.  It’s not as bad as it sounds


But that was not enough to stop the spread of Covid.

At first glance, the fact Seychelles, with such high vaccination coverage, still faces an epidemic that questions whether countries can get vaccinated out of the pandemic.

However, experts and local officials say the outbreak in Seychelles is not a sign that the vaccines are not working.

Either way, the tropical nation reminds that even countries with high levels of immunization cannot let their guard down.

The situation in Seychelles

Just over a month ago, Seychelles was so confident with its handling of Covid-19 that it dropped restrictions for most tourists.

With few cases and a mass vaccination campaign underway, the tourism-dependent country reopened its borders to almost all international travelers, meaning anyone with a negative PCR test could enter the country without quarantine. . This was a crucial step for a country where tourism directly or indirectly generates around 72% of the GDP and employs over 30% of the population. At this point, the country had reported less than over 3,800 cases and 16 deaths.
Since then, the total number of cases has more than doubled to 9,184 cases and 32 deaths, according to health ministry figures released at a press conference on Thursday.

It is not known what led to the spread, although Sylvestre Radegonde, the Minister of Foreign Affairs and Tourism, said the virus was likely in the country from the start and had spread as the vaccination returned. more accommodating people. Improved contact tracing and testing has also helped authorities detect more cases.

Covid-19 cases reported daily

“In the last few months after vaccination, people have found that whoever is infected does not get seriously ill, that no one dies, that no one has a lot of complications,” he said. Islanders – who he says love to party – socialize without taking any precautions. “People have let their guard down.”

Seychelles relies on Sinopharm and Covishield made in China, AstraZeneca vaccine made in India. Of all those fully vaccinated, 57% received Sinopharm, which was given to people aged 18 to 60, while 43% took Covishield, which was given to those over 60.

About 37% of the positive cases from the week to May 8 had been fully vaccinated, the government said, although it has not released data on the vaccines they received. The government has not released data on the age distribution of patients with Covid-19.

About 20% of those admitted to hospital for treatment had been vaccinated, but their cases were not serious, the health ministry said on Monday. Almost none of the critical and serious cases requiring intensive care had been vaccinated, and no vaccinated person died from Covid-19.

Radegonde said Thursday that only two people in the country are in intensive care.

“The bottom line is that vaccines protect people. Those who have been vaccinated do not develop any complications,” said Radegonde. “We remain convinced that the vaccines – both – have helped the country. Things would have been worse.”

CNN has contacted the Seychelles Ministry of Health and the Health Care Agency for their comment.

What this tells us about vaccines

For some, vaccinated people who become ill with Covid seem to suggest that the vaccines are not working. But local authorities, experts and the World Health Organization (WHO) believe the Seychelles experience is broadly in line with expectations.

Although both vaccines have been approved by the WHO, neither vaccine is 100% effective against Covid-19 – AstraZeneca claims 76% effectiveness against symptomatic coronavirus disease and 100% effectiveness against severe or critical illness or hospitalization, while Sinopharm has a 79% effectiveness rate against symptomatic coronavirus or hospitalization, according to data from a large multi-country phase 3 trial.

Dr Richard Mihigo, program coordinator for vaccine-preventable diseases, WHO regional office for Africa, said data from Seychelles matched evidence that Covid-19 vaccines are very effective in preventing serious illnesses, hospitalizations and deaths.

“As long as everyone is not protected, there is no reason why the disease should not continue to spread,” he said in an email, adding that the teams of the WHO continue to review data, assess progress and understand trends in the country.

Michael Z. Lin, associate professor of neurobiology and bioengineering at Stanford University, said vaccine efficacy rates meant that about 20% of the population would still be susceptible to the virus, even though they were all vaccinated.

“It is no surprise that the virus will continue to infect some people, unvaccinated cases and some breakthrough cases of the vaccine,” he said.

But on the plus side, people who had been vaccinated appeared to be less likely to be hospitalized with Covid than those who had not been vaccinated, he said.

Of course, there are data gaps – crucial elements that would give us a better idea of ​​vaccine performance.

It is not known, for example, what proportion of positive cases Covishield has taken compared to Sinopharm.

It’s also unclear which variants are circulating or how widespread they might be. The Seychelles news agency reported last month that the variant first identified in South Africa occurs in Seychelles, but has not yet reported the Indian variant. Radegonde said it was possible that other variants were present, but limited genomic testing meant they had not yet been detected.
If the variant first identified in South Africa is widespread, this could impact the effectiveness of the vaccine. AstraZeneca has been shown to provide only ‘minimal protection’ against mild and moderate Covid-19 of the South African variant.

What does this mean for life after vaccination?

Seychelles recalls that even after generalized vaccinations, infections are unlikely to stop completely.

The available vaccines are able to reduce serious infections, although they may not confer sterilizing immunity – or full protection – against Covid-19, said Jeremy Lim, associate professor at Saw Swee Hock at National University of Singapore (NUS). School of Public Health.

“It’s just a reflection of our naivety or our stupid optimism,” he said.

But Cassie Berry, professor of immunology at Murdoch University in Perth, notes that the situation in Seychelles would not necessarily be reflected around the world.

Seychelles is 60% vaccinated but infections continue to increase.  It’s not as bad as it sounds
The rate of infection in those vaccinated would depend on a number of factors, including the type of vaccine they were receiving and the genetics of the population. Collective immunity would be achieved faster in countries using vaccines with a higher rate of effectiveness, she said. Pfizer, for example, has a critical illness efficacy rate of over 90%.

Lin said getting the vaccine was “more desirable” than being left unprotected and exposed to the 1% death rate from the disease. “The vaccines have been very effective in preventing death,” Lin added. “It certainly pays off to take whatever vaccine you can get, rather than waiting for something perfect.”

And Jennifer Huang Bouey, an epidemiologist at California think tank RAND Corporation, noted that not all countries have the opportunity to get one of the most effective vaccines, especially given the temperature supply chain. controlled required by some vaccines.

An edifying tale

Seychelles is a vaccine success story. But it’s also a cautionary tale that vaccines aren’t a panacea – and that countries need to be wary of new variants and transmission, Berry said.

“We all run for vaccinations, but we must always remember social distancing and fresh air and masks are very effective in preventing transmission,” she said. “I think it will simmer for a while.”

Bouey said public health professionals increasingly agreed that while vaccines are essential in mitigating Covid-19, they will not eliminate transmissions or epidemics.

“Covid is not going to go away suddenly. The most likely scenario is that the world will just have to live with Covid,” Lim of the National University of Singapore said.

Seychelles is 60% vaccinated but infections continue to increase.  It’s not as bad as it sounds

This is certainly the attitude in Seychelles, where tourism was devastated last year. With widespread vaccination, Radegonde said falling seriously ill from Covid was less of a concern – of greater concern was the impact that a higher number of cases might have on the economy.

So far, there has been no impact – around 500 visitors arrive each day, said Radegonde, the tourism minister.

“If the situation worsened to the point where tourists stopped coming, that would be a great concern,” he said. “The Seychelles remain open to visitors. We welcome everyone. We have absolutely no intention of changing that.”

Seychelles appears to have taken the view that Covid with minor symptoms is an acceptable price to pay.

But while it was good for Covid to circulate among their populations, countries needed to do more than just vaccinate, Lim said. This included adequate border control, widespread testing, and hospitals capable of dealing with outbreaks.

Lin of Stanford agreed, “You can’t just throw away the public health manual after you’ve immunized 60% of your population.”

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