Seychelles COVID-19 surge: Are vaccines not working in world's most vaccinated country?

The world's 'most vaccinated country' Seychelles has been witnessing a rapid surge in COVID-19 cases raising doubts about the effectiveness of coronavirus vaccines. With more than 60 per cent of its population fully vaccinated, Seychelles set an example for everyone when it began to offer free vaccinations early this year. However, the island nation is once again facing the brunt of the deadly pandemic as it witnessed a renewed surge of infections.

Despite the best efforts to inoculate its people, the island nation in the Indian Ocean reported the highest number of COVID-19 cases per capita the last week. The Health Ministry of Seychelles said on May 10 that the number of active cases had more than doubled since last week to 2,486 people. More alarming is the fact that 37% of these cases are the people who received two vaccine doses.

COVID-19 vaccination in Seychelles

With a population of less than 100,000 people, Seychelles has reported nearly 8,000 COVID-19 cases since the start of the pandemic. Seychelles' economy largely depends on tourism and the island nation started an accelerated vaccination drive in January with the hope to get back to normal soon. However, the seven day rolling average of positive cases increased from 120 on April 30 to 314 on May 8 raising alarms.

Nearly 62.2% of its population has received at least two doses of coronavirus vaccines so far. Nearly 57% of those who were fully inoculated received China-made Sinopharm shots while the rest were administered Covishield, a vaccine made in India under a license from AstraZeneca Plc. Speaking on the increase in cases despite vaccination, the World Health Organization has said that vaccine failure in Seychelles couldn't be determined without a detailed assessment.

In February, the country reported a case of the B.1.351 variant, first identified in South Africa late last year. AstraZeneca's vaccine appeared to be less effective against that variant in a study, and South Africa halted plans to use those injections.

Are vaccines working?

A large Phase III trial of Sinopharm has shown that two doses, administered at an interval of 21 days, have an efficacy of 79% against symptomatic infection, 14 or more days after the second dose. AstraZeneca said in March its COVID-19 vaccine was 76% effective.

Of those cases, 84% are Seychellois and the rest are foreigners, Daniel Lucey, Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, said in a blog post. Just under two thirds of those are either unvaccinated or have only had one dose, and the rest have had two doses, he said. "A comparison between Sinopharm, Covishield, and unvaccinated infected persons” could be done using genetic sequencing and data on the severity of their infections, a Clinical Professor of Medicine Dr. Daniel Lucey said in a blog post.

“Given the widespread international use of these two vaccines there are global implication to what is happening now in the Seychelles e.g., international travel, mass gatherings events whether religious, musical, or the Olympics,” he said. “The variant B.1.351 or a novel variant must be ruled out ASAP by large-scale genetic sequencing,” Dr. Lucey added.

Amid widespread doubts over vaccine effectiveness, President Ramkalawan said the vaccine is effectively helping to protect people from getting sick. He noted that the two vaccines that the country has administered have served the population very well. However, the health ministry statement said but “the rate of transmission remains high and is of concern”.

"People may be infected but they are not sick. Only a small number are. Isn't this how the vaccine is supposed to help us? So, what is happening is normal," he said.

WHO on COVID surge in Seychelles

WHO is closely following the situation in the Indian Ocean nation and on May 11 said that it was reviewing coronavirus data from Seychelles. Both the ministry and the WHO stressed that the majority of those who tested positive had not been vaccinated or had only received one dose. The health ministry of the island nation also no one who had died was fully vaccinated and that nearly all severe or critical cases were unvaccinated. 

Earlier on several occasions, the WHO had warned that vaccination alone would not stop transmission entirely, and preventive health measures such as social distancing, mask-wearing and hand washing must continue.

COVID surge in Seychelles worse than India

On May 7, the country's active coronavirus cases doubled raising concerns that inoculation is not helping turn the tide in some places. Seychelles this week reported the highest number of COVID-19 cases per capita. While India has not even 3 per cent of its population fully vaccinated, the island nation's total inoculation is more than 60%. According to Our World in Data, the latest rolling 7-day average for daily new COVID-19 cases per capita in Seychelles is more than twice India’s.

With the alarming rise in infections recently, the country has announced new measures, including shutting down schools and cancelling sporting activities. Seychelles’ Health Minister Peggy Vidot told a press conference that the COVID-19 situation in the country is critical despite all the “exceptional efforts”. The mandate also bans weddings and other gatherings of more than four people; cancels in-person meetings, conferences and sporting events; and require shops, bars and casinos to close at 7 p.m.

Tourists can still visit Seychelles

In March, the tropical paradise lying off the east coast of Africa opened borders to international travellers even as other countries continued to keep borders closed. Currently, anyone visiting the country must provide proof of a negative PCR test result received no more than 72 hours prior to arrival. While it is not mandatory for the visitors to be vaccinated, a health authorisation form has to be filled up along with proof of travel insurance. There is no minimum stay or quarantine requirements and travellers can stay in any certified hotel.

Maldives facing similar surge

As the cause of the surge in cases in Seychelles is yet to be determined, it is not the only country that is facing a rise in cases despite inoculation. The Maldives has also been seeing a rise in fresh cases. The country has the most new cases per 100,000 people and active cases jumped from 4,978 to 9,423 on May 9. The Maldives has so far inoculated 35% of the population with two shots of vaccine using Sinopharm and Covishield. As of May 8, over 300,000 people in the Maldives had received at least one dose of a vaccine, according to the Health Protection Agency.