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The most vaccinated country in the world is seeing a COVID outbreak. Should the Bay Area be worried? – San Francisco Chronicle

Over the past two weeks, Seychelles — which has been dubbed “the most vaccinated country in the world” — has seen a spike in coronavirus cases, causing alarm and panic even among Americans who live more than 10,000 miles away.

The archipelago in the Indian Ocean, with a population of about 98,000, has fully vaccinated more than 60% of its population, but it’s also seen its number of active COVID-19 cases nearly double over the past month. The country has closed schools and canceled activities to attempt to curb the spread.

If a country with such a high vaccination rate can still see a COVID outbreak, what does that mean for even the highly vaccinated Bay Area?

Infectious disease experts say that, though it’s worrying in a global context, what’s happening in Seychelles underscores how effective the Bay Area vaccination rollout has been.

Poor or unreliable vaccines

Though Seychelles has been called the world’s “most vaccinated country,” not all vaccines are created equal.

The country used two vaccines to inoculate its population — Sinopharm, a Chinese state-owned vaccine, and Covishield, a version of the AstraZeneca vaccine, both of which have not been proven to be as effective as the Pfizer-BioNTec and Moderna vaccines primarily used in the U.S.

Just last week, the WHO expressed “very low confidence” in data provided by Sinopharm around its risk of severe side effects. Recent clinical trial data found the vaccine was about 78.1% effective after two doses, but the Seychelles outbreak could suggest that the efficacy is less than that, said UCSF infectious disease expert Peter Chin-Hong.

Data also found that the AstraZeneca vaccine may be less effective at reducing symptomatic COVID-19 than the Pfizer and Moderna vaccines. Clinical trials found it to be about 66.7% effective, compared to the 97% efficacy of the Pfizer vaccine.

“From the perspective of an American, I’m not particularly worried,” said UC Berkeley infectious disease expert John Swartzberg. “The reason why is we’ve seen the U.S. demonstrate how well these vaccines do to protect us.”

Places like Seychelles also didn’t see huge COVID surges earlier in the pandemic, and have lower levels of natural immunity in their communities.

Chile is another example of a country with a high vaccination rate that now is seeing a spike in COVID-19 cases. Its number of new daily cases nearly doubled in April from the prior month, even though the country has vaccinated more than 45% of its population, according to Reuters.

But the country’s experience is another example of the importance of nuance when it comes to saluting vaccination efforts. The main vaccine used among Chileans was Sinovac — another Chinese vaccine — and data shows it may be even less effective than Sinofarm. The country released its own study of the Sinovac vaccine and found that it was only 16% effective in preventing infection, and 36% effective at controlling hospitalizations after one dose, Bloomberg reported.

CDC data has found that even after one dose of Pfizer, the risk of infection fell by 80% after two weeks, which aligns with the Bay Area’s relative success in squashing COVID-19 so far. On Thursday, San Francisco General Hospital reported zero COVID patients for the first time since March 2020.

Variants

Aside from being less effective at controlling COVID-19 infections, both vaccines used in Seychelles are overall less equipped to handle some of the variants that the country is seeing rapidly spread, including B.1.617, the variant discovered in India. It is thought to be even more transmissible than the highly infectious variant discovered in the U.K., B117, which is now dominant in the U.S.

But even still, Chin-Hong says, most cases in Seychelles are likely in people who are not yet vaccinated, or at least fully vaccinated.

“None of these factors are independent, but they all work together, and you kind of get the perfect storm when you get a highly transmissible variant, a not effective vaccine, and not enough people immunized,” he added.

Still, it’s important to distinguish case counts from serious side effects. Most people who are getting infected with the coronavirus in Seychelles aren’t having serious symptoms, and most of them aren’t dying.

That’s very different from what’s happening in India, which is dealing with a deadly combination of low vaccination rates, excessive crowding, and other systemic issues that make it harder to treat people who are ill, Chin-Hong said.

“That’s the reason why it’s just a moral and humanitarian catastrophe,” he said. “It’s a syndemic. Add disparities and social ills onto a pandemic and you get much worse things happening.”

“The world in 2021, because of the variants, is a very different world than 2020,” Chin-Hong said, adding that unvaccinated people who travel internationally will be playing virus Russian Roulette.

On the other hand, for those who have been vaccinated, even some of these much-talked about variants don’t seem to pose huge issues. “Every one that exists currently responds well to our vaccines,” said Swartzberg.

But the Bay Area, California, and the U.S. are not islands, he added. With more holidays and summer coming up, people are going to be traveling more — and they already have, which of course could impact the situation on both sides of the Atlantic.

“If I want to worry about something, I’m worried about the unknown variant that hasn’t been produced by the virus,” Swartzberg said. “Not one that exists currently. The best way to prevent that from happening is to get everyone on the planet vaccinated.”




Annie Vainshtein is a San Francisco Chronicle staff writer. Email: [email protected]

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