The Seychelles is dropping its 10 day quarantine requirement for people who have been fully vaccinated against Covid-19. Passengers will still need a negative PCR test taken within 72 hours of travel.

Someone with a negative test, and that has been vaccinated, just isn’t going to be high risk. There are no guarantees but those two things taken together get close – close enough, at least, for countries that haven’t fully closed off throughout the pandemic (such that their entire population remains vulnerable) or that don’t have overwhelmed hospitals. Approaches to public health are always and everywhere about weighing competing risks and costs.

Vaccines aren’t guarantees, however the Pfizer and Moderna vaccines are nearly 100% effective against severe Covid in addition to being 94%+ effective against symptomatic Covid in Phase 3 trials. The AstraZeneca vaccine reported 100% effectiveness against hospitalization.

We don’t have enough proof yet that the Pfizer and Moderna vaccines reduce transmission but we’re beginning to get there. An Israeli study studies 102 vaccinated patients and found “that people who received both doses of the vaccine will most likely not become carriers of the virus and will not spread it further.”

We’ll see significant data on this in the coming weeks, according to BioNTech’s CEO, late January or early February. And let’s be clear: no one believes that these vaccines do not reduce transmission. They probably reduce transmission by a lot. We just haven’t had the data. Indeed, this week (before the new Israeli study, so not expressing a judgment about it):

Although no rigorous study has yet analyzed whether vaccinated people can spread the virus, it would be surprising if they did. “If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!” Dr. Paul Sax of Harvard has written in The New England Journal of Medicine. (And, no, exclamation points are not common in medical journals.)

Asymptomatic infection is likely reduced by vaccination, so asymptomatic spread is as well. Antibodies may not be as present in the lungs via a vaccine as in a recovered patient. Maybe vaccines aren’t as good at stopping spread then as having had the virus and recovered, although the Israeli study found more antibodies in those vaccinated than those who recovered from the virus. And we don’t yet know how long vaccination lasts (Moderna thinks it’ll be annual but is starting testing on duration now, with folks who participated in early trials).

By mid-March the Seychelles expects to have 70% of its citizens vaccinated and plans to drop quarantine requirements for everyone, not just those who have been vaccinated, although pre-travel testing is expected to remain.

Once about 70% of people have been recently vaccinated or confirmed to have had prior infection transmission should slow markedly. There isn’t nearly as many places the virus can go to infect people. Hospitals in most places shouldn’t face risk over becoming overburden such that they cannot provide proper care.

There’s been very little guaranteed during this pandemic. We’ve learned a tremendous amount quickly, and nearly everything remains tentative. Certainly viral mutations remain cause for concern, and the slow pace of vaccine rollout. The U.S. should approve the AstraZeneca vaccine now though this wouldn’t be a silver bullet.

However as bad as the next couple of months are going to be there’s a strong likelihood we’re approaching the end of the pandemic, but most governments will be slow to react to improving conditions. Travel restrictions will likely persist longer than necessary, whether outright bans or testing requirements.