Lyme Vaccine: Current Status

Abstract

Rheumatology| November 01 2000 Lyme Vaccine: Current Status AAP Grand Rounds (2000) 4 (5): 50. https://doi.org/10.1542/gr.4-5-50 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Lyme Vaccine: Current Status. AAP Grand Rounds November 2000; 4 (5): 50. https://doi.org/10.1542/gr.4-5-50 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: lyme disease vaccine, lyme disease Source: Thanassi WT, Schoen RT. The Lyme disease vaccine: conception, development, and implementation. Ann Intern Med. 2000;132:661–668. The article by Thanassi and Schoen summarizes 2 large studies of Lyme vaccine1,2 in which over 20,000 participants were vaccinated. The efficacy rate for both trials approached 90% in preventing Lyme infection. There were minimal side effects—mainly tenderness at the injection site (81% of participants). The autoimmune side effects (worsening arthritis or some other exacerbation of Lyme infection) which are theoretically possible with the introduction of a foreign substance have not shown up in vaccinated patients. Currently, the vaccine is recommended for individuals age 15–70 who are at high risk for Lyme Disease (ie, those who live, work, or play in areas that are at high or moderate risk for the disease and those who engage in activities that result in frequent or prolonged exposure to tick-infested areas.) This is a helpful review of the Lyme vaccine. Lyme disease in the United States is caused by the spirochete Borrelia burgdorferi that is carried by the tiny Ixodes tick. Currently licensed Lyme vaccine contains a recombinant preparation of the protein OspA produced by the spirochete. Individuals who have received 3 doses of the vaccine produce high titers of antibody to this protein. OspA is produced by the spirochete during the time that it resides in the mid-gut of the host tick. When the tick feeds, the organisms are transferred to the tick’s salivary gland where they are warmed to 37°C and the expression of OspA is downregulated. Thus OspA antibodies seem to inactivate the organisms when they are still inside the ticks so they are no longer infectious. Trials for this vaccine are currently taking place in Europe3 and US pediatricians are already being asked to administer it to their patients by anxious parents. Although the efficacy and side effect profile of the currently available OspA vaccine looks appealing, it should be remembered that there are still problems with this approach to prevention: Despite the success rate in adults, it appears, based on the risks and benefits outlined in this review article, that we need to keep the Lyme vaccine in tow (or is that tow the Lyme) when it comes to recommending it as a good prevention strategy for children. You do not currently have access to this content.