COMMENTARY

A Call for a Lyme Disease Vaccine

Paul G. Auwaerter, MD

Disclosures

May 22, 2018

The Centers for Disease Control and Prevention (CDC) recently released a report highlighting that vector-borne illnesses are on the rise.[1] Data from 2004 until recently suggest that there has been a threefold rise in the number of vector-borne diseases.[2] This increase was mostly in the tick-borne infection Lyme disease and the infection caused by the mosquito-borne Zika virus, resulting in more than 600,000 cases and nine newly discovered infectious pathogens. So, as our molecular techniques for diagnosis improve, we are finding more explanations to account for insects and arachnids (such as ticks) that spread disease to humans.

From a public health perspective, CDC emphasizes that people should be more aware of the risk for vector-borne diseases and take personal protective steps (using DEET, doing tick checks of their skin, etc.). However, with the increase in the number of infections, I agree with Stanley Plotkin, who argues that one of our biggest public health fiascos is that we don't have an effective vaccine on the market for Lyme disease.[3] An estimated 300,000 cases occur yearly in the United States alone.[4,5] Some of those patients, despite antibiotics, do not sufficiently improve and have persistent symptoms. Given the impact—both acute and long term—of Lyme disease, developing a Lyme disease vaccine is really a public health priority. I'm hoping the CDC's report stimulates interest in a vaccine.

An earlier Lyme disease vaccine was withdrawn from the market because of poor sales. It was an effective vaccine but it required multiple shots. There were also some concerns (that were never truly proven) about side effects that accounted for low sales.

But now the time is right. We need to help pharmaceutical industries understand that a vaccine would be well embraced. We also must help our regulators and politicians understand that resources need to be devoted to this effort.

There are certainly other worthy candidates for vaccines. For example, we need an effective Zika vaccine to prevent transmission in people living in high-risk areas, including transmission across the placenta to the fetus, where it can cause congenital disease.

Lyme disease has been festering for a long time.[6,7] I truly hope that we can help speed the development of a vaccine. We need something in our offices to give people comfort that we are doing all we can to prevent what is now the most common vector-borne disease in North America. Thanks very much for listening.

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