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A new vaccine against Lyme disease was approved by the FDA in December 1998 and is now available.

Lyme disease is the most common disease spread by insects in the United States. More than 16,800 cases were reported in 1998 which is an increase of 70% since 1992. More than 90% of cases occur in the northeast and north central states, including northwestern and westcentral Wisconsin.

The disease is caused by the organism Borrelia burgdorferi transmitted only through bites of infected Ixodes (deer) ticks. Peak activity is reported from April through July. Ticks must remain attached to the skin for at least 24 to 48 hours in order to transmit the infection.

Lyme disease is not contagious and can not be transmitted from infected people or animals. Early Lyme disease usually presents with one or more symptoms such as the characteristic "bull's-eye" rash (erythema migrans), fever, fatigue, muscle or joint aches. However, not all cases are symptomatic. Untreated infection can cause symptoms that occur months or years after the initial exposure. These late manifestations of Lyme disease include arthritis and neurological symptoms that may mimic other diseases. At any stage, the disease can usually be treated successfully with antibiotics.

Measures to prevent infection include avoiding tick habitats, use of protective clothing, applying tick repellents, and frequently checking for and promptly removing any attached ticks.

Vaccination is indicated for persons aged 15-70 years with frequent or prolonged exposure to ticks in geographically infected areas. For individuals with only brief or occasional exposure to areas where Lyme disease occurs, the benefits of vaccination compared to early diagnosis and treatment are not clear.

For those individuals who desire vaccination, a series of three injections is required. The initial dose is followed by a second in one month and a third in one year. The vaccine series ideally should be started in February or March so that the second and third doses can be given before the peak transmission season.

In clinical trials the vaccine was 50% effective in preventing symptomatic Lyme disease after two doses and 78% after all three doses were received. The vaccine was 100% effective in preventing asymtomatic infection after three doses. Side effects are usually mild and consist of local reactions to the injection and occasional fever, muscle aches, or flu-like symptoms. The duration of protection from the vaccine is unknown at this time and the need for booster doses has not been determined but will probably be required to maintain immunity.

The safety and efficacy in children under age 15 or in pregnant women has not been evaluated. The vaccine contains the outer surface protein (OspA) of the organism that causes Lyme disease and is manufactured through a genetic engineering process, containing no substance of human or animal origin. There is no risk of contracting Lyme disease from the vaccine. The vaccine works via a unique mechanism to prevent infection.

After vaccination, high levels of antibodies develop in the recipient. When a person is bitten by a tick, these antibodies then enter the tick and kill any infectious organisms within the tick before they can be transmitted into the victim's body and cause disease. Therefore, the vaccine is effective for preventing disease but cannot be used for treatment after infection occurs.

Patients who previously have been infected with Lyme disease can be safely vaccinated to prevent a second infection if they remain at risk for disease exposure. Prior infection does not confer long-term immunity to protect against subsequent infection.

The vaccine, called "LYMErix," is manufactured by SmithKline Beecham.

Editorial Note: Since LYMErix was introduced thousands of people have received the vaccine with no adverse reaction, however some people have experienced serious side effects. To learn more talk with your doctor about the risks.

Click on the map for a view of national risk factors.

Updated 8-5-2001

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