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Lyme Disease Vaccines

Pierce Gardner, MD
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State University of New York at Stony Brook; Stony Brook, NY 11794-8432 Requests for Reprints: Pierce Gardner, MD, Health Sciences Center, Level 4, Room 157, State University of New York at Stony Brook, Stony Brook, NY 11794-8432.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(7):583-585. doi:10.7326/0003-4819-129-7-199810010-00015
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Lyme disease is the most common tick-borne disease in the United States; 16 455 cases were reported in 1996 [1], and the actual incidence may be 10-fold higher [2]. In areas with a high incidence of Lyme disease, the licensing of vaccines against the causative spirochete, Borrelia burgdorferi, has been anticipated with great enthusiasm by the medical community and the general public. Two recombinant vaccines, each containing 30 µg of outer surface protein A (OspA), are in the final stages of approval by the U.S. Food and Drug Administration (FDA). The SmithKline Beecham product (LYMErix) contains an aluminum adjuvant, whereas the Pasteur Merieux Connaught product (Imulyme) does not. In studies in adults, 96% of participants showed a fourfold increase in antibodies against OspA antigen 2 weeks after receiving a second dose of either vaccine [3], although clinical trials have indicated that a third dose is necessary to further boost antibody levels and provide a protective efficacy of more than 80%. Diminished efficacy was noted in persons older than 65 years of age [45].

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