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The Lyme Disease Vaccine: Conception, Development, and Implementation

Wendy Todaro Thanassi, MA, MD; and Robert T. Schoen, MD
[+] Article, Author, and Disclosure Information

From Yale University School of Medicine, New Haven, Connecticut.

Requests for Single Reprints: Wendy Todaro Thanassi, MD, Section of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, New Haven, CT 06519.

Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Thanassi: Section of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, New Haven, CT 06519.

Dr. Schoen: Section of Rheumatology, Department of Internal Medicine, Yale University School of Medicine, 60 Temple Street, Suite 6A, New Haven, CT 06510.

Ann Intern Med. 2000;132(8):661-668. doi:10.7326/0003-4819-132-8-200004180-00009
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In the past 20 years, remarkable strides have been made toward understanding and preventing Lyme disease in humans. In December 1998, the U.S. Food and Drug Administration approved a recombinant outer surface protein A vaccine against Lyme disease (LYMErix, SmithKline Beecham, Philadelphia, Pennsylvania). The vaccine, which is derived from a lipidated outer surface protein of the causative spirochete Borrelia burgdorferi, is important because it may decrease the morbidity and financial costs associated with Lyme disease. Its mechanism is unique because it works inside the tick vector itself, preventing the human from becoming infected.


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Figure 1.
Number of reported cases of Lyme disease in the United States, 1982-1997.

Adapted from the Centers for Disease Control and Prevention.

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Figure 2.
Levels of antibody to the protective epitope of outer surface protein A (LA-2-equivalent antibody in vaccine recipients) over time.(63)

Arrows indicate month of primary immunization given. Error bars represent 95% CIs. Adapted with permission from Steere et al. .

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Figure 3.
Reverse cumulative curve of LA-2-equivalent antibody levels at month 2.(63)

Dashed-and-dotted lines indicate 20 vaccinated persons with breakthrough cases of definite Lyme disease; dashed lines indicate 512 vaccinated persons in whom Lyme disease was not confirmed at year 1; solid lines indicate 395 vaccinated controls. Adapted with permission from Steere et al. .

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