Vaccination Against Lyme Disease
Source: Steere AC, et al. N Engl J Med 1998;339:209-215.
More than 10,000 new cases of lyme disease are reported to the CDC annually, making it the most common vector-borne disease in the United States. Impracticality of vector control has motivated development of effective vaccine therapy. A vaccine based upon outer surface protein A (OspA) of the Borrelia burgdorferi spirochete has already been shown to be effective in preventing infection in animal studies. This report details results of a double-blind, randomized trial of an OspA vaccine in humans (n = 10,936) who reside in states in which Lyme disease is endemic. Immunizations were given at time zero, one month, and 12 months later.
In the first year, vaccine efficacy was 49%, but study subjects had only received two injections during that period. In the second year, efficacy increased to 76%. Subjects in whom the vaccine was not effective were found to have significantly lower antibody titer responses to the vaccine. Corroborating the role of high antibody titers is the demonstrated significant rise in efficacy of the vaccine after the anamnestic boosting dose in month 13, which resulted in a substantial increase in vaccine efficacy. Vaccine therapy is a useful tool in preventing Lyme disease.
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