For the past couple of years, I’ve been wondering why the Vet can vaccinate our dog for Lyme*, but the best our doctor can offer is a dose of doxycyline, ex post facto. Why is it, despite the spraying and tucking and checking out the nooks and crannies post-walk, a simple stroll on a glorious summer day is more of a health risk for humans than for their best friend? (And here in Western MA, it’s a big risk.) Why isn’t there a human Lyme vaccine? In part, there isn’t a human vaccine thanks to the anti-vax movement.
There was once a vaccine. I recall when my mother-in-law participated in a Lyme vaccine trial, we were living in Long Island at time. A hot-bed of Lyme, I remember parading my husband down the hallway of the Marine Science Research Center at Stony Brook, showing our colleagues the text-book bulls-eye rash spreading across his back. And I remember being hopeful for a vaccine. But, as it turns out the vaccine wasn’t perfect. It was only about 80% effective and required boosters, but, scientists agree, it wasn’t harmful. I assumed that its relatively low efficacy (compared with say, the inactive polio vaccine which has an efficacy of over 99% after three doses) led to its demise. But it turns out that was only one factor. The vaccine was also under pressure from the antivax movement and lawsuits by those who believed they were harmed by the vaccine. The Lyme vaccine, first offered in 1998, was pulled by the developer (GlaxoSmithKline) in 2002.
Back then, in 2002, having moved north to western Massachusetts we were snooty about Lyme. It was a “southern” disease; Long Island, Rhode Island, Connecticut. We stopped taking our kids to Rhode Island in the summer (my husband’s home state) because of Lyme. And I’d forgotten about the vaccine. We didn’t need one anyway. Our kids ran though the tall grass field behind our house with little worry. At that time in the late 1990s there were a handful of reported cases in our rural county. But now, a bit over a decade later there are hundreds of confirmed cases; possibly thousands of cases including those that were not confirmed. Lyme has become our problem too as one neighbor after another downs the doxycycline. According to the CDC confirmed cases in the U.S. as a whole have almost doubled since 1995. Concentrating along the mid-Atlantic coastal states, in 2015 it was declared an epidemic in our region. So, is there a vaccine in our near future?
Writes Gregory Poland, Director of the Mayo Vaccine Research Group about any hope for a new vaccine in a 2011 article: “it is important to note that few, if any, scientists believe the evidence points to any substantive safety concerns. Although multiple factors played a role, it appears that the anti-vaccine sentiment and class action lawsuits that resulted, will, in and of themselves, effectively hamper development of any further Lyme disease vaccine candidate in the United States.” *sigh*
And while there are some really cool new strategies to control Lyme that don’t involve vaccinating humans, even if those make it through the gauntlet of testing and then public opinion (some involve genetic engineering) they are years away.
Vaccination along with other medical interventions like antibiotics and other drugs is not perfect. Sometimes they are pushed ahead and then pulled for safety. But, there is no question that they save lives, prevent disease and dramatically change how we live and die.
So, if you think that those celebrities like Mr. Kennedy and Mr. Trump who sow distrust of vaccines won’t affect you, think again. Yes, you can choose to vaccinate but those who choose not to, not only contribute to a loss of herd immunity (the immunity we gain as a population by agreeing to be vaccinated – thereby protecting those who cannot be vaccinated) but they also may give pause to vaccine developers. And that will be our loss.
(If you are curious about what’s been killing us over the past century check out this visualization of death in the 20th century here And for more about the rise and fall of the human Lyme vaccine see here.)
*There is also plenty of controversy over the efficacy of the Lyme vaccine in dogs.