Vaccines against Lyme disease: What happened and what lessons can we learn?

@article{Poland2011VaccinesAL,
  title={Vaccines against Lyme disease: What happened and what lessons can we learn?},
  author={Gregory A. Poland},
  journal={Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year={2011},
  volume={52 Suppl 3},
  pages={
          s253-8
        }
}
  • G. Poland
  • Published 1 February 2011
  • Biology
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
This article reviews events that led to the withdrawal of the only vaccine to prevent Lyme disease licensed in the United States. The primary issues that led to the vaccine's withdrawal appear to be a combination of vaccine safety concerns, sparked by a molecular mimicry hypothesis that suggested that the vaccine antigen, outer surface protein A, serves as an autoantigen and hence was arthritogenic; concerns raised by anti-vaccine groups regarding vaccine safety; vaccine cost; a difficult… 

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References

SHOWING 1-10 OF 24 REFERENCES
The Lyme vaccine: a cautionary tale
TLDR
In 1998, the FDA approved a new recombinant Lyme vaccine, LYMErix™, which reduced new infections in vaccinated adults by nearly 80%.
Recommendations for the use of Lyme disease vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP)
  • S. M. Hewitt
  • Medicine
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports
  • 1999
This report provides recommendations for use of a newly developed recombinant outer-surface protein A (rOspA) Lyme disease vaccine (LYMErix, SmithKline Beecham Pharmaceuticals) for persons aged 15-70
Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. Lyme Disease Vaccine Study Group.
TLDR
Three injections of vaccine prevented most definite cases of Lyme disease or asymptomatic B. burgdorferi infection in 10,936 subjects in areas of the United States in which Lyme disease is endemic.
Vaccination against Lyme Disease with Recombinant Borrelia burgdorferi Outer-Surface Lipoprotein A with Adjuvant
TLDR
Three injections of vaccine prevented most definite cases of Lyme disease or asymptomatic B. burgdorferi infection in 10,936 subjects in areas of the United States in which Lyme disease is endemic.
A vaccine consisting of recombinant Borrelia burgdorferi outer-surface protein A to prevent Lyme disease. Recombinant Outer-Surface Protein A Lyme Disease Vaccine Study Consortium.
TLDR
OspA vaccine was safe and effective in the prevention of Lyme disease and there was no significant increase in the frequency of arthritis or neurologic events in vaccine recipients.
Arthritis following recombinant outer surface protein A vaccination for Lyme disease.
TLDR
The potential arthritogenic effect of OspA suggested by in vitro and animal studies finds a clinical correlate in these 4 cases of males who developed arthritis following recombinant OSPA vaccination.
Autoimmune mechanisms in antibiotic treatment-resistant lyme arthritis.
TLDR
Molecular mimicry between a dominant T cell epitope of OspA and hLFA-1 may be an important factor in the persistence of joint inflammation in genetically susceptible patients with treatment-resistant Lyme arthritis.
...
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