To Your Health
Vaccine for Lyme Disease

by Paulette Avery, R.N., M.S.N.

A day working in the garden could be all it takes to get Lyme disease, a chronic and potentially debilitating disease contracted through a tick bite. California is among the states categorized as moderate risk for Lyme disease.

Earlier this year, LYMErix, a vaccine developed and manufactured by SmithKline Beecham, was approved by the FDA for use in people between 15 and 70 years old to protect against Lyme disease. If you are considering vaccination with LYMErix, here is information to help with your decision.

The vaccine is given is three doses, the first two a month apart and the third a year after the first. However, recent studies indicate the vaccine may be just as effective administered in a three-month period as when given over a year. Clinical trials show the vaccine to provide effective protection in 78 percent of cases after all three doses, and 50 percent after the first two doses. The FDA also says the timing of the final dose may be important. The highest efficacy appears to occur when the final dose of LYMErix is given between January and April, the period just before the tick population in the northeastern US reaches its peak.

Clinical trials on the use of LYMErix on children are currently underway, but for now it is not approved for anyone under 15 or for pregnant women. To date, people who received the vaccine have been followed for just 20 months, so how long protection will last is not yet known. Safety tests in the 20,000 people vaccinated with LYMErix indicate it is very safe, but the manufacturer continues to study safety issues, and the FDA says further clarification is needed in this area. Common side effects from LYMErix include soreness, redness and swelling at the injection site, and mild to moderate flulike symptoms. Since not all insurance companies currently pay for the vaccine, cost may be a factor in your decision-making. Each injection costs $70, for a total of $210.

Based on the information I have read, I m not going to run right out for the vaccine. It is recommended for people in areas with a high risk of the disease, and California doesn t fall into that category. Additionally, to begin the shots this late in the year would provide minimal protection during the summer months, when the risk of tick exposure is highest. If you engage in activities that put you at higher risk, I would discuss the issue with your doctor. Meanwhile, and even if you do receive the vaccine, using other precautions remains wise.

When you can, avoid tick-infested areas, especially during May, June, and July, when the poppy seed-sized immature deer ticks are most prevalent. Wear light-colored clothing (making it easier to spot the ticks) that is tight around the wrists and ankles, and spray your clothing with DEET or with the insecticide permethrin. Walk in the center of trails to minimize contact with ticks from brush and overhanging trees.

When you are back inside, check yourself for ticks. If possible, have someone help with this process, checking your back or other areas hard for you to see. If you find any ticks, remove them with tweezers. Avoid squeezing the tick s body during removal by grasping as close to your skin as possible and pulling the tick straight out. Since a tick must be attached to you for about 48 hours to transmit the disease, prompt removal can prevent Lyme disease.

Paulette Avery is a registered nurse and a freelance writer specializing in health issues.