Potential barriers to accepting a Lyme disease vaccine

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Welcome to another Inside Lyme Podcast with your host Dr. Daniel Cameron. In this episode, Dr. Cameron discusses the potential barriers to the public’s acceptance and utilization of a Lyme disease vaccine.

The study, “Understanding consumer and clinician perceptions of a potential Lyme disease vaccine,” was published by Devchand and colleagues in the journal Health Education Research.¹

It has been two decades since the LYMErix vaccine for Lyme disease was withdrawn from the market by the manufacturer, GlaxoSmithKline Pharmaceuticals after poor sales.

Why is it taking so long for another vaccine to become available?  Several factors have been mentioned including: complex recommendations for the use of the vaccine; the lack of approval for the use of the vaccine in children, the group at highest risk; unvalidated claims of the vaccine causing Lyme arthritis and the coincident rise of general anti-vaccination sentiment among the public.”

CLICK HERE TO WATCH A VIDEO DISCUSSING POTENTIAL BARRIERS TO A LYME DISEASE VACCINE

The authors conducted 9 online focus groups which included consumers and 30 in-depth interviews among clinician groups.

The LYMErix vaccine was effective at preventing a rash but only 50% effective at preventing chronic manifestations of Lyme disease.

“Individuals who strongly disagreed with the importance of vaccines in general were excluded from the study to minimize skewed opinions that may not reflect the opinions of the general population,” the authors wrote.

They point out that their findings may not be generalizable. Nevertheless, the participants in the survey raised several potential barriers to accepting a Lyme disease vaccine.

Several of the clinicians’ concerns included:

• “A quarter of the clinicians argued that a Lyme disease vaccine would be less important than other routine vaccines because Lyme disease can be prevented through other measures, cannot be transmitted person-to-person, is not widespread throughout the United States and has a lower disease burden than other vaccine-preventable diseases.”
• “The most commonly presumed barriers to vaccine uptake were patient concerns about cost and safety and anti-vaccine sentiment.”
• “Five clinicians expressed concern that a vaccine might promote a false sense of security against Lyme disease and other vector-borne diseases.”

The consumers also raised several potential barriers to accepting a Lyme disease vaccine. Below are a few of the consumers’ concerns:

• “Four consumers expressed concerns about side effects, with most others assuming it would have minimal risks. Three consumers suggested that potential side effects may make a vaccine more risky than other preventive behaviors.”
• “Four consumers shared that they prefer to avoid vaccines in general. Two consumers also mentioned generally that anti-vaccine sentiment in their communities might be a barrier for vaccine acceptance more broadly.”
• “Two consumers mentioned that the vaccine could create a false sense of security among recipients if the vaccine was not completely protective against Lyme disease.”

One in three of the consumers were undecided about getting a Lyme disease vaccine for either themselves or a family member.

Survey Limitations

The participants were not asked to review the safety and efficacy of the LYMErix vaccine or a future vaccine. The LYMErix vaccine was effective at preventing a rash but only 50% effective at preventing chronic manifestations of Lyme disease, according to the LYMErix package insert.

It is not clear from the survey whether the clinician and consumer participants reviewed what they referred to as “unvalidated claims of the vaccine causing Lyme arthritis.” It is also unclear how to generalize their results, as the investigators excluded “Individuals who strongly disagreed with the importance of vaccines in general.” Finally, it is unclear whether the authors informed the participants that a Lyme disease vaccine would not protect a person from a co-infection.

The following questions are addressed in this Podcast episode:

1. What was the LYMErix vaccine based on?
2. What were the benefits and problems with the LYMErix vaccine?
3. What was your experience with the LYMErix vaccine?
4. Why would a Lyme disease vaccine be helpful?
5. What new vaccines have been introduced?
6. Do you agree with the participants concerns with a Lyme disease vaccine?
7. Is there a vaccine for co-infections?
8. How important would it have been to include participants who strongly disagreed with the importance of vaccines?

Thanks for listening to another Inside Lyme Podcast. Please remember that the advice given is general and not intended as specific advice to any particular patient. If you require specific advice, please seek that advice from an experienced professional.