Can You Get Lyme Disease More Than Once?
Can you get Lyme disease more than once? Many patients assume that once they’ve had Lyme disease, they’re protected. But in clinical practice, repeat infections and recurring symptoms are common—and often misunderstood.
Short answer: Yes. You can get Lyme disease more than once. Limited strain-specific immunity may occur, but it does not reliably protect against future infections.
For a broader overview of how Lyme disease presents, see Lyme disease symptoms guide.
Why Lyme Disease Does Not Provide Full Immunity
Research suggests that some patients may develop partial immunity to a specific strain of Borrelia burgdorferi, the bacterium responsible for Lyme disease.
A 2014 study found that immunity to a particular strain may last several years. However, this protection is limited.
At least 16 different strains of Borrelia burgdorferi have been identified in the United States. This means a person can be reinfected if exposed to a different strain through another tick bite.
As a result, prior Lyme disease does not guarantee long-term protection.
Reinfection After a New Tick Bite
One of the most common explanations for getting Lyme disease more than once is reinfection.
Patients living in endemic areas may be exposed to ticks repeatedly. Even after successful treatment, a new tick bite can lead to a new infection.
Nadelman and colleagues described multiple patients who developed Lyme disease more than once, confirming that prior infection does not prevent future illness.
If you are concerned about repeat exposure, review Lyme disease prevention strategies.
Persistent Infection vs. Reinfection
When symptoms return, the cause is not always clear.
In some cases, symptoms may reflect reinfection. In others, they may be related to persistent infection or ongoing immune activation.
Studies in both animals and humans have found evidence that Borrelia burgdorferi may persist in some patients despite treatment.
However, this remains an area of debate, with some clinicians attributing symptoms to post-infectious mechanisms rather than ongoing infection.
To explore this further, see persistent Lyme disease overview.
Role of Co-Infections
Another reason symptoms may return is untreated or unrecognized tick-borne co-infections.
Ticks can carry multiple pathogens, including bacterial, viral, and parasitic infections. These co-infections can complicate diagnosis, delay recovery, and contribute to ongoing symptoms.
Examples include Babesia, Bartonella, Anaplasma, and others.
Learn more about Lyme disease co-infections.
Clinical Perspective
Patients often ask whether Lyme disease provides lasting immunity. While limited strain-specific immunity may occur, it does not prevent reinfection in real-world settings.
Recurrent symptoms may reflect new infection, persistent infection, or co-infections—each requiring a different clinical approach.
Understanding this distinction is critical, especially in patients with ongoing exposure to ticks or unexplained symptom recurrence.
Editor’s note: This article is part of the Ask the Lyme Doc series. For transparency, I am an author on the International Lyme and Associated Diseases Society (ILADS) treatment guidelines and believe that symptoms in some patients may be related to persistent infection.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
About 30 years ago, after 1- 1/2 years I was diagnosed with Lyme disease. I took all the antibiotics and other than some loss of sight lung damage and arthritis I was fine. Until last November when I was diagnosed with an enlarged nodule on my parathyroid. I finally had the surgery in March to remove it. Everything went back to normal but I’m not. While waiting to undergo surgery I Iost over 22% of bone density. With all the leeching of my calcium out of my bones, teeth and brain is it possible that I disturbed any Lyme disease that may have been in crevices of my brain? I am back to all the same Lyme symptoms . My infectious disease doctor told me you never really get rid of all of it. Worst is the sweating. My Dr. said my body is going through menopause again. I have had vertigo since before surgery, now it’s much worse. Sorry this was so long. I was trying to be thorough.
I am sorry to hear how challenging your years has been. I have patients who have benefited from retreatment and some that don’t. You might find it interesting to read about Babesia, a tick borne illness that can mimic menopause and cannot be treated with doxycycline. read https://danielcameronmd.com/sweats-may-be-a-sign-of-babesia/
10 Years ago at age 53, I had Lyme disease and began to feel the benefits of the first dose of antibiotics litterally with in the first hour.
The symptoms had been severe, all my joints felt painfully arthritic, and I was floored with a severe flu and headaches.
In 4 days of antibiotics I was symptom free.
I finished out the full 21 days of antibiotics and never looked back…
This year, at age 63, I had five ticks on my hips, colarbone and back.
The ticks went unnoticed for two days as I now wear glasses and didn’t notice them.
Having the time to drill in and Transfer the bacteria overtime seems to be a key factor at least for me. It has been in disease severity.
Three of the ticks caused the classic bull’s-eye redness pattern, and the other two ticks made a bright red blotch around their Bite.
My doctor put me on antibiotics before any symptoms showed. At first side effect reactions to the antibiotics, but then I realized that all of my complaints were the symptoms of Lyme disease.
Looking at the list, it was nearly every single symptom. I realize that there are 16 to 18 different strains of the Lyme bacteria and my impression is, I may have gotten five new strains into my body.
This infection has been very severe, every single symptom on the checklist, especially horrible arthritic like joint pain fluttering in my heart, including a mini stroke and hypersensitivity to where every invasion into my body over the last five or six years, was painful from cavities filled in my mouth to my repaired hernia operation, which has never given me problems. Even the stent I had put in my heart five years ago had pain, hurt.
Even fire ant bites over the last few years although long healed, all hurt again it was as if the bacteria woke up every injury to my body for the last five years…
At one point, my left knee locked up and I’ve never had a knee problem in my life, and I stretch my knees along with my whole body every morning and every night for most of my life… I have played many years of sports and have always continued stretching in all the off-seasons.
Every stretch hurt. I never did have a fever or any flu like symptoms with this second infection,but every other symptom was a big checkmark.
At one point, my doctor prescribed a steroid for me and that helped my knee to feel better, and I honestly do feel like I get slightly better every day but at this rate it may take years.
At a follow up visit with my doctor I asked “now after the antibiotics and steroids, what am I supposed to do just continue suffering ?” and she said no you get better, but some people get better in weeks and some people in months and some people have long-haul symptoms for years and everybody’s different so far after a few months, I am at least in the months category. I hope not the years.
I wish there would be more research done on this horrible disease, but I can share this: whenever I go hiking it is my custom to spray insect repellent around my legs just above my knees to keep ticks from climbing up and then I also pick up my shirt and spray on my skin on my stomach, so that if the ticks get past the first layer of inspect spray, they will hit the next layer at my skin, but on the last day of my recent hiking up in the northeast, I said to myself, I don’t need that poison on my skin. I’ve had no ticks the first few days – oh boy was I wrong, I really needed that poison on my skin because these five ticks have done serious damage to me.
I hope to recover but it isn’t happening quickly – as I’m writing this from the hospital where I had a mini stroke last night and the doctors saying it could have been triggered by blood clots created by Lyme disease…
I sincerely hope that successful work is done on the research and treatment of Lyme disease as I hear horrible stories about it – Good luck to you if you get Lyme disease…