Dr. Keith Roach: Lyme disease vaccine's disappearing act

Dr. Keith Roach: Lyme disease vaccine's disappearing act

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Dear Dr. Roach: I moved to the Northern California mountains about 17 years ago. There was much discussion about Lyme disease at that time. My husband and I decided, since we were surrounded by tick-carrying deer, that we should take all precautions. There was a vaccine available, given in three separate doses. We learned that our insurance company would pay for the vaccine, and we received the injections.

Lately I have come to realize that this vaccine disappeared some time ago. It is like it never was. The elderly physician who administered it is long gone. No one has heard of it. I can't find references to it. So, do you know anything about this treatment? What was wrong with the vaccine? Is there some unseen disaster lurking? I would appreciate any information you can give me.

-- C.J.

A: There was a Lyme disease vaccine (LYMErix, made by what is now GlaxoSmithKline) marketed in the U.S. from 1998 until 2002, and another (ImuLyme) that was never licensed. The vaccine had some issues. It was estimated to be about 75 percent effective against symptomatic Lyme disease and 100 percent against asymptomatic disease. The duration of effectiveness wasn't (and still isn't) known, and booster shots were thought to be possibly necessary. There also was a relatively high rate of side effects to the vaccine (27 percent had local reactions, and 19 percent had systemic reactions).

Another concern was whether the vaccine might cause an auto-immune arthritis, based on theoretical concerns of an antigen used in the vaccine. There certainly were people who developed arthritis after getting the vaccine. However, follow-up studies showed that there was no overall increase in the rate of arthritis among those who got the vaccine, compared with people who did not. This suggests that the number of cases caused by the vaccine is low.

Because of the concerns for arthritis, multiple lawsuits and poor sales of the vaccine, the manufacturer stopped production in 2002 and Pasteur, the manufacturer of ImuLyme, decided not to attempt to license its vaccine, despite having higher effectiveness in early trials.

There is a Lyme vaccine available for dogs, and I have read reports of people, desperate to reduce susceptibility to Lyme disease, using the canine vaccine (this is a bad idea). A new human vaccine is being developed by Baxter and tested in Europe; so far, there have not been major adverse events reported. The antigen used in the previous vaccine, thought to have potential to cause arthritis, has been removed from the Baxter vaccine. If the new vaccine is proven safe, it has the potential to prevent Lyme disease, which sometimes can go undiagnosed for months or longer and can then affect the heart, nervous system and joints.

Trapezius muscle strain

Dear Dr. Roach: My husband was diagnosed with trapezius muscle strain, but he remains in constant pain throughout his shoulder and back. It came after overusing the shoulder. Can you tell us anything about this condition? (No, he's not a trapeze artist.)

--P.K.

A: The trapezius is a very large muscle that inserts on the spine all the way from the top of the neck to the lumbar spine on one side, and the shoulder blade on the other. It's called trapezius because it is in the shape of a trapezoid (as is a trapeze).

Because it is such a large muscle, it can have pain throughout many areas. However, a trapezius injury can lead to a rotator cuff injury, and I would get him re-evaluated if the pain lasts more than a week or two.

Dr. Keith Roach writes for North America Syndicate. Send letters to Box 536475, Orlando, FL 32853-6475 or email ToYourGoodHealth@med.cornell.edu.

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