Your Guide To Adult Vaccines
Nothing can cramp a camping trip or hamstring a hike quite like the threat of a potentially debilitating disease brought on by a bite from a bug no bigger than the size of an apple seed. And it’s a reality that is only becoming more common.
Tick-borne illnesses are on the rise in the U.S., and cases of Lyme disease rank at the top of the list. According to the Centers for Disease Control and Prevention (CDC), nearly half a million Americans contract Lyme disease each year by way of the black-legged tick (also known as the deer tick), whose population is thriving. If left untreated, the infection can become serious and spread to the joints, heart and nervous system.
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Yet despite its growing prevalence, prevention strategies for Lyme disease remain thin. Some insect repellents can reduce the risk of getting bitten by a tick that carries the disease-causing bacteria; so can wearing long sleeves and long pants.
But soon there could be a new tool to keep Lyme disease at bay: a vaccine that can stop the infection before it takes hold. Pfizer and French company Valneva recently announced the launch of a phase 3 clinical trial to study the safety and effectiveness of their Lyme disease vaccine candidate in about 6,000 participants, young and old, after earlier studies yielded promising results. If all goes well in late-stage testing, the vaccine would be the first on the U.S. market in more than two decades, and the only one available for use.
An earlier vaccine, called LYMERix, was discontinued in 2002 by its manufacturer for “insufficient consumer demand.” But experts say demand may be back as case rates grow, especially among people who spend a lot of time outdoors in areas where Lyme disease is common.
“I can definitely tell you over the last 20 years that the knowledge base and recognition [of Lyme disease] has increased. And I think people do recognize that it is a disease that can have significant long-term effects,” says Christopher Bazzoli, M.D., an emergency medicine physician at Cleveland Clinic and an expert on wilderness medicine.
Pfizer and Valneva’s vaccine targets a protein on the surface of the bacteria transmitted by the tick. And the way it works, Bazzoli explains, is it helps to kill the bacteria before it even enters the body. (According to the CDC, the tick typically has to be attached for 36 to 48 hours or more before the Lyme disease bacteria can be transmitted.)
“Similar to many vaccines that we use for other diseases, it basically trains your own immune system to produce antibodies, which then are ingested by the tick as it feeds. And those antibodies cling to the surface of the bacteria, allowing it to be killed,” Bazzoli says.
Pending a successful clinical trial, the vaccine could gain federal approval for use in adults and children as early as 2025, Pfizer said in a news release. At the same time, researchers from the University of Massachusetts Medical School are studying another option that could be used to prevent Lyme disease: a human monoclonal antibody given in advance of potential exposure. The CDC explains the approach would provide seasonal protection against Lyme disease, meaning it would likely be given as an annual shot at the beginning of tick season. Human trials are expected to begin soon.
Cassandra Guarino, a senior extension associate for serology and immunology at the Cornell University College of Veterinary Medicine Animal Health Diagnostic Center, predicts “outdoorsy folks” will be most interested in these types of preventive options. But there’s potential for broader appeal as well.
“I know that the fear of Lyme disease does prevent a lot of people from being comfortable going out in nature, and being out in nature is so important for our mental and physical health and well-being. So, if we had a vaccine that could help make people more confident in going into nature, that could have great benefits,” she says.
In the meantime, Bazzoli says people who live in areas where ticks are endemic— up and down the East Coast, throughout the South, and in much of the Midwest and some areas along the West Coast — should be mindful when spending time outside, particularly in tall grass or wooded areas, and especially as the climate changes. (The Environmental Protection Agency notes that climate change has contributed to the expanded range of ticks, increasing the potential risk of Lyme disease.)
Wear long sleeves and long pants, and tuck your pant legs into your socks, if you can. Bazzoli says you can also treat your clothing with an insecticide called permethrin (the CDC has more information on how to do this) or buy permethrin-treated clothing.
And don’t forget to check yourself for ticks after you come inside. “If we’re catching a tick on you in less than 24 hours, that’s within a margin of safety,” Bazzoli says, pointing to the fact that it takes, in most cases, more than a day for the bacteria that causes Lyme disease to pass from the tick to the human.
Finally, if you have a concerning rash (one shaped like a bull’s-eye is a signature sign) or think you may be exhibiting symptoms of Lyme disease (fever, chills, headache, fatigue, and muscle and joint aches), talk to your doctor, Bazzoli urges.
Signs of Lyme Disease
Lyme disease can produce a wide range of symptoms, depending on the stage of the infection.
Early warning signs can include:
- Muscle and joint aches
- Swollen lymph nodes
- A bull’s-eye-shaped rash that begins at the site of the bite and grows
Later signs and symptoms can include:
- Severe headaches
- Neck stiffness
- Rashes on other areas of the body
- Facial palsy
- Arthritis with severe joint pain and swelling, particularly in the knees and other large joints
- Intermittent pain in tendons, muscles, joints and bones
- Heart palpitations or an irregular heartbeat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain
- Shooting pains, numbness or tingling in the hands or feet
Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.