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Should Children Be Vaccinated Against Lyme Disease?


The AAP recommendations also say that the Lyme disease vaccine can be considered in teens aged 15 and over who live, work, or play in areas of high or moderate risk, or those who stay in such places during the peak transmission season of spring and whose activities result in frequent or prolonged exposure (i.e. lawn and garden work, beach-combing, boating, etc.).

But what about children between the ages of 5 and 15? In a study of 250 children reported in Pediatrics in November 1999, Henry M. Feder, MD, and others found that the vaccineappeared to be well tolerated and produced a high level of antibodies to the bacteria in 99% of the children who received the vaccine. The presence of the antibodies suggests that the children's immune systems had been primed to fight off Lyme disease.

"The preliminary feeling with the vaccine is that the side effects in children are, if anything, no more than in adults and probably less, and the immune response is at least as good, but probably better," says Feder, professor of pediatrics at Connecticut Children's Medical Center and professor of family medicine at the University of Connecticut Health Center in Farmington, in an interview with WebMD.

Feder says that because the vaccine is "not perfect" at protecting patients against infection, "it's very important that whatever people try to do to avoid Lyme disease, they should keep doing. I think that's one of the things that worries some physicians about the Lyme vaccine -- the idea that 'Oh, now that I've had the vaccine, I don't have to be careful [about exposure to ticks].'"

Shapiro tells WebMD that he agrees with the panel's recommendations for more study of the risks vs. benefits of the vaccine in children. "Perhaps more relevant is the fact that Lyme disease is generally a benign illness, so I would question the need for the vaccine as a routine," he says. "The recommendation of the expert panel is that its use be considered for people who are at high risk, but most kids are not at high risk, and in general it's an easily treated illness, so there's no real need for immunization."

Among the concerns about the vaccine, Shapiro notes, are the multiple doses required (three injections over as many months), frequent reports of pain and swelling at the injection site, and a high number of false-positive antibody tests in patients who have received the vaccine. False-positive antibody results could cause physicians to mistakenly believe that a patient has Lyme disease and overlook other possible causes of a patient's symptoms.

"I don't routinely recommend [the vaccine] to anyone," Shapiro says.



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