Should Children Be Vaccinated Against Lyme Disease?
The AAP panel recommends that people take commonsense measures against infection, such as avoiding tick-infested areas, using protective clothing (pants tucked into socks, long-sleeved shirts), and using an insect repellent containing the chemical DEET (n,n-diethyl-m-toluamide) on the skin. A different type of repellent designed for application on clothing only and containing the chemical permethrin has also been shown to be highly effective.
The panel opposes routine use of antibiotics in people who have been bitten by a tick but have not been positively diagnosed with Lyme disease, saying that the practice "is of unproven value and is associated with potential risks and costs."
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].'"