Q) Is it effective?
A) Yes, but not nearly 100 percent .

Q) Is it safe?
A) Short-term, yes.  Long-term, not known.

Q) Can it produce more disease, like auto-immune arthritis?
A) Possibly, the potential is there.  We simply do not know at this time.

Q) So, after careful discussion with a knowledgeable physician, who should consider getting it?
A) There is  increasing clinical evidence that there are two categories of people at potential risk: those who are genetically susceptible, and who have very likely had  the disease one of more times already; and those who have never had the disease despite at  least 25 years of undoubted exposure to the infected ticks in this region and elsewhere.  A third category includes persons who have developed treatment-resistant Lyme arthritis.

In my opinion, which is subject to change at any time based on further information in this rapidly changing scientific scene:

a) Persons who have never had Lyme Disease so far are probably not genetically susceptible and probably do not need the vaccine;

b) Persons who have had Lyme  Disease - except for treatment-resistant Lyme arthritis - may benefit from Lyme  vaccine and should consider it;

c) Persons who have treatment-resistant Lyme arthritis should not receive Lyme vaccine.

Meanwhile, what can we all do to avoid this miserable infection, caused by an organism of the same family as causes Syphilis, and with some similar characteristics?

1. Avoidance of exposure to ticks anywhere.  Helpful hints are widely available.
2. Prompt showering and complete body search after every potential exposure to wooded areas, tall grass, etc.
3. Awareness of the appearance of the classic rash (E.C.M.), and prompt attention to any eruption and any tick bite.
4. Awareness that flu- like symptoms, experienced  between Spring and Fall, with or  without a known a tick bite or a rash, may be Lyme Disease.  Check with your physician.

GS