A Losing Battle For Science
The Article: How Science Lost a PR War and We Lost a Lyme Disease Vaccine by Michael Berne in Vice.
The Text: I have no idea where you live, but here in my current home state of Maryland we have ticks just, like, materializing out of thin air. Merely seeing a spot of grass in the distance makes you tuck your pants into your socks and reach for the Deep Woods Off. That is because ticks are among the worst things going in nature — their whole thing is to shove their wretched little faces into your flesh and suck and suck until they either get fat with blood and fall off, or are found and tweezed. Finding one latched onto your ankle like some kind of pimple-insect hybid elicits an entirely unique kind of shudder.
Ticks also carry Lyme disease, a potentially disabling bacterial infection that’s on the rise and will likely continue to rise (2009 saw 30,000 cases in the U.S.). And tick-wise — and Lyme disease-wise — this season threatens to be brutal. You might want to get vaccinated. . . except the vaccine was yanked from the market by its manufacturer in 2002.
In 1998, GlaxoSmithKline released a vaccine. It was made from a protein found on the surface of the Lyme disease bacterium Borrelia burgdorferi; you get a dose and it triggers antibodies, which, rather than killing the bacteria, travelled into the tick itself, knocking out the bacteria at its source before it can enter the body. As far as vaccine mechanisms go, it’s pretty clever and one-of-a-kind. Unfortunately, it didn’t take long before things to go downhill.
“Between December 28, 1998 and July 31, 2000, 905 reports were made to [the Vaccine Adverse Events Reporting System] about adverse events after the administration of the Lyme disease vaccine,” according to the History of Vaccines, a no-bullshit, well-sourced project (and Webby honoree for science writing) from the College of Physicians of Philadelphia. “Of these, 66 were classified as serious – that is, they resulted in a life-threatening illness, hospitalization or lengthened hospitalization, or disability.”
That’s a number that might make your average person concerned: 905. But it’s also not a number that indicates a higher incidence of symptoms than one might find in the general population minus the vaccine. 905 normal, unvaccinated humans would experience those same symptoms in the same time period no matter what. Herein is the vast problem with the media and public, statistics, and missing context. You can do most anything you want with a naked number. One of those things is putting a large number of people unnecessarily at risk for disease.
Also from the HoV: “As research was done to test the hypothesis, the media began to cover the topic heavily. Although stories usually pointed out that no study or research to date had shown that the vaccine could cause arthritis, headlines on the same articles tended to present the issue pessimistically.” Science, which proved well enough the safety of the vaccine, quickly lost the PR war.
“In 2002, in response to low vaccine uptake, public concern about adverse effects, and class action lawsuits, SmithKline Beecham withdrew the vaccine from the market despite the fact that both pre- and post-licensure safety data showed no difference in the incidence of chronic arthritis between those who received the vaccine and those who had not,” the HoV continues. People weren’t getting vaccinated, so they stopped making it. This is unlikely to change anytime soon. You can, however, get a Lyme disease vaccine for dogs (which reminds me…).
“In my opinion, this is a public health fiasco,” Stanley A. Plotkin, a pediatrician and infectious disease specialist at the University of Pennsylvania, Philadelphia, told Discovery. “There are well over 20,000 annual cases of Lyme disease and probably more than that. When else do you have a disease with that incidence where you know you can prevent it with a vaccine, but you don’t make it?”
Lyme disease is the sixth most-common infectious disease in the U.S. — in the same number range as HIV — and isn’t particularly known for fatalities; it’s treatable by antibiotics (weeks and weeks of antibiotics via painful shots). Treatable, but also serious and potentially life-ruining. (Disclosure: This post was actually inspired by a friend of a friend raising money for late-stage Lyme disease treatment. $12,000 needed.)
In fact, the vaccine was yanked so quickly that hardly anyone knew it existed. As the History of Vaccines concludes:
Many people today are unaware that there ever was a human vaccine against Lyme disease – though many are aware of a vaccine to protect dogs – and the incidence of the disease in the United States continues to rise. The combination of poor communication about the recommended use of the vaccine and the poor reporting about possible side effects should not be forgotten in light of the current distrust of vaccines among some members of the public. A 2006 editorial in Nature remarked that in the case of Lyme disease, “unfounded public fears place pressures on vaccine developers that go beyond reasonable safety considerations.”[x] Still, the authors acknowledged that public opinion is a strong factor in companies’ decisions to pursue the development of a vaccine, stating, “It may go against the scientific grain for marketing considerations to play such a part in steering vaccine development. But in the real world, this may be unavoidable.”
Who was GlaxoSmithKlein acting in the interests of in withdrawing the vaccine? Could it have defended the lawsuits and fought back stronger on the PR front? Maybe, but it’s also doing what corporations do, which is make money. Fighting a war for a vaccine for a generally non-fatal and regionally confined illness is a war waged for the public health, not profits. So ultimately the picture is just distorted all over the place for the Lyme disease vaccine, from media misinformation to America’s boned health care system.
Finally, until some other corporation or the NIH decides to get something new out, you’d be well advised to check yourself for ticks. Research suggests it might take up to 36 hours for the disease to get from the tick to your bloodstream. Which is a whole lot of sucking.
