No Lyme disease vaccine yet; maybe U.S. should consider

Q: When I contracted Lyme, my doctor diagnosed it early and treated me within days with doxycycline. I once read that a vaccine for Lyme disease was available at one point. Because the source was online, I’m not sure it was reliable. Is it true that there was once a vaccine? And is it true that “it just wasn’t cost-effective to produce,” as it would only be used by a small portion of the population?

A: If you had a dog and lived where deer ticks are widespread, your veterinarian could offer a Lyme vaccine for your canine companion. Sadly, though, there is no human vaccine available.

The Food and Drug Administration approved LYMERIX in 1998 to protect people from infection with the microbe that causes Lyme — Borrelia burgdorferi. Three shots provided 76% protection (Epidemiology & Infection, January 2007).

Questions about vaccine safety at that time created tremendous controversy, not unlike today. Some people who developed arthritis after vaccination sued the drug company. Although the FDA concluded the benefits far outweighed the risks, negative publicity resulted in few people requesting the shot. As a result, in 2002 the manufacturer withdrew it.

Lyme disease infection can itself cause persistent, hardto-treat arthritis, severe pain, neurological complications and heart damage. The Centers for Disease Control and Prevention estimates that nearly 500,000 Americans contract Lyme annually. Perhaps we should revisit the potential value of a human vaccine against Lyme disease.

Q: Lately I’ve been struck by two different TV commercials for Dupixent to treat asthma and eczema. Can you elaborate on how one medication could be advertised to treat these two completely different conditions?

A: Dupilumab (Dupixent) is a “biologic” injectable drug. The “mab” at the end of the generic name stands for “monoclonal antibody.”

The drug works by interfering with cytokines, natural immune system compounds that play a role in inflammation. Both asthma and eczema (atopic dermatitis) are the result of allergic inflammation.

The drug can trigger severe allergic reactions. It can also cause several serious eye problems. People taking Dupixent are also more susceptible to herpes infections (both cold sores and genital herpes).

Q: When I turned 50, my doctor prescribed a statin due to my family history of heart disease. I had no health problems, and my cholesterol was fine.

Once I started Crestor, I developed body aches and pains down to my fingertips. She prescribed different statins, but the pain kept getting worse and she prescribed high-dose ibuprofen.

Then I developed diabetes and was put on metformin. Everything got worse, and I ended up in a wheelchair. Only then did she take me off the statin.

A year later, I could finally walk again, but I now have permanent diabetes, joint pain and kidney damage from the ibuprofen. Shouldn’t doctors warn us about potential side effects?

A: Absolutely! Thousands of patients have shared tragic statin side-effect stories. Diabetes and pain are well-documented complications. Our eguides to Cholesterol Control & Heart Health and Preventing & Treating Diabetes provide insights into the pros and cons of statins and other medications that raise blood sugar. These online resources can be found under the Health eguides tab at Peoplespharmacy.com.