Lyme borreliosis: reviewing potential vaccines, clinical aspects and health economics

Abstract

Lyme borreliosis (LB) is a multisystem infectious disease with a growing burden in many parts of North America, Asia and Europe. Persistent infection of LB can usually be treated effectively with antibiotic therapy, but it may be followed by post-treatment Lyme disease syndrome. Therefore, it is important to begin with treatment in the early phase of the disease. Vaccination shows potential as the most effective way of preventing LB and reducing its burden in these continents. It is concluded that there is a need for continuous effort in research from all perspectives on LB, especially regarding prevention with novel vaccines, their development, clinical efficacy and cost–effectiveness. This review may help to further develop (cost-) effective strategies for prevention and control of the disease to reduce its burden and achieve population-wide health benefits.

Keywords:

• Borrelia burgdorferi
• cost-effectiveness
• health economics
• Lyme borreliosis
• Lyme disease
• treatment
• vaccines

Financial & competing interests disclosure

Prof Maarten J Postma received grants and honoraria from various pharmaceutical companies, inclusive of those developing and producing vaccines. However, all grants and honoraria are fully unrelated to the specific topic of this paper. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Lyme borreliosis is an infectious multisystem disease that may lead to serious long-term sequelae, affecting patients’ quality of life and causing high health and economic burdens for societies.

• A potential novel multivalent outer surface proteins A vaccine against Lyme borreliosis, still in the phase of the development, promises to be the most effective prophylaxis against the disease in the endemic areas of USA, Europe and Asia

• Cost–effectiveness studies with this novel vaccine are needed for efficient guidance, recommendations and policies for prevention of Lyme borreliosis, to (cost-)effectively reduce the disease burden and achieve population benefits