Article

Lyme vaccine demonized by advocacy groups

Nature (Impact Factor: 41.46). 04/2006; 440(7082):278. DOI: 10.1038/440278b
Source: PubMed

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Available from: Edward Mcsweegan, May 05, 2016
© 2006 Nature Publishing Group
CORRESPONDENCE NATURE|Vol 440|16 March 2006
278
Wiki ware could harness
the Internet for science
SIR — Your News story “Experts plan to
reclaim the web for pop science” (Nature 439,
516–517; 2006) describes a project called the
Digital Universe, which aims to create, and
provide links to, trustworthy peer-reviewed
content on the Internet.
As suggested by critics in your News story,
it seems wasteful to try to reproduce content
that already exists in an open, accessible and
improvable form. I would encourage those
working on projects such as the Digital
Universe to consider a strategy that truly
leverages the power of the Internet. For
example, the free and editable encyclopedia
Wikipedia (en.wikipedia.org) contains
innumerable articles that are scientifically
accurate, although it obviously contains
errors, omissions and some articles of low
quality. But MediaWiki, the software upon
which Wikipedia is based (see www.mediawiki.
org), allows one to link to specific versions of
articles. Thus, expert peer reviewers could
analyse articles, improve them and provide
links to the trusted version of that article.
A web portal that provided a ‘filtered
version of the Internet, with links to the most
trustworthy available article on a given
subject, would be a boon to scientists and
science enthusiasts alike.
Kevin Yager
Department of Chemistry, McGill University,
Lab 406, Otto Maass Chemistry Building,
801 Sherbrooke Street West, Montréal,
Québec H3A 2K6, Canada
Lyme vaccine demonized
by advocacy groups
SIR — As a microbiologist who managed
a federal programme on Lyme disease in the
1990s, I consider that any new clinical trials
of a vaccine candidate based on the protein
OspA, as mentioned in your News Feature
“Uphill struggle” (Nature 439, 524–525;
2006), should be confined to Europe, for
three reasons.
First, Lyme disease is non-communicable,
readily treatable with common antibiotics
and geographically localized in the United
States. Neurological cases — where treatment
can be problematic — are more common in
Europe and a new vaccine may reduce the
costs and consequences of infection.
Second, European experience with the
widely used tick-borne encephalitis virus
(TBEV) vaccine may facilitate vaccine-trial
recruitment and greater public acceptance
of a new Lyme vaccine.
Third, Europe is a less litigious environment
and is largely free of organized Lyme-patient
advocacy groups. In the United States,
activists have turned Lyme disease into
everyones backyard bogeyman. They have
demonized experts for their views on
treatment and prevention, and hired lawyers
to successfully argue the dangers of vaccine-
induced autoimmunity (Philadelphia Inquirer
B03, July 9 2003).
The activists are already using Internet
discussion groups to warn against a new
vaccine. One of them recently wrote “I would
encourage all Lyme patients to consider
writing letters, emphasizing the lack of
demand for the last vaccine, and also the fact
that any future vaccines can expect a lack of
cooperation, protests, legal quagmires, etc.
A careful, hysteria-free trial of the new
OspA vaccine in Europe may help to
undermine the opposition to it in the
United States.
Edward McSweegan
1692 Barrister Court, Crofton,
Maryland 21114, USA
Lyme vaccine: studies have
raised genuine concerns
SIR — The lamentable hostilities between
researchers into Lyme disease and the
patients on whose behalf they purportedly
labour will not be eased by Natures account
of the issues surrounding GlaxoSmithKlines
decision to pull its vaccine, LYMErix, from
the market (“Uphill struggleNature 439,
524–525; 2006).
The News Feature portrays truth-seeking
researchers on one side and angry patients
and their advocates on the other, with the
latter torpedoing a perfectly good vaccine
with scare tactics and bad publicity. But
a significant portion of the Lyme research
community had strong reservations about the
product. LYMErix’s initial approval by the
vaccine advisory committee of the US Food
and Drug Administration (FDA) was hedged
with caveats that questioned its safety and
even its usefulness (J. Am. Med. Assoc. 279,
1937–1938; 1998). One case series in the
peer-reviewed medical literature describes
a group of six patients, with no history
of neurologic problems, who developed
neuropathy or cognitive impairment shortly
after receiving the vaccine (J. Peripher. Nerv.
Syst. 9, 165–167; 2004).
And there were other factors that hindered
its success in the marketplace. It was relatively
expensive at $50 per inoculation, and it
required three doses, spaced over a period
of one year, to achieve its full efficacy rate,
which topped out at only 79%. Perhaps most
disappointingly, study subjects lost their
immunity relatively quickly, meaning that
booster shots would be required every year
or two — shots that the FDAs advisory
committee refused to sanction without
further study (www.fda.gov/ohrms/dockets/
ac/98/transcpt/3422t1.pdf). In addition,
the vaccine was not approved for children
under the age of 15.
Carl Brenner
Lamont-Doherty Earth Observatory
of Columbia University, Route 9W,
Palisades, New York 10964, USA
Reprocessing method
could allay weapons fear
SIR — We believe that your worry about US
plans to reprocess nuclear fuel (“Recycling
the pastNature 439, 509–510; 2006) is
misplaced. Since President Carter imposed a
reprocessing ban in 1977, it has become clear
that other nations’ decisions about building
nuclear weapons do not depend on what the
United States does with its spent fuel.
Furthermore, we consider your claim that
recycling involves separating components
that can readily be used to build nuclear
weapons” to be misleading on two counts.
First, degraded plutonium in spent reactor
fuel can only be used in an explosive device
with considerable difficulty. Second,
although current recycling processes produce
pure plutonium that can be used for weapons,
the US plan is to perfect a new method called
UREX+, which would be configured so
as never to separate weapons-quality
plutonium.
UREX+ processing is the first step towards
consuming excess plutonium in advanced,
metal-fuelled fast reactors and reducing the
rate at which reactor-grade plutonium is
accumulating around the world. Moreover,
fast reactors can extract more than 99% of the
energy in mined uranium — over a hundred
times better than the thermal reactors used
today. The combination of recycling and fast
reactors also reduces the time that waste
needs to be isolated, from thousands of years
to a few hundred.
There is still the associated problem that
the Nuclear Non-Proliferation Treaty gives
all signatories the right to develop a full-scale
fuel cycle, and with it the technological
infrastructure for making bombs. President
Bush has begun to address this, by proposing
that the spread of reprocessing technology
be curtailed, with waste management and
nuclear fuel supplied at reasonable cost—
although to be acceptable, such a scheme
should be run by an international entity
such as the International Energy Agency or
the International Atomic Energy Agency.
Properly managed, nuclear power can
meet growing energy demand safely, cleanly
and indefinitely.
Gerald E. Marsh*, George S. Stanford†
*5433 East View Park, Chicago,
Illinois 60615, USA
†4700 Highland Avenue, Downers Grove,
Illinois 60515, USA
16.3 Correspondence MH 13/3/06 5:17 PM Page 278
Nature
Publishing
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    • "The public opinion battles over LYMErix TM were fought, and lost, in cyberspace. The battle over the next generation of Lyme vaccines is already underway [9]. Vaccine manufacturers and researchers need to develop communication strategies that will provide the wired public with accurate and compelling information about new vaccines and the public health benefits of immunization. "
    Full-text · Article · Feb 2007 · Epidemiology and Infection
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    [Show abstract] [Hide abstract] ABSTRACT: This article reviews events that led to the withdrawal of the only vaccine to prevent Lyme disease licensed in the United States. The primary issues that led to the vaccine’s withdrawal appear to be a combination of vaccine safety concerns, sparked by a molecular mimicry hypothesis that suggested that the vaccine antigen, outer surface protein A, serves as an autoantigen and hence was arthritogenic; concerns raised by anti-vaccine groups regarding vaccine safety; vaccine cost; a difficult vaccination schedule and the potential need for boosters; class action lawsuits; uncertainty regarding risk of disease; and low public demand. This article reviews lessons learned from these events and proposes that future candidate Lyme disease vaccines are unlikely to be developed, tested, and used within the United States in the near future, thus leaving at-risk populations unprotected.
    Preview · Article · Feb 2011 · Clinical Infectious Diseases
  • No preview · Chapter · Jul 2011