Hunters weigh a possible Lyme disease vaccine

It is tick season, and officials and researchers say the problem may be especially severe this year. As climate change expands the places where ticks can survive, more Americans are being exposed to the parasites and to the illnesses they can carry. Those illnesses include Rocky Mountain spotted fever, alpha-gal syndrome, and, most commonly, Lyme disease.

A new Lyme vaccine could eventually offer another layer of protection. This spring, Pfizer and Valneva said they plan to seek regulatory approval for a vaccine aimed at preventing Lyme disease. It is not the first attempt. A Lyme vaccine was sold in the late 1990s, but it was taken off the market three years later after lawsuits, public concern about side effects, and limited interest.

Whether a new vaccine would fare better is uncertain, especially in the post-COVID period, when vaccine skepticism remains part of public life. To get a sense of how it might be received in a group at high risk of exposure, KFF Health News spoke with hunters in Missouri. The setting made sense. Hunters spend long stretches in the woods, where ticks are common. At the same time, hunters as a group tend to be conservative, rural, and male, according to a Theodore Roosevelt Conservation Partnership survey, and those identities are often linked with greater hesitation about vaccines, said Ashley Kirzinger of KFF, a health information nonprofit that includes KFF Health News.

Lyme disease can be serious if it is not treated. The Centers for Disease Control and Prevention says it can cause fevers, chills, headaches, arthritis, shooting pains, and inflammation of the brain and spinal cord. The CDC estimates that about 476,000 people in the United States may be diagnosed and treated for Lyme disease each year. Part of the reason is that the geographic range where cases have been reported has expanded significantly since 1995.

On a recent Saturday at the Busch Shooting Range in Weldon Spring, Missouri, just outside St. Louis, KFF Health News spoke with seven hunters and one hiker about the possibility of a vaccine. Jess Manganelli was the most enthusiastic. She said she would take it “given my proclivity for the outdoors.” Manganelli, who had hunted turkeys the previous weekend, said she thought she may have had Lyme disease before, although she was never formally diagnosed. Two years ago, after a tick bite, she experienced muscle weakness, tiredness, fatigue, swelling, and headaches. When she went to urgent care, she was told they did not test for Lyme.

Most of the others were not ready to say yes, but they were open to learning more. Six of the eight said they would consider getting the shot, though they would want more information about how safe it is, how effective it is, and how likely they are to get Lyme disease in the first place.

Nearly all of the hunters said they knew someone who had had Lyme disease, including a roommate, a family member, friends, or a former student. Several had seen the difficulties that can come with the illness. Lyme can be hard to diagnose and treat, and it is often misdiagnosed at first. The people they knew had dealt with long stretches of illness, and in some cases the symptoms had been debilitating.

Steven Rinella, author and conservationist and host of the hunting show MeatEater, said that kind of familiarity was not surprising. “I’m a turkey hunter. In talking about turkey hunting, you talk about ticks as much as you talk about turkeys,” he said. “Just the nature of turkey hunting puts you into exposure. You’re sitting for long periods of time trying to use vegetation for concealment.”

Rinella also has direct experience with Lyme disease. Thirteen years ago, he and his older son contracted it during a bluegill fishing trip in the Hudson Valley in New York. His son developed Bell’s palsy, a sudden paralysis on one side of the face, but recovered quickly after oral antibiotics. Rinella’s symptoms lasted for months. He said he could not walk downstairs without holding a handrail and could not ride a bike. He then received intravenous antibiotics for a month. “I thought my life had changed,” he said, “but I recovered, as far as I know.”

That experience is one reason Rinella said he would absolutely consider a Lyme vaccine if it proved safe and offered substantial protection. The fact that a person has had Lyme disease before would not rule out future benefit, since prior infection does not provide permanent immunity.

Other hunters described a mix of caution and openness. Jeremy Hollingshead said he might be less inclined to take a vaccine because a former roommate had Lyme disease and, in his view, still has lingering effects 10 years later. Still, Hollingshead said he has spent his whole life in the woods and has only heard of one Lyme case among hundreds of people he knows who also spend time outdoors. He said that makes his own odds seem low.

Julian Barnes, by contrast, said seeing a relative struggle with Lyme disease made him more willing to consider vaccination. He said it took a long time for doctors to reach the diagnosis and that finding good treatment was equally difficult. “I would say I am vaccine-hesitant, generally speaking,” he said. “But Lyme, I’ve seen the way it affects people in my life.” He added that he would need to understand how the vaccine works before deciding.

The vaccine candidate Pfizer and Valneva are working on is a four-dose shot. The companies say it is about 75% effective in reducing cases, though it technically missed one of the trial benchmarks because not enough participants contracted Lyme disease during the study. They still plan to submit it to regulators for approval. When KFF Health News asked Pfizer about its regulatory work in June, a spokesperson said there were no updates to share.

The political and public health setting also matters. Robert F. Kennedy Jr., now health and human services secretary, was a prominent anti-vaccine activist before taking over the agency that oversees vaccine approvals, and his changes to the department have prompted some vaccine makers to scale back development. At the same time, he has spoken positively about Lyme disease. In May, he announced an initiative to combat it. During his Senate confirmation hearings, he said his family had been deeply affected by Lyme disease and that nobody would work harder than he would to find a vaccine or treatment.

If the vaccine is approved by the FDA, an endorsement from Kennedy could matter a great deal, Kirzinger said, especially among supporters of his Make America Healthy Again movement, who tend to be more skeptical of vaccines. She said they trust him as much as they trust their own doctors when it comes to health information. If he publicly supports the vaccine and points to his administration’s role in making it available, she said resistance could be lower in that group.

Kirzinger also said the vaccine could become a target for misinformation. New KFF polling shows that people without a trusted medical provider, and people who rely on social media and artificial intelligence for health information, are more likely to believe common vaccine myths.

Only one of the hunters said he definitely would not want the vaccine. JP Cummings said he would “kind of hand it off to God and the body he gave me” and added that he considers himself durable. Even so, he said he is interested in watching what other hunters decide as more information becomes available. “Hunters care about the wildlife; hunters care about health,” he said. “They love the wildlife, they love their deer, and they love their fellow hunters.”