Lyme vaccine not a major factor in the development of arthritis

Neither treatment-resistant Lyme arthritis HLA-DRB1 alleles nor any other HLA alleles are found with significantly greater frequency in persons in whom arthritis developed after they received the Lyme disease vaccine. Neither antibody nor T-cell responses to Borrelia burgdorferi outer surface protein A (OspA), the Lyme disease vaccine antigen, are significantly more common in arthritis, suggesting that in many cases, cross-reactivity between OspA and a human antigen probably is not a factor underlying the arthritis.

Ball and coworkers recruited patients with definite new-onset inflammatory arthritis identified in the Vaccine Adverse Event Reporting System for a case-control study. They matched 27 patients with 3 control groups of 54 patients each: arthritis controls, those with inflammatory arthritis only; vaccine controls, persons with Lyme-vaccine arthritis only; and normal controls, who had no arthritis.

An exploratory comparison of the prevalence of each DRB1 allele between cases and controls showed no significant differences. T-cell response to OspA was similar in cases and vaccine controls. In Western blot analysis, cases were less likely than vaccine controls to have IgG antibodies to OspA.

The authors noted that the short duration between last vaccine dose and onset of arthritis in many cases makes an immunopathogenetic linkage by commonly accepted mechanisms unlikely to occur.