Statistically home to one of the highest percentages of tick-borne illnesses in the world, Martha’s Vineyard will soon be the setting for a clinical trial of a vaccine aimed at preventing Lyme disease.
Michael Loberg, president of Vineyard Medical Care in Vineyard Haven, confirmed this week that scientists employed by Pfizer Pharmaceuticals, in collaboration with French Pharmaceutical Company Valneva, are in the development phase of creating a vaccine against borrelia burgdorferi, the bacteria present in deer ticks that causes Lyme disease.
Lyme disease has reached epidemic proportions on the Island, according to Mr. Loberg, who is also a member of the Tisbury board of health. The prevalence of Lyme and other tick-borne illness makes the Vineyard an ideal setting for further research and phase three trial of the vaccine.
“When companies are conducting clinical trials they need to go to places where there will be a large number of people with the conditions,” Mr. Loberg said. “Clearly, with the numbers we have at Vineyard Medical Care there are a lot of people here with Lyme disease. We, along with the Island’s health agents, consider Lyme prevention the number one unmet health need on the Island.”
According to Patrick Roden-Reynolds, a public health biologist and the new Island tick expert, human incidents of tick-borne disease are approximately 10 times greater on the Vineyard than in the remainder of Massachusetts.
On the Island, Mr. Roden-Reynolds said 25 to 60 per cent of adult deer ticks host Lyme disease. Additionally, he said, between five and 20 per cent of adult deer ticks carry babesiosis, and between four and 10 per cent carry anaplasmosis.
Dog ticks, while not carriers of Lyme disease, do carry tularemia at a rate of two to five per cent — higher here than the national average — and one and three per cent carry Rocky Mountain spotted fever, Mr. Roden-Reynolds said.
He cautioned, however, that data showing percentage rates of ticks carrying diseases do not immediately correlate with the human risk of contracting tick-borne diseases, due in large part to the life-cycle of ticks and also to human outdoor activities, which usually increase in the warmer months.
“More adult deer ticks are infected with the Lyme disease agent than nymphal deer ticks,” Mr. Roden-Reynolds said. “But we still see most cases of Lyme disease in humans during June and July each year when adult deer ticks are typically not active and nymph deer ticks are. The risk of contracting tick-borne disease is probably more linked to human behavior and activity [such as] summer months when outdoor recreation is the highest.”
Martha’s Vineyard Hospital spokesperson Marissa Lefebvre reported that the emergency room saw 151 visits for tick bites since May 1. Information on how many visits resulted in a positive diagnosis for a tick-borne illness was not yet available, Ms. Lefebvre said.
Mr. Loberg cautioned that blood test infection rates do not tell the full story. He said the Massachusetts Department of Public Health counts cases reported by state labs only through blood tests, but Lyme is often diagnosed and treated through symptoms without a blood test. He explained that doctors at Vineyard Medical Care are more likely to readily prescribe doxycycline, the antibiotic used to treat Lyme, after suspected exposure because of its prophylactic nature.
“A false positive is of very little consequence to the patient, [putting them on medication] will affect them minimally,” Mr. Loberg said, referring to doxycycline’s minor side effects of nausea and increased sun sensitivity. “A false negative is much more consequential and the outcome of an untreated disease is severe,” Mr. Loberg said.
It is precisely this rationale that prompted the Island boards of health to stress prevention as the number one factor in minimizing tick-borne illness. Edgartown health agent Matt Poole considers education his department’s priority in combating the disease.
“The goal was to improve tick IQ in households — seasonal and year-round — so that people had some familiarity with risk, how to reduce risk and how to respond to a tick bite when prevention doesn’t work,” Mr. Poole said. “People need to have sort of basic awareness. Then you get into recognizing a bite that you have to act on. That is the point we hand off to the local health care providers.”
Health officials are now looking forward to adding vaccination as another goal in the tick IQ information campaign.
Tisbury health agent Maura Valley expressed optimism about the trial, stressing how much a vaccine against Lyme would mean to the residents of the Vineyard.
“It’s a great opportunity for the Island,” Ms. Valley said. “While not directly involved with this trial, the Island boards of health are here to support the development of any vaccine and do whatever we have to do to help, especially with public outreach,” she added.
That time is coming soon. Mr. Loberg said phase one and two of Pfizer’s research, which tested the safety and efficacy of the vaccine, have already been completed. The third phase is focused on measuring the extent of protection the vaccine provides.
The trials will be conducted by Care Access, a clinical trial company contracted by Pfizer. Trailers operated by Care Access will be stationed in various places around the Island to process Vineyard residents volunteering for the trial.
According to the Valneva website, the vaccine in development (VLA15) is the only active vaccine program in clinical development against Lyme disease.
The trial will be in a double-blind, placebo-controlled format, and will take place beginning in August and running into 2023. Vineyard residents, including children above the age of five, are encouraged to volunteer. Mr. Loberg said anyone interested in signing up for the trials should contact Vineyard Medical Care at 508-693-4400.
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