Part of our Losing to Lyme series

For Dr. Stanley Plotkin, a prominent vaccine scientist, Lyme disease is personal. His son, Alec, collapsed from a slow heart rate when he was 39, brought down by a rare heart complication from Lyme.

His son survived, but the incident helped cement Plotkin's resolve to pursue a human vaccine against Lyme disease. Using his bully pulpit as an emeritus professor of infectious diseases at the University of Pennsylvania, he’s taken his case from The New York Times to the New England Journal of Medicine, in which he called the lack of Lyme protection "the worst recent failure to use an effective vaccine."

That’s because we used to have a vaccine for Lyme, called LYMErix, but it was pulled from the market. Now, the only family member who can get a Lyme vaccine is your dog.

LYMErix had some problems. It required three doses at $50 each, and they were not covered by insurance -- so involved some inconvenience and out-of-pocket money. Despite a good safety record in clinical trials, some people experienced what they thought were side effects and sued SmithKline Beecham, the manufacturer. In 2002, SmithKline pulled the vaccine, after only four years on the market. (More on the history of the Lyme vaccine here.)

While the official line is that poor sales led the vaccine's maker to pull it, most experts think the specter of lawsuits was a key factor. Though an FDA panel ultimately found no link between the vaccine and arthritis, SmithKline settled lawsuits making that claim. And by then, the vaccine was already dead.

That cautionary tale still reverberates at companies developing new potential Lyme vaccines. "When I talk to manufacturers, they essentially ask me: 'Will it happen again?' " Plotkin said.

Bring Back The Old Vaccine?

A number of scientists hope to change that. One is Tufts University professor Sam Telford, an expert on tick-borne diseases, who in the early 1990s organized one of the LYMErix clinical trials.

Telford hopes to bring back that same vaccine technology, knowing that pharmaceutical companies will be hesitant. “Pharma won’t touch LYMErix again,” he said. “It’ll take some quixotic wacko like me, under a nonprofit, to bring it back.”

“Why pay $150 to $200 million to bring a new vaccine to market?” Telford asked, likely even underestimating the typical vaccine R&D costs of up to $500 million a new Lyme vaccine could require. “For $10 million, the old vaccine could be pushed forward.”

Given his prior research, Telford knows the vaccine recipe. The patent rights have expired, so it would be relatively cheap to produce, he thinks.

Lyme disease bacteria b. Burgdorferi as seen through an electron microscope (Claudia Molins/CDC)

But Plotkin thinks the safety concerns make the possibility of bringing the old vaccine back a non-starter. Instead, it’s better to start over, and eliminate the controversial parts of the old vaccine blamed for the alleged bad side effects, “even if the scientific evidence doesn’t justify it,” he said.

In 2014, the health care giant Baxter was working on a promising vaccine that fit Plotkin’s mold. It included vaccine targets that would work on both North American and European strains of Lyme, allowing them to expand the market to make the investment financially viable.

But Baxter decided instead to sell off its entire vaccines portfolio. A couple of mergers and acquisitions later, the Baxter vaccine is still not being developed: Baxter spun off its vaccine business, which was later bought by the company Shire, and Shire "does not have a Lyme disease vaccine in the pipeline,” a spokesperson said.

While Baxter decided to divest itself of vaccines, it tried an unorthodox way of selling the rights to its Lyme vaccine, Plotkin said: Instead of negotiating a royalty agreement, which would be the industry standard for a product that has not yet been approved by the FDA, Baxter asked for a very large up-front payment. No one bit.