A multicenter, double-blinded, placebo-controlled study was done compa
ring a 30-mu g dose of a single protein recombinant OspA vaccine prepa
ration with a saline placebo for efficacy in prevention of Lyme diseas
e in humans. The OspA vaccine (30-mu g dose) or saline placebo was giv
en intramuscularly at day 0, 1 month later, and 12 months later. Cases
of possible Lyme disease were evaluated clinically and using culture,
polymerase chain reaction and immunoblot assays. Safety data are bein
g analyzed separately 1,634 adult volunteers were enrolled at a single
center in New York State. Vaccine efficacy during the first year was
40% and during the second 37%. Compared with placebo, the OspA vaccine
significantly reduced the frequency of Lyme disease during the 2-year
study period (P < 0.04, one-tailed Fisher's exact test). Vaccine effi
cacy was restricted to volunteers under 60 years old (50% vs 9%, P < 0
.03, two-tailed Fisher's exact test). A recombinant OspA vaccine prepa
ration was found to have moderate activity in preventing Lyme disease
in adults under 60 years old from New York State. Reasons for vaccine
failure need to be addressed and a risk benefit ratio calculated.