Lyme Vaccine Remains Untested

SPH Researchers Seek Volunteers

NANTUCKET, Mass.--Harvard School of Public health researchers believe they may have found the cure for Lyme disease, the infection which has stricken nearly 20 percent of this island's year-round population.

That may have been the easy part in dealing with a disease which infected 10,000 Americans last year, researchers say. For Harvard lecturer in Tropical Public Health Sam R. Telford, the next task is to find enough volunteers on which to test the vaccine.

Despite repeated assurances that the trial is safe, Nantucketers--who are typically weary of something as innocuous as an occasional summer visitor--so far have balked.

"It's not going very well," says Telford. "We've had to undertake a new publicity campaign."

The only treatment currently available for Lyme disease, which is caused by a spirochete, a type of bacteria, is antibiotics, typically amoxicillin. Telford's effort to bring the Lyme disease vaccine trial to Nantucket began several years ago with a phone call from Yale University researchers who told him: "We have a vaccine which works in the lab."

Dr. Erol Fikrig, an assistant professor of medicine at Yale, had isolated and duplicated a protein present on the surface of the bacteria, carried by deer ticks, which is thought to cause the disease.

Possessing that protein made possible the creation of a vaccine, which when injected into laboratory mice, protected 95 percent of the animals against Lyme disease infection. The body's immune system should react to the protein as it would the bacteria, but without any of the harmful effects of the disease. The vaccination allows the body to build up an arsenal enabling it to quickly defeat the real bacteria should it later attack the body.

The medical community was so excited about the prospect of a vaccine against Lyme disease that the Yale and Harvard researchers won backing from the Smith-Kline and Beecham pharmaceuticals company.

The support prompted a successful 24-person safety trial last year in Europe. Telford and fellow researchers began planning for the second of three phases of safety testing required by the Federal Drug Administration.

That second phase found Telford in Nantucket, where he has been plucking ticks from field mice for the last 10 years. Despite some doubts, Telford says he could think of no better place than Nantucket, plagued by the disease, to test the vaccine.

At a Nantucket Rotary Club meeting in June, Telford announced his plans to test the vaccine on the island. He said he needed 500 volunteers to test the vaccine and another 500 to take a placebo. But so far, he has received fewer than 30 responses.

"This is the field trial work. That's where we come in," says Telford, who returned from a European vacation hoping to find a tall pile of replies waiting on his desk. "Nantucket people can be part of something that will protect their kids and be used the world over."

To get the word out, Telford has doubled his advertisements in the local papers here. He has also called in a few favors, like help from his longtime friend Hamilton Heard Jr.

Heard, who sells insurance, says he's going door-to-door, visiting businesses which cater to year-round Nantucketers, the only inhabitants who can participate in the study.

Heard also began distributing yellow and black signs which carry, in large type, information about the vaccine trial. The problem, Heard says, is not that Nantucketers don't want to participate in the study. They just don't know about it.

When people hear about the trial, "I think it's going to be very well received," he says. "We are the perfect place to try it. We just need to get a number of participants.