Even as a virologist, there’s one insidious type of bacteria that weighs on my mind. Borrelia- carried by ticks, causes Lyme disease. Thank you @pfizer for recognizing that we do after all need a vaccine (GSK pulled theirs due to unsubstantiated fears).investors.pfizer.com/investor-news/…
Ticks have been spreading throughout the US and Europe. Like mosquitos, they transmit pathogens. Borrelia is a twisty, tricky menace, like the tick itself. 
You don’t always see the tick and the initial borrelia infection doesn’t always leave the classic bullseye pattern you may have heard about.
If you were to realize you were bitten by a tick, it’s believed that taking even one dose of doxycycline (a generic antibiotic) would dramatically reduce your chance of infection, so call your doctor fast. But like I said, you won’t always know.
If the bullseye pattern shows up, then you will likely be prescribed 2-3 weeks of doxycycline, which is thought to have about an 80% chance of curing you of the infection.
But if you don’t see that a tick on you (they can be tiny), don’t get the bullseye, or otherwise aren’t cured of borrelia infection, then something really terrible can go wrong with your body. It’s a horror show of pain and neurological problems. We call it Lyme Disease.
It’s not easy to diagnose and the tests are imperfect (sounds familiar to anyone following covid)? But once it’s diagnosed, antibiotics don’t work as well. The bacteria is thought to be able to hide out in the body and resist antibiotics. It can take many years....
...of repeated treatments with cocktails of antibiotics (not the kinds with umbrellas... the kinds with IV tubes) to possibly cure the infection. That’s why it’s critical that we have a vaccine. But here’s the thing, many Americans won’t need it. Lyme is a threat to those...
...who live in regions where there are ticks, which are carried & spread by wildlife like deer and mice (a deer can be sucked dry by ticks!). If you live in cities & don’t hike, you probably don’t worry about ticks. This will be an expensive vaccine to develop yet will be used...
...by a minority of the country. That means that the cost will be spread over fewer people each year than the cost of flu and measles vaccines. On a per person basis, that could make it one of the more expensive vaccines.
So if insurance companies charge high copays to discourage people from using it and fewer people take the vaccine, then the market shrinks and the costs have to be spread over even fewer people. If that means copays go up, then fewer people will get it.
This is a great example of the insidious nature of copays and insurance design in America. There should not be out of pocket costs to discourage people from taking medicines and vaccines they need.
The more people get the vaccine, the less it need cost per person, & yet cost per person is not as important as value to America as a whole. Like vaccines for SARS2, a vaccine for Lyme disease is something America can easily afford from its collective budget.
Think of it as insurance against catastrophe. Like all of us paying for a fire department. You don’t see the fire department charging a copay and letting your home burn if you can’t afford it (though they used to, now it’s illegal).
Yet America’s insurance company functionally deny poorer people access to medicines that even they acknowledge these patients need. As I’ve written about in my book & on Medium, we must reform American insurance so cost of innovation is borne by everyone (from premiums/taxes)...
...and not shifted to patients or, in case of Lyme vaccine, just people who happen to live where there are ticks. Disease can come for any of us anytime. Building up our armamentarium of medicines is a worthy goal. & drugs offer great value b/c they go generic, unlike hospitals.
Some drugs don’t go generic, & in my writings I also call for a reform of@industry to ensure that all of its products become inexpensive generics when it’s their time (contractual genericization). Patent gaming is rent extraction & my industry shouldn’t be in the rent business.
We in the biotech industry are builders and we are paid with a finite steam of mortgage payments (cost of branded drugs). When those payments end, society owns our inventions as an inexpensive public good forever and we have to hustle to invent something new and useful.
That relentless drive to innovate has functionally cured cancers, transformed HIV, cured Hepatitis C, and is clearly on display as the industry works on myriad fronts to tackle COVID. So thank you again Pfizer and Valneva for seeing the unmet need and investing in its solution.
I hope insurance will someday make the Lyme vaccine available to all who need it (as they do with flu vaccine). Someday that vaccine will be generic & protect us inexpensively forever from this one threat. In the meantime, has anyone looked at the other horrors ticks carry!?!!
I mentioned my book... if you have questions about price gouging, EU paying less for drugs, DTC advertising, EpiPen, price-jacking, gene therapy, insurance, PBMs, & the opioid crisis, consider reading it. I use analogies to explain things simply. thegreatamericandrugdeal.com
And I talked about covid vaccines, why we don’t yet have vaccines for common cold (some of which caused by coronaviruses), and about the lyme vaccine in this article published by @CityJournal not long ago. city-journal.org/covid-19-our-a…
To learn more about Lyme & to support critical Lyme research (vaccine won’t protect everyone; we still need better diagnostics & treatments), visit bayarealyme.org where you’ll find Wendy Adams (@adamswendya), the most knowledgeable & thoughtful leader in this field.
