I’m far more more concerned about “undetected tick bite => lifetime incurable Lyme disease” than “detected tick bite => unnecessary course of antibiotics”.

Last summer, I noticed an odd spot on a leg of my female colleague when she arrived at work in a short skirt.

Fortunately, we are good friends and I could tell her without any kind of trouble.

Yes, she had a tick on that precise place a week before. Yes, it looked like erythema migrans, a typical early sign of a Lyme infection (borreliosis). No, she never heard about that and was a bit reluctant about doing anything about it. Yes, I persuaded her to see her doctor now. She got antibiotics immediately and seems to be fine.

That makes sense, except how does one have an undetected tick bite?

One reason Lyme disease is so scary is that it’s really common to not notice that you got bit. How often do you inspect the back of your knees? (If you live in tick country, it should be “every time you get back from being in the woods”, but many don’t know/practice this.)

It’s a common story to hear about people who don’t connect the dots, and don’t get properly diagnosed early when it’s more treatable.

Ok... and you think the people that don't know to check for ticks will know to get a Lyme vaccine? This doesn't seem logical to me. Most people in those environments know to check for ticks in my experience. The ones who don't are not the type to request a vaccine that they probably don't even know about.

It's easier to get one vaccine a year than to check 50 times (to be generous) a year. Also that would only tell you that you have a tick and then you need to check again that you see the red swelling to know you are infected. Then you need to get the antibiotics and then you need to hope that works.

Also I expect/hope vaccinations will develop into some kind of regular maintenance thing like software updates. With the mRNA technology that would be really easy. Scary for many people, also, but really, why not? Every year there are scientifical reasons to update the immunization for almost everyone against certain antigens. This way we may eliminate many strains of Sars-Cov-2, Influenza, other cold viruses, measles, maybe even HIV and the Herpes family eventually.

"It's easier to get one vaccine a year than to check 50 times (to be generous) a year."

This isn't a replacement, you still have to check even if you're vaccinated.

"Also that would only tell you that you have a tick and then you need to check again that you see the red swelling to know you are infected."

Wrong. The red swelling does no occur in all cases. You can be infected without it. Generally, one should have the tick examined to see how long it was attached (if they don't know).

"Then you need to get the antibiotics and then you need to hope that works."

You would need to do this even if you have the vaccine (assuming the tick was attached for longer than 24 hours or there's reason to believe it was interrupted from a previous meal and then but you - testing the tick will tell).

Your "refutations" don't actually contradict anything I said, I just don't dump everything that comes to mind or that could come to mind into every HN comment I write.

Prevention is always better than a cure, so yes you still have to check. Yes I know the Erythema is optional. Yes I know a vaccine isn't 100% effective. I'm actually a licensed veterinarian you are trying to mansplain here...

There are plenty of places where just going outside means you really should check for ticks, but that doesn't happen every time.

Most people take a shower every day, especially if they're doing stuff outside. You really only have to check once per day since the transmission risk is essentially zero if attached for less than 24 hours.

Tick bites don't hurt.

They tend to itch. Not to mention there's a tick hanging off of you...

Ticks tend to hang off you in places that aren’t immediately obvious.

Which is why you look for them.

Could we not check for the type of antibodies just like we do with covid?

This how it’s done in germany. Just got tested for Lyme disease. Tick bite was in late summer no rash. The skin in the area changed to red/blue after 5 months, so i got tested and the test was positive. Antibodies IgG 46, IgM 5. Now 3 weeks of antibiotics.

> You'll still end up being treating whether vaccinated or not.

Isn’t the typical treatment a course of antibiotics? In other words the risks from being “unnecessarily” treated should be fairly low.

It's sort of the inverse. If you're treated either way, then the vaccine is unnecessary. There are risks, even if rare, associated with vaccines. Basically, there's no value added and a very slight increase of risks.

Any unnecessary use of antibiotics should be avoided, as it can create an environment for the development of antibiotic-resistant bacteria.

Yes, but I believe the most common antibiotics prescribed for Lyme disease are doxycycline and monocycline, two antibiotics that are used by millions daily (on a somewhat long-term basis) already for the management of things like acne.

While certainly not ideal, with 8 million prescriptions in the US alone, I'm not sure an additional potentially unnecessary course of doxycycline is the worst thing in the world when compared to the possibility that the alternative is full blown Lyme disease.