By Cathy Barnette, DVM, a paid Consultant for Covetrus^® 

Should your patients receive a Lyme vaccine? In many areas of the country, answering this question may seem anything but straightforward. We want to make risk assessments based on an honest appraisal of the pet’s lifestyle; however, clients do not always think to report every relevant detail.

Assessing a dog’s risk factors for Bordetella can be relatively straightforward. Is the dog in contact with other dogs, at a boarding facility, groomer, dog park, or during neighborhood socialization time? If so, the dog needs a Bordetella vaccine. Evaluating a dog’s risk of Lyme disease, however, can be more challenging. 

The Spread of Lyme Disease
While Lyme disease was once confined to a small geographic area, this disease is spreading rapidly and affecting more patients. In humans, the incidence of Lyme disease has nearly doubled since 1991, with the distribution of cases also expanding over time.¹

Similar trends are observed in veterinary patients. In the 2022 Companion Animal Parasite Council (CAPC) Pet Parasite Forecast, they noted that Ixodes scapularis (the vector of Lyme disease) is continuing to expand its range southward and westward, increasing the risk of Lyme disease in many areas of the country.² The highest risk of Lyme disease is still found in the northeastern United States, but high-risk areas now extend south through coastal South Carolina and as far west as North Dakota.² Additionally, Lyme disease has now been confirmed in all 50 states, underscoring the need for all dog owners to be aware of this condition.³

The Value of Tick Prevention
Preventing Lyme disease in a high-risk area requires a two-pronged approach: tick prevention and vaccination. Consistent messaging throughout your hospital is a key method for ensuring that owners hear and internalize this message. Every patient should receive year-round parasite prevention, using a product that is approved for the prevention of Ixodes scapularis. In recent years, unseasonably warm winters have become more common; it is no longer unusual to see ticks even during the winter months. Therefore, year-round prevention is key.

Your entire team should be involved in making parasite prevention recommendations, providing consistent messaging from the reception desk to the exam room. Ensuring that each of your patients is on year-round tick prevention is an essential component of Lyme disease prevention.

Lyme Vaccines: An Additional Layer of Protection
While tick prevention is valuable, at-risk dogs should also be vaccinated for Lyme disease. Even compliant owners may miss or delay a dose of tick prevention; doses may also not be fully absorbed, for any number of reasons. Lyme vaccination offers a second layer of protection in dogs that are at high risk of this disease. Evidence has repeatedly shown that Lyme vaccination reduces the risk of symptomatic infection.⁵ The 2022 American Animal Hospital Association (AAHA) Vaccination Guidelines recommend Lyme vaccination for “dogs that live within or travel to regions with emerging or endemic Lyme disease.”⁴ A key factor in this recommendation is travel; recommendations should not only be based on your location, but on the potential for future travel. If a client plans to travel to an endemic area, vaccination should be completed 2-4 weeks prior to travel.⁴

Unfortunately, many dogs fail to receive recommended Lyme vaccines. A 2022 study of nearly three million dogs, all of which were current on their core vaccinations, found that only 16.2% of these dogs nationwide were vaccinated for Lyme disease.⁶ Even more concerning, however, was the finding that only 47.9% of dogs living in the eleven states identified as highest-risk were vaccinated for Lyme disease.⁶ This suggests that over half of dogs are not vaccinated in compliance with current recommendations, increasing their risk of clinical Lyme disease.

Need for Client Education
Clients are more likely to remember, and take action upon, a message that is heard repeatedly. Therefore, a discussion about Lyme disease should not be relegated to a brief question asked during check-in.

If you are in a Lyme-endemic area, use educational materials throughout your hospital that emphasize the serious threat of Lyme disease and other tick-borne diseases. Have materials available in your lobby and exam rooms, allowing clients to learn about the risk of tick-borne diseases.

Check your patients’ records at every visit to determine whether they are up-to-date on both tick prevention and Lyme vaccination (if indicated). If you notice a gap in a pet’s protection against Lyme and other tick-borne diseases, address that with the client immediately and make a plan to ensure the pet is protected.

Finally, train your team. It is important for your entire veterinary team to deliver consistent messaging around ticks and tick-borne diseases, including Lyme disease. Make Lyme disease the topic of a team meeting and work with your team on strategies to overcome client objections to tick prevention and vaccination. In our current era of vaccine skepticism, it may take some effort to convince clients of the value of vaccination, but the benefits for your patients are worth it. 

About the author Cathy Barnette, DVM is a veterinarian and freelance writer, based in Southwest Florida. After graduating from the University of Florida in 2006, Dr. Barnette spent 14 years working in small animal general practice. Her current professional focus is veterinary writing, creating educational content for veterinary teams and their clients. Dr. Barnette is a paid Consultant for Covetrus^®.

1. United States Environmental Protection Agency. Climate Change Indicators: Lyme Disease. Retrieved from: https://www.epa.gov/climate-indicators/climate-change-indicators-lyme-disease 2
2. Companion Animal Parasite Council. 2022 Annual Pet Parasite Forecasts: Lyme Disease. Retrieved from: https://capcvet.org/articles/2022-forecasts/
3. Companion Animal Parasite Council. Parasite Prevalence Maps. Retrieved from: https://www.petsandparasites.org/parasite-prevalence-maps/#/2023/all-year/lyme-disease/dog/united-states
4. Ellis, J., Marziani, E., Aziz, C., Brown, C. M., Cohn, L. A., Lea, C., Moore, G. E., & Taneja, N. (2022). 2022 AAHA Canine Vaccination Guidelines. Journal of the American Animal Hospital Association, 58(5), 213–230. Retrieved from: https://www.aaha.org/aaha-guidelines/2022-aaha-canine-vaccination-guidelines/key-vaccination-considerations-by-antigen/borrelia-lyme-disease/
5. Vogt, N. A., Sargeant, J. M., MacKinnon, M. C., & Versluis, A. M. (2019). Efficacy of Borrelia burgdorferi vaccine in dogs in North America: A systematic review and meta-analysis. Journal of veterinary internal medicine, 33(1), 23–36. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335541/
6. Malter, K. B., Tugel, M. E., Gil-Rodriguez, M., Guardia, G., Jackson, S. W., Ryan, W. G., & Moore, G. E. (2022). Variability in non-core vaccination rates of dogs and cats in veterinary clinics across the United States. Vaccine, 40(7), 1001–1009. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0264410X22000068?via%3Dihub