In " Recommendations for the Use of Lyme Disease Vaccine: Recommendations of the Advisory Committee on Immunization Practice (ACIP) ," in the section "Effect of Vaccination on the Serologic Diagnosis of Lyme Disease," on page 9 the statement that "anti-OspA antibodies do not develop after natural infection" is incorrect. Although antibody to OspA in patients with early Lyme disease is rarely evident, this antibody can be found in increasing amounts in patients with later stages of Lyme disease, particularly those with Lyme arthritis. Therefore, the paragraph should read: "Care providers and laboratorians should be advised that vaccine-induced anti-rOspA antibodies routinely cause false-positive ELISA results for exposure to Borrelia burgdorferi (74). Experienced laboratory workers, through careful interpretation of the results of immunoblots, can usually discriminate between B. burgdorferi infection and previous rOspA immunization. Although vaccination is expected to elicit antibody to OspA only, natural infection results in the production of antibody to additional diagnostic antigen bands in immunoblots."
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