The current landscape and future directions of Lyme disease vaccines

Lyme disease (LD) represents a significant public health challenge in North America and Eurasia. The persistent increase in its incidence may create an opportunity for vaccines to gain broader acceptance. Recent years have seen notable advances in vaccine development. However, achieving a balance between broad-spectrum protection and durable immunity remains a critical bottleneck. This article is presented as a narrative review that systematically summarizes recent progress in Lyme disease vaccine research worldwide, with particular emphasis on the strengths and limitations of approved and investigational candidates. Unlike existing reviews, this study integrates recent clinical investigations of multivalent vaccine candidates with breakthrough advances across diverse vaccine platforms, yielding a comprehensive and current synthesis. We identify critical challenges in contemporary vaccine development and propose actionable solutions. Our forward-looking perspective centers on a triangular strategy that integrates antigen multivalency, platform personalization, and geographical customization, providing a conceptual framework to guide future LD immunoprophylaxis research.