258 Robert A. Aronowitz and mental anguish following vaccination. Benjamin Luft, a promi- nent LD researcher, noted a failure to deliver on an earlier, if implicit, promise that in return for very quick approval of a “personal choice” vaccine, surveillance data would be collected to resolve lingering doubts about safety. SKB had been given “a gift,” Luft argued. “I’m disap- pointed today. Because I hear some information here and I hear some information there. And I don’t hear good data. We really are sitting in a situation in a sea of just what we feel. Because no one is giving us data” (VRBPAC 2001). One reason that data were scarce was that the vaccine was being used much less often than predicted, making it difficult for either the adverse event–reporting system or the HMO surveillance program to reliably identify vaccine problems. The low uptake also signaled that the vaccine was in (market) trouble. In February 2002, SKB, citing poor sales, voluntarily discontinued the manufacture and distribution of LYMErix. Dear Doctor/Investigator letters were sent, and refunds were given for returned vaccine vials. SKB promised to complete all clinical studies. A related dog vaccine has been very successful. Heterodox Opposition to Vaccine The preexisting controversy over the definition, scope, and significance of chronic Lyme disease ultimately shaped every aspect of the controversy over the LD vaccine. In retrospect, the developers of the LD vaccine did not fully appreciate what was at stake in these controversies and how these stakes would affect the reception of the vaccine. SKB gave financial support to different LD advocacy groups in the 1990s, presumably expecting them to be allies in bringing an effective and safe vaccine to market. They indeed might have helped turn the great concern about LD in endemic areas into vaccine sales, but instead, many LD advocates and the groups representing them ultimately turned on the vaccine and vaccine makers. As Loren Cooper (personal communication, August 11, 2011), counsel to SKB for much of the ensuing LD litigation, put it in retrospect, given the discord within the medical community and among LD advocates and support groups, “We stepped into a hornet nest.” One example of SKB’s early strategy was the testimony on be- half of SKB and LYMErix at the 1998 VRBPAC meeting given by