274 Robert A. Aronowitz about what was sometimes referred to as the “yuppie vaccine.” These misgivings were partly a matter of the limited objective health impact of any putatively effective vaccine, but they also were about diluting the moral and political consensus that has stood behind vaccines as public health measures, and the danger to medical credibility of blurring ap- peals to public and individual health benefits with consumerist benefits. Policymakers were, and remain, at a loss for dealing with the kind of oppositional lay advocacy manifested in LD. Even the pharmaceutical companies acting as market actors seemed to have misunderstood, at least initially, what might be at stake in their new product. Responding to these challenges necessarily involves simultaneous critical appraisal of extant data about the objective dangers and benefits of interventions along with their anticipated social, political, and economic impacts. Endnotes 1. Not unlike other pharmaceutical companies in the 1980s and 1990s, Connaught underwent rapid-fire changes in ownership and administration. The company’s acquisition in 1990 by the Me´rieux Institute (which had recently acquired Pasteur Production) for almost a billion dollars was widely reported as a sign that the hitherto moribund (in terms of profits) vaccine industry was entering a new era. The promise of a financially successful LD vaccine, which was already in the works at Connaught, was presumably part of this attraction. One article reported that Me´rieux expected to increase its vaccine sales from $547 million in 1988 to $2.5 billion in 2000 (Andrews 1990, D7). 2. Although SKB merged with GlaxoWellcome in 2000 to form GlaxoSmithKline, I will continue to refer to SKB in this period to preserve continuity. 3. There also were claims of actual harm, some of which were settled by the company out of court to avoid the expense and uncertainty of litigation, according to SKB lawyers (Cooper, personal communication, August 11, 2011). 4. Available at http://www.newspaperarchive.com/SiteMap/FreePdfPreview.aspx?img= 149837946. 5. Len Sigal (personal communication, July 6, 2011) did not think the DTCA campaign was a major cause of LD fear. Instead, he blamed infusion companies that sponsored billboards encouraging fears of Lyme disease and including telephone numbers to operators who referred people to “Lyme-literate” practitioners. 6. Both enthusiasm and apprehension could have been read into what had transpired earlier in the decade with dog LD vaccines. A New York Times article reported that “with the aid of aggressive marketing, the [dog] vaccine found a ready public. Since last July nearly two million doses have been sold” (Eckholm 1991, 48). But there was a backlash to the successful, aggressive marketing. Organized veterinarians and the U.S. Department of Agriculture urged that the vaccine be limited to dogs at high risk. They also voiced concerns that the dog vaccine might cause Lyme disease–like symptoms. Another account of dog vaccine backlash reported that Alan Barbour, a co-discoverer of B. burgdorferi, had seen a billboard in Houston, where there was no LD risk, that queried, “Has your dog been vaccinated for Lyme?” (Weiss 1994, F7).