268 Robert A. Aronowitz in your local park, in your own back yard, or even mowing the lawn,” was the voice-over in one television advertisement (Goetzl 2000). A print ad from the same period pictured a woman, with her dog, standing on her lawn who offered the following advice: “I got Lyme disease last spring and I’m being treated for serious health problems. I couldn’t prevent it then, but now you could.”4 The campaign aimed to increase awareness of the risk of Lyme disease and to communicate a sense of urgency about taking the vaccine.5 The DTCA campaign resembled the aggressive one that Merck used a decade later to promote its human papillomavirus (HPV) vaccine, Gardasil (Aronowitz 2010). In both cases, the vaccine manufacturers promoted their vaccines as consumer choices, raising awareness and fear of the target disease and promising relief from not only the target condition (a benefit that would accrue to only a small segment of the population) but also the anxiety, loss of control, and fear associated with being at risk for the disease. In both cases, vaccine manufacturers attempted to win over consumers by initially funding lay groups they believed could influence the vaccine’s market success. In the case of Gardasil, Merck also took aim at state legislators who might vote to include Gardasil among the vaccines mandated for school entry. Given the great degree of concern already present in some commu- nities about LD, SKB had reason to believe that it had developed an economically successful vaccine. A prominent LD investigator specu- lated in 1999 that “one group who will demand it are people who fear Lyme disease with no real cause” (Revkin 1999, CT1). The vaccine’s efficacy and safety in clinical trials only reinforced this promise. But the vaccine’s social and psychological efficacy was quickly undermined by individual stories of harm related to the vaccine’s putative immune dangers.6 Conclusions Many informed observers of LD vaccine developments have offered ex- planations for why the LD vaccines failed. Allen Steere stated that “the withdrawal of the SKB vaccine . . . represents the most painful event in our Lyme disease history” and concluded that “the vaccine was re- ally withdrawn because of fear and lawsuits, not because of scientific findings” (2006, 629). While there is a consensus among vaccine