This case was reported by a lawyer and described the occurrence of joint pain in a female subject of unspecified age who was vaccinated with LYMERIX. A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMERIX (unknown). At an unspecified time after vaccination with LYMERIX, the subject experienced joint pain, and swelling, particularly in her hands, knees, elbows, shoulders, and hips, flu-like symptoms, fatigue, possible neurological injuries, possible autoimmune disease, decreased activities of daily life, tingling in her extremities, shooting pains in her arms, vertigo, headaches, and possible memory loss. At the time of reporting the outcome of the events was unspecified. This information was received via a Statement of Injuries. Follow up information was received on 19 December 2008 via an interview between the subject and attorney(s). The subject was vaccinated with LYMERIX in February 1999, March 1999 and January 2000. Within one month of the third LYMERIX vaccination, the subject developed painful swollen joints. In 2000 she developed dizziness/lightheadedness and headaches. In 2001 or 2002 she developed fatigue. Treatment included ADVIL, ALEVE, AMOXICILLIN, unspecified medication for vertigo, and antibiotic. She developed aggravation of acid reflux, which she attributed to ALEVE and ADVIL taken for joint pain. The events were unresolved at the time of this report. Follow-up information in the form of medical records was received on 16 January 2009. On 26 July 2000, the subject was evaluated for her anxiety which had been a problem recently. She was started on EFFEXOR for treatment. An exam dated 21 August 2000 indicated that the subjects anxiety and depression were stable and she continued treatment with EFFEXOR. On 11 October 2000 the subject was complaining of questionable ear problems and dizziness. The problems had been ongoing for a while and has been taking EFFEXOR. As a result of these conditions the subjects coordination was off. On 13 October 2000, the subject reported experiencing vertigo, dizziness and generalized hearing loss. She also indicated that her coordination was slightly off. She underwent a psychiatric evaluation in May 2001 following what subject called a severe anxiety attack. The subject has a known history of anxiety and depression. She was noted to have panic disorder with agoraphobia and major depression. The subject was to continue her concurrent medication EFFEXOR XR at 75 mg daily and switch from her current XANAX to KLONOPIN 0.5 mg, half tab three times daily. An exam dated 04 August 2003 revealed arthralgias. The subject complained of fatigue, swollen joints and headache which had been present for about one year at the time. It was noted that the subject had a negative sed rate and rheumatoid factor a little over a year ago. Her Lyme screening test was positive but the confirmatory Western Blot was negative. She reported having a tick bit about a year ago (date from documentation was short time prior to 26 October 2001 as she presented with the tickbite on that date). An exam dated 18 August 2003 revealed right lower quadrant painand polyarthralgia. The subject presented with right sided lower abdominal pain and joint pain all over her body at the time.