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Article History

Received: 2 May 2025

Accepted: 18 November 2025

First Online: 27 November 2025

Declarations

:

: This study was carried out in accordance with the principles of the Declaration of Helsinki and adhered to institutional regulations and guidelines. As this study used deidentified repository clinical isolates that are considered non-patient material and only used a limited selection of pseudonymized patient data that was previously collected, the Medical Ethics Committee of Amsterdam UMC has indicated it to be outside the scope of the Dutch Medical Research Involving Human Subjects Act (MEC decision 2024.0906). Analysis of deidentified patient data was carried out under a waiver of consent.

: Not applicable.

: Authors who are current or former employees of Pfizer may be shareholders of Pfizer, Inc. Pfizer was involved in the study concept and design, the collection, analysis and interpretation of data, the drafting of the manuscript, and the decision to submit the manuscript for publication. J.W.H. has ongoing research collaborations with Pfizer, Inc., and collaborates, or has collaborated, with Moderna, Antigen Discovery, Inc., Bio-Rad Laboratories, Abbott, and ZEUS Scientific on other projects on Lyme borreliosis. J.W.H. has an application for a provisional patent related to Borrelia antigens pending. A.V. and A.P.V. declare no conflicts of interest.