Deer tick. Photo by Lauren Bishop/CDC

As warming temperatures allow ticks to creep further north, the prevalence of tick-borne diseases continues to rise. (See my related tip sheet on climate change and Lyme disease.)

“Going out into the woods is an inherently healthy thing to do, and so choosing not to do outdoor activities [to avoid tick bites] is not necessarily a healthy decision,” Nick Ogden, Ph.D., with the Public Health Agency of Canada said. “It’s better to try and manage the risk than give up on your outdoor time.”

Most prevention recommendations focus on individual behavior and haven’t changed over the past several decades, despite the explosion of cases. Clearly, these tried-and-true methods are not cutting it (and awareness about them also lags). Although Lyme disease and other common tick-borne diseases are treatable, they can be tricky to diagnose and can cause long-term health problems.

So, preventing tick bites in the first place is the ideal approach. Tick prevention measures are a highly active area of research, Ogden says. Given the rising number of cases in a warming world, there’s a need for better awareness of what works as well as improvements in prevention methods.

Tick prevention 101 Wear long pants and long-sleeve shirts to reduce skin exposure. When you get home, take off those clothes and put them in the dryer on high heat for at least six minutes.

Use bug sprays containing deet or icaridin to prevent tick bites. (A new compound derived from donkey skin seems to be an effective repellent but is not yet widely available.)

Treat indoor-outdoor pets with a monthly acaricide to prevent ticks from coming inside.

Install gravel boundaries around your yard or high-use areas.

Keep grass mowed.

Wear permethrin-treated clothing, especially for outdoor workers and others who regularly spend time in tick-prone environments.

Stay on marked trails when hiking, as more tick encounters happen in overgrown areas.

Check everyone for ticks after being in tick-prone environments.

Emerging research on tick bite prevention

Rodent-targeted methods (tick tubes and bait boxes): Host-targeted methods aim to treat wildlife for ticks or Lyme disease. For example, tick tubes are toilet-paper-roll-sized tubes filled with cotton balls treated with a pesticide for ticks, such as permethrin or fipronil. The idea is that mice (or other rodents) will crawl into these cozy spaces and then take the cotton balls to build their nests, treating them and their babies for ticks. Bait boxes are rodent boxes with a similar treatment or sometimes with oral vaccines for Lyme, but they must be installed by a professional, increasing expense.

Early research shows some promise, though it is mixed. The presence of other host species besides mice and the use of other prevention measures with this approach seem to matter a great deal in their success.

“My colleagues at the University of Montreal have been studying using oral treatment, and it does reduce the density of infected ticks in the environment,” Ogden said, “but possibly not as much as people had hoped, because, of course, there are many different hosts for ticks and also for [the bacteria that causes Lyme disease].”

A buck feeds from a plastic 4-poster. The design of the device causes the buck to tilt its head toward the application rollers, ensuring that Tickicide is transferred to its head, neck, and ears. Public domain photo by Wayne Ryan/USDA

Deer-targeted methods (four-posters): Similar to the treatments for mice, treating deer with fipronil (the active ingredient in Frontline) has been explored for deer. Four-posters are contraptions with a bait box in the middle and four posts around the sides, made with PVC pipes and paint rollers treated with fipronil. When the deer comes to the bait, it has to rub against a couple of the posts and gets a tick treatment. Usually, these treatments are most useful on publicly accessible land for outdoor recreation and use.

Landscape management: For larger areas than a yard that you can mow and confine, regular prescribed burning can markedly reduce tick numbers. This topic is an emerging area of research, and how well managed fires work in various landscapes and ecosystems needs more study.

Vaccines and prophylactics for people: A vaccine for Lyme disease, VLA15, is currently in phase 3 clinical human trials. The research community is awaiting information on its effectiveness, and it could be submitted for FDA approval in 2026.

In the 1990s, two vaccines for Lyme disease made it through phase 3 clinical trials. LYMErix was approved by the U.S. Food and Drug Administration (FDA) in 1998. Anecdotes about arthritis as a side effect reported to the Vaccine Adverse Events Reporting System, an open reporting database to which anyone can submit adverse effects that they think are related to the vaccination, led to a class-action lawsuit. Although an FDA investigation found no link between arthritis and LYMErix, the vaccine was taken off the market because of the bad press and decreasing demand in 2002. The other vaccine, ImuLyme, was never submitted for FDA approval, for unknown reasons. Because Lyme disease cases have more than tripled in the United States since then, demand is likely higher, although so is vaccine hesitancy. Nevertheless, market research demonstrates high and increasing demand for Lyme-related pharmaceuticals, and surveys have indicated high interest in a Lyme disease vaccine.

A monoclonal antibody treatment called Lyme PrEP is in phase 2 and 3 clinical trials and, if effective, would offer seasonal protection to those who get the injections.

Offering various prevention options — both vaccines and monoclonal antibody treatments — can increase uptake.

Prevention improvements were needed, yesterday. Even though climate change is increasing our exposures to tick-borne diseases, humans are upping our game as well. Right now, though, the bacteria are outrunning us.