Lyme Evidence Sheet

Reviewed 2026-07-24

What does equivocal or borderline mean?

Equivocal or borderline wording is not a complete yes-or-no answer by itself. It needs the full testing sequence and the laboratory’s final interpretation.

What the evidence says

  • A positive or equivocal first-tier result is generally followed by second-tier testing in the recommended sequence.
  • Laboratory reports can present the intermediate wording and final interpretation differently.

What this can tell you

  • That one report term may not be the final interpretation.
  • What wording to locate in the full report.

What this cannot tell you

  • Whether Lyme is confirmed or ruled out without the complete sequence.
  • Whether a website can read an incomplete report.

A useful question for your clinician

Was the second tier completed, and what is the laboratory’s final interpretation of the full sequence?
Sources (2)
  1. Centers for Disease Control and Prevention. ‘Testing and Diagnosis for Lyme Disease.’ https://www.cdc.gov/lyme/diagnosis-testing/index.html. Accessed July 24, 2026. Open source ↗
  2. Centers for Disease Control and Prevention and Association of Public Health Laboratories. ‘Suggested Reporting Language, Interpretation and Guidance Regarding Lyme Disease Serologic Test Results.’ 2024. https://www.cdc.gov/lyme/media/pdfs/2024/05/Suggested-Reporting-Language-Interpretation-and-Guidance-Regarding-Lyme-Disease-Serologic-Test-Results.pdf. Open source ↗