The purpose of this paper is to take seriously the role of the tick in Canadian Lyme disease discourse. I analyse Public Health Agency of Canada Lyme disease awareness materials alongside patient narratives from the 2016 Canadian Conference to Develop a Federal Framework on Lyme Disease to show that the tick has a more complex, symbiotic relationship to the Lyme disease sufferer. The tick, therefore, is not just a threat, but also is essential in the making of sufferers. This analysis draws on animal studies and new materialisms to understand public health messaging about Lyme disease in terms of preserving distance and separation between humans and ticks. I argue that public health messaging that emphasises the need for excluding the tick makes space for one kind of Lyme disease experience—the acute sufferer—and simultaneously renders impossible other forms of illness experience—the chronic sufferer. In contrast to Public Health messaging that emphasises exclusion, chronic Lyme disease sufferers embrace a human/tick entanglement as a way of claiming reality of their existence. The tick, then, is not just the vector for Lyme disease, but this creature plays a central role in determining the ontological possibilities of patients and sufferers and offers certification of an identity that is often characterised as not possible in mainstream medicine.