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Once Bitten, Twice Shy (10 player)
Defeat Blood-Queen Lana'thel once as a vampire and again without becoming a vampire in 10-player mode.
Once Bitten, Twice Shy (10 player) requires you to defeat Blood-Queen Lana'thel twice in 10-player mode — once after receiving the Essence of the Blood Queen debuff (becoming a vampire), and once while never receiving that debuff at all.
Kill Lana'thel as Vampire
Enter the raid and allow yourself to receive the Essence of the Blood Queen debuff at least once during the fight, then defeat Blood-Queen Lana'thel. You must survive the entire fight without dying, or credit will not be awarded.
Kill Lana'thel Without Infection
On a separate lockout, defeat Blood-Queen Lana'thel without ever receiving the Essence of the Blood Queen debuff. You must survive the entire fight without dying, or credit will not be awarded — and note that simply killing her before combat fully initiates does not count.
Tips
This achievement requires two separate kills across two different lockout resets, so plan for at least two weekly resets to complete both steps.