The shingles vaccine may reduce the risk of dementia

robot_jesus

https://archive.ph/PzPop

satya71

TL;DR Shingles vaccines reduces chances of dementia by 20%. Yet, most countries health systems only look at the upfront cost of ~$300 and don’t recommend for all who could benefit.

robot_jesus

I'm in my 40s with genetic predisposition for Alzheimer's. Been seriously considering the past year or two paying out of pocket for Shingrix. I think it would be ~$500 total for two doses. Sure, I could wait 7 or 8 years until I qualify via insurance, but is that really worth the risk for what is an easily absorbed cost to me? Especially when I have a friend in her late 30s who just went through a very rough bout of shingles? It makes sense to have targets like age 50 for population-wide public health recommendations. But it can and does infect people of much earlier ages. Recent articles like this make me think I'll go ahead.

hereme888

Replicated association, which is strong, but not proof. Initial study saw a 3.5% absolute reduction in dementia diagnoses over seven years with a very wide confidence interval. In Australia the study was replicated with 1.8% absolute reduction over 7.4 yrs. Canadian replication: 2% over 5.5 yrs. Infections generally increase the risk of future dementia. Like the more colds you have throughout life.

syntaxing

I know quite a few people who got shingles in their early 20s. One of their doctors didn’t believe she had shingles until the blisters formed. The vaccine can definitely help those younger than 50, dementia benefits or not. Some of them have permanent nerve damage after getting shingles.

antaviana

So if you had shingles in your youth then you are better protected against dementia?

khriss

Recently, even the TDAP (Tetanus) vaccine was correlated with lower incidence of dementia https://news.ycombinator.com/item?id=26919881 I recall seeing a few discussions on HN comments hypothesizing that immune system stimulation via the vaccine might be the root cause. Now that the Amyloid hypothesis is on the wane, hopefully we'll explore other paths.

what_hn

Is it also possible they're finding healthier people that are proactive in their treatment, maybe even exercise more, work longer, etc...

WarOnPrivacy

PSA: For us uninsured, the shingles vaccine costs ~$500 out of pocket (>$250 x2). I want folks to get it but - I feel "Just Get It" admonitions carry a vibe that the cost is negligible.

cubefox

> Most of the evidence of its anti-dementia effect relates to an earlier version of the vaccine, which used a weakened form of the live virus. It has since been largely replaced by a new one, Shingrix, which contains just a sprinkling of proteins from the virus and is seen as safer because it cannot cause an infection. Unfortunately the apparent anti-dementia effect of this old vaccine (Zostavax) recently turned out to be a statistical illusion: https://youtube.com/watch?v=qlTnnQytOJ0 It is not clear whether the effect from Shingrix (the new one) is real or not. We currently don't have a case-control study which could prove causation.

ChrisMarshallNY

I had the vaccine, last year (but I’m 64). Hoowee, it made me sick , but only for a day (twice, as you get a booster, six months later). Had chickenpox (and measles, at the same time), when I was a kid. That was fun. My mother used to get recurring bouts of the shingles. Definitely not fun.

jonatron

I got shingles after the covid vaccine, which is a rare but statistically highly significant risk: https://pubmed.ncbi.nlm.nih.gov/35470920/ . Both covid and shingles sucked, luckily it was years ago now.

modeless

Unfortunately this is a spurious finding. See this presentation: https://youtu.be/qlTnnQytOJ0 The mechanism is that people with the shingles vaccine are less likely to visit the hospital (because they don't get shingles). Because they have fewer hospital visits they are less likely to receive an incidental diagnosis of dementia from a hospital.

mullingitover

> Another is that the vaccination gives the immune system a firm kick up its B-cells, activating it against other bugs that might contribute to dementia. It's weird that they kinda gloss over the very real and open questions here, because the idea that the AS01 adjuvant is involved in the dementia protection is very much alive and an ongoing topic. A paper from last year[1] looked into it and found that the Shingrix shingles vaccine and the RSV vaccine are about the same in their risk reduction for dementia (with a bunch of caveats). I believe the current evidence point to the shingles vaccine helping, but also a protective effect happening from the AS01 adjuvant on its own. I'm not a researcher but my layman's take is that the Economist whiffed it here, and there's a more interesting and complicated story to be told beyond this clickbait-adjacent science journalism. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC12198376/

erelong

...and there may be damaging side effects while there are probably lots of accessible "natural" demetia remedies that you can do without having to resort to experimental drugs that may cause more problems and cost more

panny

HORSE PASTE!!! NO!!! NO MEDICINE HAS TWO USES!!! HORSE PASTE!!! Did I do it right? https://c19early.org/i Edit: I just learned all the dementia patients have undiagnosed shingles. Please ignore my comment now. :-|

tsoukase

Dementia might have dozens of risk factors, each adding up a little. Physical and emotional stress, insomnia, head microinjuries, arteriovascular risk factors, infections and there lies herpes zoster. Only the latter has a causal treatment and is only single stone on the wall of disease.

pstuart

I got shingles in my early 50s and did not know there were antivirals that could help mitigate its effects. I now have postherpetic neuralgia and the pain is not quite enough to off myself but the fact that I have to live with this for the rest of my life weighs me down. It turns out that "pain management" is more art than science and almost all the pharma options out there come with significant risks and concerns. I ended up turning to kratom to manage the pain, which it does, but it's come at significant cost as well (addiction being one of them). I'm now going to try peptides (ARA-290 and BPC-157) to see if maybe that can help but it's all a crap shoot. I share this as a warning/advice: get the vaccine if you can, even if insurance resists, push back. It may be worth it out of pocket IMHO. If you can't, remember to get access to antivirals immediately if you can.

pengaru

will we ever be free from the curse of believing correlation == causation

gdudeman

If you haven't seen the chart from the UK study, I highly recommend checking it out: https://erictopol.substack.com/p/the-shingles-vaccine-and-re... When the vaccine came out in the UK, they included a hard age cutoff: Above a certain age, you weren't eligible. Below that age, you were eligible. They looked at the probability of a dementia diagnosis over the 7 years after the vaccine was introduced. People who were born in the "can get the vaccine" group have markedly lower rates of dementia. People in the "too old" group have higher rates. It's cut and dry. The researchers didn't separate out the people who actually got the vaccine. It's one of those studies where you don't even need to look at the p-value to see the difference between the cohorts.