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.
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.
As per one of the slides around 7 minutes in, there are many vaccines that show a 20-40% reduction in mortality and dementia.
The talk above basically says that “observational studies” may show great results, like the so-called protective action of the shingles vaccine against dementia. However when brought to a well designed RCT all those benefits don’t actually show up. And the speaker shows later on that the shingles vaccines shows a marked benefit for shingles but nothing for dementia.
On the topic of vaccines, if you were vaccinated against measles before it switched to the two-dose schedule (1989 in the US), you might want to have your titers measured.
I was vaccinated in the early 70s when it was a single dose. With measles in the news recently, I asked my doc to add a measles antibodies test to my blood draw. Came back negative. No immunity. I went to the local pharmacy and got an MMR booster the next day.
I read before that iirc because of waning protection it’s better not to get it too early. It’s not clear to me why you can’t get it twice, but what I read (and it was some online discussion so could be wrong) was that someone had been specifically told by their doctor to wait to 50 as the best spot to get it. I’d like to know more, I’m in my 40s and would be happy to get it now too but not if it was going to be worse overall for some reason.
Hmm but as I understand it, dementia begins in your 30s. It's just that we don't see the signs of it until much later. So if it is protective, waiting doesn't seem wise (on the dementia side of it).
My primary care suggested I hold off to mid-late 50s instead of right at 50 for this reason. Between not wanting shingles, and some of the newer research into neuroprotective angles I'm not sure I'm going to do this however.
The antibodies you develop to fight the virus fade over time. I just had it fairly recently (young 30s, vaccinated with the attenuated chickenpox virus, never had chickenpox, so this was likely the vaccine strain¹). Did a lot of reading and research during and after. The antibodies seem to offer good protection for 5-10 years following either vaccination or infection according to the literature I was reading.
¹ The vaccine strain tends to be much more mild than the wild strain, and indeed it was quite unpleasant, but not extremely painful for me. The wild strain is considerably more painful and linked to a greater incidence rate of complications. Please do not skip chickenpox vaccinations for your kids, the minor risk of latent infection from attenuated vaccine is far less harmful than the consequences of not vaccinating. Most important of all, if you have a cluster of blisters or rash on one side of your body that keep popping up, make sure to see a doctor and get on antivirals within the first 72 hours for best results.
Yes. In my case, the virus became active after severe and chronic sleep deprivation one summer where I tried experimenting with going from a 16/8 sleep schedule to a 24/12 sleep schedule, on a now-resoundingly-disproven hypothesis that the ratio of waking hours to sleeping hours was more important than the absolute number of each for healthy functioning.
Stress and sleep deprivation are known triggers for the virus, which lies dormant in the nervous system for life after initial infection, and can be dormant for decades at a time between reactivations.
My understanding is that they're not sure if the vaccine will last in your system for more than 30 years, and that subsequent doses may be less effective, so getting it early may weaken you later.
But I am with you. My personal bet is we'll know more about this by the time that becomes an issue.
The earliest cohorts of vaccinated children are approaching their 30s, so we should learn about long term efficacy this decade.
> they're not sure if the vaccine will last in your system for more than 30 years
Vaccines don't really last in your system more than a few days (although some cells get dragged off to the lymph nodes and get harshly interrogated for longer than that). It is the T-cell and B-cell responses that are persistent for years.
> and that subsequent doses may be less effective
They should activate B cells that you already have and produce high-affinity mature antibodies.
It's a fair callout, but for me (and increased propensity for Alzheimer's) the calculus is a bit different. Making to to my mid-70s with full mental faculties would easily be worth the tradeoff of an increasing likelihood of shingles at that point. And besides, I would presume I would be able take the vaccine again?
You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.
We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card.
So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.
There is a large industry in the US that specializes in catering to people that want medications, vaccines, diagnostics, and treatments that are outside the recommended standard of care that medical insurance or public health systems cover. You have to pay for these services directly but the market is competitive so the cost is quite reasonable.
A doctor must sign off on these but that step is mostly performative outside of some narrow exceptions. My impression is that this type of medical care is much more accessible in the US than most other developed countries.
Not exactly. My doctor wanted to start me on a medicine that would make me more likely to develop shingles so he asked me to get the vaccine series before he'd prescribe the medicine. I guess there's no such thing as a prescription for a vaccine, so I just went to my local pharmacy. I made the mistake of writing on the form that I had no health issues. The pharmacist came out and said because I wasn't 50 and had no health issues they weren't allowed to administer the vaccine. Even after I explained my condition and the doctor's request they still refused. They wouldn't even let me fill out a new form. I had to go to a different pharmacy which conveniently didn't ask about my current health status.
It's stupid too, because the question I answered "wrong" wasn't clear. It basically sounded like they were asking me if I currently had a cold or covid.
You can just ask for vaccines at the pharmacy. I got a potentially missed childhood vaccination as an adult and they asked a few questions about why I wanted it, but were happy to give it to me. If it’s something odd you might need to go to a travel clinic.
I'm in my 40s and asked my GP for it since I similar had a bad experience with it a few years ago. After warning me 3 times that it might not get covered by insurance, they gave it to me. I tried to get the second dose at a pharmacy, and they would not do it since I'm under 50. I got the second dose at my GP again a few months later.
If you just want to pay out of pocket or with an HSA, etc. you can get many vaccines at a pharmacy. Might need to check if there are limited hours for that service or appointments needed. Not sure if Shingrix is one of them.
If you have already had shingles as an adult, aren’t you fairly well protected for the next ten years or so, at least? I’d wager that you are one of the people least at risk since your immune system is already primed and readying suppress the virus that’s latently infecting you.
I got shingles at 45 and it was -not fun-. My arm is slightly disfigured.
I think the age 50 target is dated. With reduced childhood incidence of chicken pox, we're all exposed to varicella zoster less, and it seems like the ages of incidence of shingles is falling. Public health recommendations are slow to catch up with research (especially for vaccinations, these days).
I got it around 36, and coincidentally a friend 5-6 years younger than me in a different part of the country got it at the same time.
My research at the time led me to the same conclusion: Since we've basically eradicated chickenpox, we're not exposed to the varicella zoster virus as much as previous generations (via children that have chickenpox). Without exposure our antibodies / resistance fade out.
Since we had chickenpox, the virus is already in us and dormant. When it wakes up and decides to do its thing, our bodies have forgotten how to fight it effectively compared to previous generations - and as a result, the incidence of shingles is increasing in younger populations compared to previous generations.
My doctor said vaccination for under 50 is only indicated after multiple occurrences of shingles... so here's to hoping I'm good til the guidelines change.
Same here. It was the worst medical event I've experienced, but thankfully I have no lasting damage other than some very small patches of skin that are desensitized. I've never experienced such pain, nausea and discomfort in my life, which thankfully only lasted < 48 hours, but other symptoms lasted over a month. I had a constant headache for 2-3 weeks straight and a level of energy depletion and brain fog that is tough to describe. I could barely hold simple yes/no conversations without getting extremely irritated and trying to concentrate on a dumb TV show felt like running a marathon. Pretty sure the experience left me with PTSD.
> Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[17][60]
People (well, Americans and Canadians at least) in their 40s now generally didn't get vaccinated as children, as their parents didn't have the option. It will be different for the next generation.
Yeah, I came here to say the same thing. I got it around 46. The horrible looking stuff on the outside is also on the inside, and it weakens your internal tissues. I know this because I tore one of the muscles in my lower back, and it still causes problems.
Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.
I think the bigger thing is that the vaccine has a peak response window, and the current medical guidance lines that up with when you're epidemiologically most likely to experience a shingles outbreak (for most people, that's very unlikely when you're young, because your immune system is so jumpy, but that wanes with age). If you get the vaccine early, its effect can be attenuated right when you need it most.
(I don't like this logic and if I had the option of just going to Walgreens and getting vaccinated, I'd do that this afternoon. I'm just saying, there's a logic to it.)
My A1C popped high, so I could get Shingrix 2 years before the nominal minimum age, paid for by insurance, on the technicality of having a T2D diagnosis. My blood sugar is much more under control now, but that's a nice little side benefit I won't hesitate to take advantage of. The most severe side effect for me was long term muscle pain near the injection site (even now 10 months after I got the shot). But it's totally worth it because the pain of shingles is far, far worse as I understand it.
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.
"association" undersells it a bit, because the data is better than the typical cohort study, which has issues like "what if people who got the vaccine are also richer and care about their health more?". There's quasi-randomization going on. From the more in depth article that's linked:
>Research is also revealing unexpected interventions that help to keep ageing minds sharp. One of the most promising derives from an analysis by Pascal Geldsetzer of Stanford University and his team of a natural experiment in Wales. In 2013 the British region started offering people aged 70-79 free vaccinations through the public-health system. This change resembled an RCT, in that a large number of people were separated almost at random into two groups: those who had already turned 80 in the weeks before the programme started, and so were not eligible to be jabbed; and those who turned 80 in the weeks after, roughly half of whom were duly vaccinated.
I'm one of those people (knock on wood) who never gets sick. I never get colds or seasonal flu, and I don't get routine flu vaccines. Never got COVID either, even when several people in the house had it (I did get the J&J vaccine for that, however).
I did have chicken pox as a kid, but have not had shingles nor the vaccine (yet). A co-worker was laid up for a week after his shingles vaccine, but that's obviously just one data point.
But, I've been considering getting the Shingrix series even if I have to pay for it. I turn 60 this year. Shingles doesn't sound fun.
The shingles virus hides in the nervous system and can come back out when immune control weakens. It causes inflammation and nerve injury, sometimes severe enough to leave people with chronic pain. From there, it’s reasonable to theorize that it could also affect the brain and even its glymphatic system over time.
Not common knowledge, but should be in this day and age.
For example, someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
When I learned it, it was in the context of the influenza and similar common viruses.
As far as I know you're overstating what is known.
There was a study that showed that people who had severe influenza (they were hospitalized) were 3 times more likely to develop dementia. And there are mouse models that show that frequency respiratory virus infections can increase may contribute to brain aging (in mice).
>someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
I can't find any evidence of this being true. I can find evidence that primary school teachers have lower rates of dementia. Pediatricians also have lower rates of dementia, so I find this highly doubtful.
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.
Good guess. The actual mechanism is that people who don't get the vaccination are more likely to need to visit the hospital to treat their shingles, and because they visit the hospital more they have more chances to get a diagnosis of dementia in a hospital. See this presentation: https://youtu.be/qlTnnQytOJ0
The lesson is to be extremely suspicious of findings of causation based on observational studies.
> 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.
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.
I think the short version is that people have developed a lot of things to substantially reduce the levels in human brains, but in practice is doesn't seem to be yielding clearly-good results.
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.
The article says that one possible reason the vaccine protects against dementia is incidental protection from other diseases. Getting chickenpox as a kid might protect you against shingles, but maybe not against those other diseases.
No! The opposite thing is true. Getting chickenpox as a kid drastically increases your likelihood of getting shingles as an adult. The initial chickenpox infection is the mechanism by which you're set up for shingles: you get it, fight it back, and it remains dormant in your nerves. Shingles is not simply chickenpox; it's the secondary infection you get from a resurgent zoster outbreak based in your nerves.
Getting chicken pox as a kid means you already have the H. zoster virus in your system, and when you get older as your immune system weakens, it may come out for a second go around, manifesting as shingles. Having had chicken pox as a kid is one of the reasons why I got my Shingrix as soon as I was able.
But what if those unstudied accessible "natural" remedies have even more problems? Should we choose to do nothing, only study nothing, or just redefine what "natural" is?
> 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.
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.
In a separate article the other factors are quoted with similar impact (listed in order of max potential magnitude)
- anti depression treatment
- education increases
- hearing improvement
- obesity reduction
- low alcohol
That may be the case in other countries, but in the US we're generally fee-for-service, so the incentives are reversed, and we still don't give it until you're 50 (which, as someone who has had it and is under 50, annoys me to no end).
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.
are there that many instances of mild dementia where a lack of diagnosis remains a lack?
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.
This finding of shingles and dementia is likely due to “healthy vaccinee” bias as per the link someone else posted below:
https://youtu.be/qlTnnQytOJ0?is=XJ0c5pWVV6Lg0IMs
As per one of the slides around 7 minutes in, there are many vaccines that show a 20-40% reduction in mortality and dementia.
The talk above basically says that “observational studies” may show great results, like the so-called protective action of the shingles vaccine against dementia. However when brought to a well designed RCT all those benefits don’t actually show up. And the speaker shows later on that the shingles vaccines shows a marked benefit for shingles but nothing for dementia.
On the topic of vaccines, if you were vaccinated against measles before it switched to the two-dose schedule (1989 in the US), you might want to have your titers measured.
I was vaccinated in the early 70s when it was a single dose. With measles in the news recently, I asked my doc to add a measles antibodies test to my blood draw. Came back negative. No immunity. I went to the local pharmacy and got an MMR booster the next day.
https://www.health.harvard.edu/diseases-and-conditions/some-...
There were a few studies around 2022 showing the influenza vaccines and pneumoccocal vaccines reduce alzheimers (influenza by up to a whopping 40%!).
I tell me patients this to increase uptake, so we can reduce alzheimer's prevalence.
(I'm a doctor)
I read before that iirc because of waning protection it’s better not to get it too early. It’s not clear to me why you can’t get it twice, but what I read (and it was some online discussion so could be wrong) was that someone had been specifically told by their doctor to wait to 50 as the best spot to get it. I’d like to know more, I’m in my 40s and would be happy to get it now too but not if it was going to be worse overall for some reason.
Hmm but as I understand it, dementia begins in your 30s. It's just that we don't see the signs of it until much later. So if it is protective, waiting doesn't seem wise (on the dementia side of it).
My primary care suggested I hold off to mid-late 50s instead of right at 50 for this reason. Between not wanting shingles, and some of the newer research into neuroprotective angles I'm not sure I'm going to do this however.
Yeah
And you can absolutely get Shingles before 50 (in some cases)
But surely you can do a booster shot?
So far as I know there's no standard booster protocol for Shingrix.
That just tells you it hasn’t been fully researched, not that it wouldn’t be useful.
You could just get one more dose, right?
The antibodies you develop to fight the virus fade over time. I just had it fairly recently (young 30s, vaccinated with the attenuated chickenpox virus, never had chickenpox, so this was likely the vaccine strain¹). Did a lot of reading and research during and after. The antibodies seem to offer good protection for 5-10 years following either vaccination or infection according to the literature I was reading.
¹ The vaccine strain tends to be much more mild than the wild strain, and indeed it was quite unpleasant, but not extremely painful for me. The wild strain is considerably more painful and linked to a greater incidence rate of complications. Please do not skip chickenpox vaccinations for your kids, the minor risk of latent infection from attenuated vaccine is far less harmful than the consequences of not vaccinating. Most important of all, if you have a cluster of blisters or rash on one side of your body that keep popping up, make sure to see a doctor and get on antivirals within the first 72 hours for best results.
You had Shingles after never having chicken pox except the vaccine?
Yes. In my case, the virus became active after severe and chronic sleep deprivation one summer where I tried experimenting with going from a 16/8 sleep schedule to a 24/12 sleep schedule, on a now-resoundingly-disproven hypothesis that the ratio of waking hours to sleeping hours was more important than the absolute number of each for healthy functioning.
Stress and sleep deprivation are known triggers for the virus, which lies dormant in the nervous system for life after initial infection, and can be dormant for decades at a time between reactivations.
My understanding is that they're not sure if the vaccine will last in your system for more than 30 years, and that subsequent doses may be less effective, so getting it early may weaken you later.
But I am with you. My personal bet is we'll know more about this by the time that becomes an issue.
The earliest cohorts of vaccinated children are approaching their 30s, so we should learn about long term efficacy this decade.
> they're not sure if the vaccine will last in your system for more than 30 years
Vaccines don't really last in your system more than a few days (although some cells get dragged off to the lymph nodes and get harshly interrogated for longer than that). It is the T-cell and B-cell responses that are persistent for years.
> and that subsequent doses may be less effective
They should activate B cells that you already have and produce high-affinity mature antibodies.
It's a fair callout, but for me (and increased propensity for Alzheimer's) the calculus is a bit different. Making to to my mid-70s with full mental faculties would easily be worth the tradeoff of an increasing likelihood of shingles at that point. And besides, I would presume I would be able take the vaccine again?
Wait, you can just pay for the shingles vaccine, before you're 50? Where do I do that?
I had shingles in my 30s. It was the sickest I've ever been.
You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.
We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card.
So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.
> You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.
Is that not usually true in other countries?
There is a large industry in the US that specializes in catering to people that want medications, vaccines, diagnostics, and treatments that are outside the recommended standard of care that medical insurance or public health systems cover. You have to pay for these services directly but the market is competitive so the cost is quite reasonable.
A doctor must sign off on these but that step is mostly performative outside of some narrow exceptions. My impression is that this type of medical care is much more accessible in the US than most other developed countries.
Not exactly. My doctor wanted to start me on a medicine that would make me more likely to develop shingles so he asked me to get the vaccine series before he'd prescribe the medicine. I guess there's no such thing as a prescription for a vaccine, so I just went to my local pharmacy. I made the mistake of writing on the form that I had no health issues. The pharmacist came out and said because I wasn't 50 and had no health issues they weren't allowed to administer the vaccine. Even after I explained my condition and the doctor's request they still refused. They wouldn't even let me fill out a new form. I had to go to a different pharmacy which conveniently didn't ask about my current health status.
It's stupid too, because the question I answered "wrong" wasn't clear. It basically sounded like they were asking me if I currently had a cold or covid.
You can just ask for vaccines at the pharmacy. I got a potentially missed childhood vaccination as an adult and they asked a few questions about why I wanted it, but were happy to give it to me. If it’s something odd you might need to go to a travel clinic.
Not this one you can't.
I told my local Walgreens I am immunocompromised and they did not ask for proof (early 40s).
https://www.cdc.gov/shingles/hcp/vaccine-considerations/inde...
See this is the information I'm looking for. :)
Happy to help!
I'm in my 40s and asked my GP for it since I similar had a bad experience with it a few years ago. After warning me 3 times that it might not get covered by insurance, they gave it to me. I tried to get the second dose at a pharmacy, and they would not do it since I'm under 50. I got the second dose at my GP again a few months later.
If you just want to pay out of pocket or with an HSA, etc. you can get many vaccines at a pharmacy. Might need to check if there are limited hours for that service or appointments needed. Not sure if Shingrix is one of them.
I've tried to get the shingles vaccine at Walgreens before and been turned down because I wasn't old enough.
Huh. Well maybe not then. Did you make it clear you'd pay out of pocket and not insurance?
Yes. I really want this vaccine.
Have you tried asking your PCP?
I'm pretty confident I could talk my PCP into it! I'm just wondering if there is some easier retail way to do it.
If you have already had shingles as an adult, aren’t you fairly well protected for the next ten years or so, at least? I’d wager that you are one of the people least at risk since your immune system is already primed and readying suppress the virus that’s latently infecting you.
You are more likely to have a recurrence of shingles after once having it before. At any rate, I had mine more than 10 years ago.
I got shingles at 45 and it was -not fun-. My arm is slightly disfigured.
I think the age 50 target is dated. With reduced childhood incidence of chicken pox, we're all exposed to varicella zoster less, and it seems like the ages of incidence of shingles is falling. Public health recommendations are slow to catch up with research (especially for vaccinations, these days).
I got it around 36, and coincidentally a friend 5-6 years younger than me in a different part of the country got it at the same time.
My research at the time led me to the same conclusion: Since we've basically eradicated chickenpox, we're not exposed to the varicella zoster virus as much as previous generations (via children that have chickenpox). Without exposure our antibodies / resistance fade out.
Since we had chickenpox, the virus is already in us and dormant. When it wakes up and decides to do its thing, our bodies have forgotten how to fight it effectively compared to previous generations - and as a result, the incidence of shingles is increasing in younger populations compared to previous generations.
My doctor said vaccination for under 50 is only indicated after multiple occurrences of shingles... so here's to hoping I'm good til the guidelines change.
> I got it around 36
Same here. It was the worst medical event I've experienced, but thankfully I have no lasting damage other than some very small patches of skin that are desensitized. I've never experienced such pain, nausea and discomfort in my life, which thankfully only lasted < 48 hours, but other symptoms lasted over a month. I had a constant headache for 2-3 weeks straight and a level of energy depletion and brain fog that is tough to describe. I could barely hold simple yes/no conversations without getting extremely irritated and trying to concentrate on a dumb TV show felt like running a marathon. Pretty sure the experience left me with PTSD.
> Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[17][60]
People (well, Americans and Canadians at least) in their 40s now generally didn't get vaccinated as children, as their parents didn't have the option. It will be different for the next generation.
Interestingly UK took a different approach and only started offering chicken pox vaccines for children this year.
https://www.gov.uk/government/news/free-chickenpox-vaccinati...
Which, if chickenpox is really the cause of a lot of dementia (as this article implies) might have been a pretty grave mistake.
Yeah, I came here to say the same thing. I got it around 46. The horrible looking stuff on the outside is also on the inside, and it weakens your internal tissues. I know this because I tore one of the muscles in my lower back, and it still causes problems.
I feel like we've probably spent more for less! Any interaction with the medical industry for less than 1k feels like a steal to me.
Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.
"An increased risk of Guillain-Barré syndrome (severe muscle weakness) was observed after vaccination with SHINGRIX"
https://www.shingrix.com/side-effects/
That seems like being penny wise and pound foolish.
Looks like the GP is in the UK.
I tried to go private (also not 50), but everyone just refused. Pharmacy, GP, private GP.
Currently I'm arranging it in the third country because WTAF.
(UK becoming the dirtiest and sickest country of Europe one more time)
Close, I'm in the US. I don't need a script to get it, only if I want the insurance to pay for it.
But if I couldn't I could still go to Mexico and buy brand name Shingrix.
The age for shingles vaccine in the UK under the NHS (so free) is 65.
Of course I got shingles when I was 64. Caught early and got anti-virals and had no lasting effects.
> (UK becoming the dirtiest and sickest country of Europe one more time)
Big Yawn
I think the bigger thing is that the vaccine has a peak response window, and the current medical guidance lines that up with when you're epidemiologically most likely to experience a shingles outbreak (for most people, that's very unlikely when you're young, because your immune system is so jumpy, but that wanes with age). If you get the vaccine early, its effect can be attenuated right when you need it most.
(I don't like this logic and if I had the option of just going to Walgreens and getting vaccinated, I'd do that this afternoon. I'm just saying, there's a logic to it.)
My A1C popped high, so I could get Shingrix 2 years before the nominal minimum age, paid for by insurance, on the technicality of having a T2D diagnosis. My blood sugar is much more under control now, but that's a nice little side benefit I won't hesitate to take advantage of. The most severe side effect for me was long term muscle pain near the injection site (even now 10 months after I got the shot). But it's totally worth it because the pain of shingles is far, far worse as I understand it.
aside from age ranges being the tested population, your just gambling no other interference pattern is involved.
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.
>Replicated association [...]
"association" undersells it a bit, because the data is better than the typical cohort study, which has issues like "what if people who got the vaccine are also richer and care about their health more?". There's quasi-randomization going on. From the more in depth article that's linked:
>Research is also revealing unexpected interventions that help to keep ageing minds sharp. One of the most promising derives from an analysis by Pascal Geldsetzer of Stanford University and his team of a natural experiment in Wales. In 2013 the British region started offering people aged 70-79 free vaccinations through the public-health system. This change resembled an RCT, in that a large number of people were separated almost at random into two groups: those who had already turned 80 in the weeks before the programme started, and so were not eligible to be jabbed; and those who turned 80 in the weeks after, roughly half of whom were duly vaccinated.
I'm one of those people (knock on wood) who never gets sick. I never get colds or seasonal flu, and I don't get routine flu vaccines. Never got COVID either, even when several people in the house had it (I did get the J&J vaccine for that, however).
I did have chicken pox as a kid, but have not had shingles nor the vaccine (yet). A co-worker was laid up for a week after his shingles vaccine, but that's obviously just one data point.
But, I've been considering getting the Shingrix series even if I have to pay for it. I turn 60 this year. Shingles doesn't sound fun.
Just curious, do you have children? Do you socialize pretty freely during all seasons indoors?
I wonder if infections do not cause more dementia, but are simply correlated with more. A weaker immune system may trigger many many things.
And similar questions about obesity "causing" many diseases, sunburns causing skin cancer (although that sounds somewhat plausible) etc.
There isn't a causal mechanistic link between shingles and Alzheimers. We don't know why the Shingrix vaccine reduces incidence of Alzheimers.
(You should very much want to avoid any chance of getting shingles, though; it's a nightmare.)
The shingles virus hides in the nervous system and can come back out when immune control weakens. It causes inflammation and nerve injury, sometimes severe enough to leave people with chronic pain. From there, it’s reasonable to theorize that it could also affect the brain and even its glymphatic system over time.
> like the more colds you have in life
Whoa wait what? This is the first time I’ve heard of this - is this actually common knowledge?
Not common knowledge, but should be in this day and age. For example, someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
When I learned it, it was in the context of the influenza and similar common viruses.
It's actually more nuanced than that. If you want to read more: https://www.openevidence.com/ask/bccc3cc2-e15d-4fb0-a0c5-16f...
As far as I know you're overstating what is known.
There was a study that showed that people who had severe influenza (they were hospitalized) were 3 times more likely to develop dementia. And there are mouse models that show that frequency respiratory virus infections can increase may contribute to brain aging (in mice).
>someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
I can't find any evidence of this being true. I can find evidence that primary school teachers have lower rates of dementia. Pediatricians also have lower rates of dementia, so I find this highly doubtful.
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.
HORSE PASTE!!! NO!!! NO MEDICINE HAS TWO USES!!! HORSE PASTE!!!
Did I do it right?
https://c19early.org/i
Is it also possible they're finding healthier people that are proactive in their treatment, maybe even exercise more, work longer, etc...
Good guess. The actual mechanism is that people who don't get the vaccination are more likely to need to visit the hospital to treat their shingles, and because they visit the hospital more they have more chances to get a diagnosis of dementia in a hospital. See this presentation: https://youtu.be/qlTnnQytOJ0
The lesson is to be extremely suspicious of findings of causation based on observational studies.
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.
> 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/
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.
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.
> the Amyloid hypothesis is on the wane
Oh? What did I miss?
I think the short version is that people have developed a lot of things to substantially reduce the levels in human brains, but in practice is doesn't seem to be yielding clearly-good results.
https://news.ycombinator.com/item?id=32183302
TL;DR A lot of evidence supporting the Amyloid hypothesis is suspect.
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.
My brother had it when he was 17
So if you had shingles in your youth then you are better protected against dementia?
No, the opposite. If you've had shingles before, you're more likely to get it again later, not less.
They asked about dimentia
The article says that one possible reason the vaccine protects against dementia is incidental protection from other diseases. Getting chickenpox as a kid might protect you against shingles, but maybe not against those other diseases.
No! The opposite thing is true. Getting chickenpox as a kid drastically increases your likelihood of getting shingles as an adult. The initial chickenpox infection is the mechanism by which you're set up for shingles: you get it, fight it back, and it remains dormant in your nerves. Shingles is not simply chickenpox; it's the secondary infection you get from a resurgent zoster outbreak based in your nerves.
Don't get chickenpox.
Well, now… I can tell you second hand that catching chicken pox as an adult is no picnic either.
No it is not. Ranked list of outcomes:
1. Not getting chickenpox at all. Highly desirable.
2. Getting chickenpox as a kid.
3. Getting chickenpox as an adult.
Getting chicken pox as a kid means you already have the H. zoster virus in your system, and when you get older as your immune system weakens, it may come out for a second go around, manifesting as shingles. Having had chicken pox as a kid is one of the reasons why I got my Shingrix as soon as I was able.
Not really, shingles is a lifetime infection. You'd be more likely.
...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
But what if those unstudied accessible "natural" remedies have even more problems? Should we choose to do nothing, only study nothing, or just redefine what "natural" is?
> 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.
https://archive.ph/PzPop
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.
In a separate article the other factors are quoted with similar impact (listed in order of max potential magnitude) - anti depression treatment - education increases - hearing improvement - obesity reduction - low alcohol
The earlier you start the better.
>anti depression treatment - regular exercise - obesity reduction - education - less/no alcohol
Injecting people with a shingles vaccine is far easier than the others you listed, which is why it stands out.
Can you share the article you reference?
Its paywalls though: https://economist.com/briefing/2026/07/09/how-dementia-is-be...
> hearing improvement
This means addressing hearing loss, e.g. via hearing aids.
Dementia largely affects people on a pension, and not working adults contributing to the pyramid scheme.
This would be a good conspiracy theory if dementia was a short illness.
Should I get the shingles vaccine at a young age? I've had chickenpox earlier in my life.
As someone who got shingles at about 46, yes.
That may be the case in other countries, but in the US we're generally fee-for-service, so the incentives are reversed, and we still don't give it until you're 50 (which, as someone who has had it and is under 50, annoys me to no end).
20% of what?