Holy shit: Causal evidence that the Shingles vaccine prevents a significant fraction of Alzheimer's cases. So 1, vaccines are a god damned miracle get your ass vaccinated, and 2 the implication that Alzheimer's disease is a preventable byproduct of viral infection is tectonic.
https://www.metafilter.com/199451/Dont-miss-your-shingles-shots
@scottmiller42 @drwho @mhoye You... *can* get it... for a price.
(Seriously, it's mostly an insurance limitation. If you have the ability to pay for it out of pocket, that's a thing that can be done.)
@scottmiller42 @drwho @mhoye I believe the reasoning is this:
- Shingles is less common and less severe in younger people
- The vaccine is not without negative side effects, even in younger people
- The vaccine also just hasn't been studied as much in people under 50
So they've got a risk/benefit thing going on, and that's where they drew the line.
Unfortunately, shingles is affecting people at younger and younger ages, possibly because the *chickenpox vaccine* has been so effective as to make re-exposure less common. Maybe they'll reconsider... or maybe by that time the "born too soon for the chickenpox vaccine, born too late for the shingles vaccine" crowd will have aged out to 50 already.
@varx
@scottmiller42 @drwho @mhoye Ya, I'm feeling miffed being in that interval. Too old for the chickenpox vaccine, too young for shingles vaccine.
Then, I had shingles in my 30sโฆ Took a year+ to shake off the nerve issues.
@varx @scottmiller42 @drwho @mhoye
The reason my doctor gave for refusing to give me (a 43-year-old with no known immune problems) the shingles vaccine was that there is only a single vaccine series administered (i.e., they normally won't give it to you if you've already had the series) and that there is no clear data on how well the vaccine works >40 years after receiving it.
I can sort of see the reasoning if I squint, but this is still altogether too much sticking to the letter of the law.
@mhoye Also now that you mention it, my grandparents who died of dementia related disease suffered multiple bouts of shingles.
Both my husband and I have had chicken pox because there was no vax available in the 70's.
Doing this as soon as possible.
I have heard this, so we are setting aside a few days for recovery each dose. Absolutely thrilled about this information.
@mhoye well seems you can only get it on NHS in UK if you are between the ages of 70 and 79โฆdo wonder if NICE will revise this if they realise it could prevent a sizeable chunk of people getting Alzheimerโs.
https://www.nhs.uk/conditions/vaccinations/shingles-vaccination/
@mhoye Protective for women, apparently, but not for men?
"The group found strong protective effects of the vaccine for women but not for men"
The root causes of dementia are still largely unclear, and the medical community lacks highly effective preventive and therapeutic pharmaceutical agents for dementia despite large investments into their development. There is growing interest in the question if infectious agents play a role in the development of dementia, with herpesviruses attracting particular attention. To provide causal as opposed to merely correlational evidence on this question, we take advantage of the fact that in Wales eligibility for the herpes zoster vaccine (Zostavax) for shingles prevention was determined based on an individualโs exact date of birth. Those born before September 2 1933 were ineligible and remained ineligible for life, while those born on or after September 2 1933 were eligible to receive the vaccine. By using country-wide data on all vaccinations received, primary and secondary care encounters, death certificates, and patientsโ date of birth in weeks, we first show that the percentage of adults who received the vaccine increased from 0.01% among patients who were merely one week too old to be eligible, to 47.2% among those who were just one week younger. Apart from this large difference in the probability of ever receiving the herpes zoster vaccine, there is no plausible reason why those born just one week prior to September 2 1933 should differ systematically from those born one week later. We demonstrate this empirically by showing that there were no systematic differences (e.g., in pre-existing conditions or uptake of other preventive interventions) between adults across the date-of-birth eligibility cutoff, and that there were no other interventions that used the exact same date-of-birth eligibility cutoff as was used for the herpes zoster vaccine program. This unique natural randomization, thus, allows for robust causal, rather than correlational, effect estimation. We first replicate the vaccineโs known effect from clinical trials of reducing the occurrence of shingles. We then show that receiving the herpes zoster vaccine reduced the probability of a new dementia diagnosis over a follow-up period of seven years by 3.5 percentage points (95% CI: 0.6 โ 7.1, p=0.019), corresponding to a 19.9% relative reduction in the occurrence of dementia. Besides preventing shingles and dementia, the herpes zoster vaccine had no effects on any other common causes of morbidity and mortality. In exploratory analyses, we find that the protective effects from the vaccine for dementia are far stronger among women than men. Randomized trials are needed to determine the optimal population groups and time interval for administration of the herpes zoster vaccine to prevent or delay dementia, as well as to quantify the magnitude of the causal effect when more precise measures of cognition are used. Our findings strongly suggest an important role of the varicella zoster virus in the etiology of dementia. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement National Institutes of Health/National Institute of Allergy and Infectious Diseases, DP2AI171011 (PG) Chan Zuckerberg Biohub investigator award (PG) At no time did the authors or their institutions receive payment or services from a third party for any aspect of the submitted work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Information Governance Review Panel of the SAIL Databank gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study are available from the SAIL Databank. Researchers must request access to the data directly from SAIL. The authors have no permission to share the data. All analysis code will be posted in a publicly accessibly repository upon acceptance of the manuscript for publication in a peer-reviewed journal. <https://saildatabank.com/data/apply-to-work-with-the-data/>
@ericmacknight @mhoye This lines up with this previous preprint from last year showing that HSV-1 (and SARS-Cov-2) can seed amyloid aggregation in CSF.
AIUI there have been studies that drew connections between the shingles vax and decreased incidence of dementia before, but they didn't control well for other variables. This new study attempts to control for those variables, and the effect is still there.
I think we're not going to know for a couple of decades yet, till the vaccine generation is old enough to start seeing cases of age-related dementia.
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