Shingles (officially herpes zoster) is a miserable viral disease that consists of painful blisters along sensory nerves that result from reactivation of that person’s primary chicken pox infection (initially caused by the same varicella-zoster virus or VZV) mostly from many years earlier.
We Have Effective Vaccines Against Shingles
The first vaccine against shingles, Zostavax, was introduced in 2006 and was moderately effective. A highly effective vaccine, Shingrix, was released in 2017. I began giving that to all our patients over age 50 as soon as it became available. I wrote about it that year in Shingrix: New! Improved! Shingles Vaccine Coming. I was always a strong supporter of these vaccines because, until the chicken pox vaccine (Varivax) came out in 1995, essentially everyone contracted chicken pox while growing up and hence was susceptible to a VZV reactivation infection with shingles in midlife or later.
Shingles Increases, Vaccines Reduce Dementia Risk
The vaccines work even better than we knew. A major study this month from Nature Medicine aptly titled Varicella-zoster virus reactivation and the risk of dementia, which looked at the medical records of 100 million people in the United States, demonstrated clearly that reactivation of VZV in the form of shingles outbreaks was associated with higher rates of dementia, that additional shingles outbreaks further increased the occurrence of dementia, and that receiving either of the two available shingles vaccines (Zostavax or Shingrix) reduced the occurrence of dementia.
The reduction in Alzheimer’s occurrence was substantial, on the order of 20%. The mechanism of benefit may be the reduction in inflammation in the central nervous system that is caused by VZV infection, though other mechanisms may be involved and 20% is not a definitive number.
Additional 2025 Studies Confirm VZV Vaccines Reduce Dementia
Two additional studies from April this year confirm the findings that Zostavax and Shingrix vaccines reduce dementia. Herpes Zoster Vaccination and Dementia Occurrence was published in JAMA based on data from Australia, and A natural experiment on the effect of herpes zoster vaccination on dementia | Nature. appeared in Nature with data from Wales.
Shingrix Is Effective, Safe and Durable
Is there any risk? The Shingrix vaccine has been administered many millions of times. It does produces frequent local reactions of sore arm and sometimes a day’s worth of FLS (Feel Like S___). There are no clearly linked deaths related to its administration nor any lingering aftermath.
Major benefits were already known. Shingrix is over 90% effective initially and produces antibodies and cellular immunity to VZV that are expected to be protective for at least a decade and likely more than 20 years. Now we also know it substantially reduces dementia that results from shingles.
If you are age 50 or over and have yet to get Shingrix, you have compelling reasons to get to the pharmacy this week and get yourself protected.
2 comments
Ben
Does Trump have shingles?
DrKanner
Good question. He likely doesn’t have it now, or at least on any visible area. Forehead blisters on one side are commonly seen, but on the chest or legs would likely be hidden by clothing. Though it is really painful when you have it and people often exhibit discomfort. But he certainly could have had it in the past few years without the public knowing. And the activation of the rash does appear to increase dementia.