Could a shingles vaccine help protect against dementia? A recent study suggests that adults over 50 who receive the shingles vaccine may experience a significant reduction in dementia risk—an unexpected benefit beyond preventing shingles.
As evidence grows, this raises an important question: Could vaccination become a key part of dementia prevention strategies? Clinicians on Healthcasts are debating whether this evidence is enough for them to further urge patients to get the vaccine, and if potential risks may sway them from doing so.
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A recent study suggested a significant reduction in the development of dementia in adults older than 50 who are vaccinated with Shingrix. The mechanism is not clear, but it may be stimulation of other immune entities besides the varicella virus. It appears to even offer some reduction in vascular disease.
Key takeaways about preventing dementia with the shingles vaccine:
Family Practice
"1. Yes. This is good news for patients, especially those witha family history of dementia.
2. It is a possibility. Though it is thought to be dormant, we know it can give rise to shingles. Meaning it is not so dormant. Perhaps it may cause other conditions yet to be discovered.
3. I believe the benefit outweighs the risk of getting Guillain-Barré syndrome."
Internal Medicine
"1. Studies are certainly hopeful. Many patients are afraid of getting dementia as they age, but are doing little in terms of a healthy diet or exercising for prevention. Shingrix is easy and already recommended to prevent the "dreaded shingles," so this seems like a win for patients.
2. The studies suggested that any virus that affects the nervous system has the potential to affect the brain and leave long-lasting effects. We need to learn more.
3. We screen patients for adverse reactions to vaccines already, but for those people who can safely take a vaccine but choose not to, it may be the push they need. Start a conversation with 'Look, there's a vaccine that studies show prevents dementia for many people.'"
Internal Medicine
"1. Absolutely. But the main indication would be to prevent herpes. I think stressing the reduction of the infection is more important than the possible unproven reduction in dementia risk.
2. May have just reported that the Epstein-Barr virus is found in multiple patients with lupus in high titers.
3. The incidence of this syndrome is very low and can occur with any vaccine. We have all seen severe cases of shingles, and this disease is no fun."
Internal Medicine
"1. I think it's a great way to suggest that there may be additional benefits beyond simply reducing the risk of shingles, as a motivator. Looking at the data, it does seem like a big drop and risk, as an association.
2. I suspect that it might just give HSV dormancy in the dorsal root ganglia, the potential for nerve damage.
3. I'm not particularly concerned about that very small risk, a few cases per million, which may I may not be related."
Internal Medicine
"1. I do not think the evidence is strong enough currently to recommend the vaccine for dementia risk reduction.
2. This is possible. It will require further research and clinical trials.
3. I believe the risk of Guillain-Barré is small enough to continue an increased effort to vaccinate against shingles."
Clinicians on Healthcasts would love to hear your input. Share your opinion and read other practitioners' comments on the full post.