Sorry - the older group has higher rates of dementia than the younger group when they reach the same age - so when they reach 75, they're more likely to have dementia.

This really isn't the case in the Shingles vaccine unless the UK study is flawed a way that isn't clear to me.

The study looked at the effect of being eligible for a vaccine and the results were clear. (see chart below the fold here: https://erictopol.substack.com/p/the-shingles-vaccine-and-re...)

There was a hard age cutoff in the UK study. Above a certain age, you weren't eligible. Below it, you were. 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 one of those studies where you don't even need to look at the p-value to see the difference.

I'm very open to being wrong about this!

If you were vaccinated on the normal schedule, what year would you generally be born to be vaccinated with the single dose?

Do you have a link to these studies? I ask because, as another commenter mentioned, I think it would be very difficult to tease out cause and effect and I think the "healthy vaccinee" hypothesis could easily explain why so often you see the association between any vaccine (just here we have shingles, influenza and pneumococcal) and Alzheimer's risk reduction.

To be clear, I would get those vaccines regardless for their stated effectiveness, it just feels like so many observational conclusions ("moderate red wine is good for you!") have been proven to be non-causitive correlations when examined more closely.

Edit: Actually, the youtube link posted above talks about tons of vaccines where observational studies show reduced Alzheimer's risk: https://youtu.be/qlTnnQytOJ0?t=340

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.

Yeah

And you can absolutely get Shingles before 50 (in some cases)

But surely you can do a booster shot?

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.

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 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.

> 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.

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?

> 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.

"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.

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.

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.

Your thymus shuts down in your 80s, and you will make no more new T cells.

I also understand that a third of the elderly will have shingles by their 80s if unvaccinated.

Just curious, do you have children? Do you socialize pretty freely during all seasons indoors?

This isn't common knowledge. This is something people (non-experts) are starting to infer, because we're seeing it with Long COVID - https://news.ycombinator.com/item?id=48877214 - but there's no reason to think this is something special about SARS-CoV-2 - it could just as well happen with all viral infections but we weren't looking.

It reminds me that we didn't look at vaccine efficacy at the individual level until SARS-CoV-2. People were getting upset that SARS-CoV-2 vaccines only have a moderate chance to stop you getting the virus, and usually lessen its impact if you do get it, and calling this an ineffective vaccine. But the truth is, we have no idea whether every previous vaccine was also like that, because we only ever looked at the population level: when lots of people get the vaccine, the virus dies out.

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...

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.

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.

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.

They asked about dimentia

RIF

This may be the case, I haven't researched it deeply enough because it was already a day late and a dollar short.

I just asked The Goog and it said the answer is effectively "possibly, but nuanced". So you may be right but not completely ;-).

I'd still suggest doing it as its likely to have a positive risk/reward ratio. But better still is to get the vaccine.

I had it at 14

>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?

> hearing improvement

This means addressing hearing loss, e.g. via hearing aids.

As someone who got shingles at about 46, yes.

This would be a good conspiracy theory if dementia was a short illness.