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).
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.
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.)
Don't let the facts to discourage you from yawning.
> [1] Of the reported 22,289 bathing waters across Europe (EU-27, Albania and Switzerland) in 2025, 84% were rated excellent quality. This share reached 85% at the EU level.
I wanted to pay the full price, but pharmacies (Boots, Lloyds, couple of small ones) refused citing NICE guidance, GP and private GP refused to "prescribe" it.
I'm glad you got lucky. I got it identified and treated with antivirals early (first 12 hours), a friend of mine turned out to be a research dermatologist who took over treatment in the first 36 hours, and still I ended up with long term effects. (Apparently if I'd gone another 12 hours without significant response, he would have put me on intravenous antivirals.)
Weird, I went to a travel vaccination clinic in London and got it no questions asked (the nurse was even familiar with the dementia research).
Try calling privatemedicalclinic.com ?
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.
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.
I've had two shingles shots: Zostavax and Shingrix. There's no reason you couldn't take either shot again. You might have to pay but no big deal.
I know people who've had shingles and it is not only a major PITA but can be life-threatening, can blind you, etc., just bad stuff. Don't delay taking advised precautions, including injections.
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.
You absolutely can get it twice. It's currently not officially recommended, but that's probably just because Shingrix is relatively new, so booster shots aren't that relevant yet.
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).
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.
> 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.
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. 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 than in 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.
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.
Some countries are even more open. You can walk up to pharmacies in some countries and ask for most medications without a prescription. Up until 10-20 years ago you could walk into pharmacies in some countries and get abusable drugs, too, but that became enough of a problem that they cracked down on it.
The unique thing about the US is that we have access to almost everything first, and you can find a doctor willing to prescribe it to you if you look hard enough. In many other countries doctors don't want to stray far from the government prescribing guidelines. You may also not be allowed certain treatments unless your doctor can prove you meet the government requirements.
In the US, the enforcement is on the backend, if at all. There have been many cases of doctors getting the bright idea of turning their prescription pad into a money printer and writing prescriptions for scheduled medications to anyone willing to pay cash. Some of them make millions before the DEA catches up and goes after them. The smarter ones have moved into spaces where the enforcement brings less attention. Prescribing opioids is out, but I can't even turn on the radio without getting ads for doctors who will write me a prescription for testosterone to "get an edge in the gym".
I doubt you need a prescription for most vaccines. Typically there's some sort of guidelines that might say normally given to over 55 years old, but there will be some wiggle room due to other hard to prove preconditions such as family history of xxx or sensitivity to yyy. You say you have one of those things and Costco or the public health dept. will give you the vaccine no questions asked. For example when the COVID-19 vaccine was rolled out it was supposed to be for older people, but also people with various other (not easy to test for) preconditions such as asthma. So everyone who wasn't an anti-vaxxer developed asthma.
Medications are different. Need prescription for that, although $$ and a zoom call can solve that problem.
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.
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.
Most age recommendations do not prevent you from access, but determine whether the insurance will pay. I got both the shingles and HPV vaccines despite being outside the age bracket.
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.
I believe that there are studies that show that merely getting very sick increases your chance of dementia - essentially it ages you faster or brings chronic disease forward. If that's the case, vaccines for things like the flu - a disease you're likely to get - are probably good overall.
They also activate the immune system in generaly, which could probably go either way in terms of longevity.
In general I don't think vaccines are preventing so much as delaying dementia, but if they stop chronic infection they might be.
While we're 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.
In the U.S., the second dose was added in 1989 so around then. You might've also gotten a booster in the U.S. if you were born earlier but lived in a college dormitory.
If you're not sure, get tested. It's a simple blood draw.
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?
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.
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.
The video explains why the analysis is wrong and gives a very clear graph of how when you look at the proper data, there’s no benefit from the shingles vaccine for dementia. The signal is clear as day.
FWIW Eric Topol is an extremely unreliable source. He has “fame” but most of his stories end up being wrong because of his poor analysis like the review above. I subscribed to him during the pandemic when he migrated to substack but ended my subscription after countless bad articles.
Most people, especially those under the vaccination age of 50, with a weak immune system don't supplement a correct dose of basic immune boosting supplements like vitamin D3 (4-6 KIU), zinc (15-25 mg), selenium (200 mcg), and beta glucan, which typically is why they have a weak immune system in the first place. Safely boosting your immune system's baseline will protect you not just against opportunistic shingles but various other things too.
If you have any developing countries nearby (holiday, etc.), you can usually get it cheaper at a clinic. I get my vaccines (when on holiday) in Thailand here: https://www.thaitravelclinic.com/vaccine-price-list/
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.
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 vastly 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.
You’re taking a mouse study, and a study that says that people hospitalized with influenza are more likely to get dementia, and stating confidently that daycare workers are more likely to get dementia.
That’s not “extrapolating some.” That’s just making stuff up.
The study you cited is from Taiwan and merely states that
“Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did.”
“physicians who are older are more likely to have dementia”.
But beyond that, pediatricians or doctors who work in hospitals or clinics covers most doctors who aren’t work from home radiologists.
Wrong. Physicians (which includes pediatricians), who are in general less likely to get dementia, experience its signs at an older age in general due to protective effects of their high education. Among physicians, pediatricians seemed to have higher rates.
The discussion is very low-yield though, since infections are already a minor point re: dementia, and none of the evidence is conclusive.
It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...
I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen.
But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.
In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).
The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians, and the study is meaningless.
Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.
Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.
In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.
Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.
Isn't cholesterol released into the bloodstream to protect arteries when it gets acidic, and over time turning into plaque buildup? Also, going the other way doesn't help either because if you got a spike in acid your arteries wouldn't cope with the overload
I'm not sure what you're referring to re: Alzheimer's plaque. They're not the same type of "plaque". Alzheimer's is basically little pieces of protein that clumped together and the body couldn't get rid of it. There's many theories for why: some think it's linked to bacteria from our mouths getting into the brain, some think it's because the glymphatic system got clogged (healthy flow of CSF fluid, like clogging of certain holes where it's supposed to flow more freely, etc, etc). Not the same substance as arterial plaque.
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.
From a legal perspective, if the injection does not provide 100% immunity (when used as directed), then it cannot be called a vaccine, instead it is a therapeutic treatment.
Because courts of law have recognized covid mRNA injections as therapeutic treatments, they cannot be mandated.
'The plaintiffs alleged that the vaccines do not prevent someone from becoming infected with COVID-19 and characterized it as a treatment rather than a “traditional vaccine.”'
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.
Very shortsighted article in that regard, but that's the new normal.
If people are concerned about brain health, they'd be wise to continue a zero-covid lifestyle into 2026 and beyond, since each re-infection (which vaccines don't prevent) increases the risk of severe health outcomes, including brain-related issues among lots of others. Adding to the confusion, 40% of COVID infections are asymptomatic but carry the same longterm risks.
Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
Fortunately at least a tiny minority are waking up to this fact, as can be seen by constant growth in communities like /r/zerocovidcommunity and Google Trends data for 'zero covid'.
most people can't really get a worthwhile quality of life like that. maybe life is worthwhile to you walking around in an N95 respirator, but not to me, at least not... indefinitely. I'd rather be dead TBH. IMO it makes sense to wait to die to be dead. Why be dead while you're still technically alive? What are you trying to optimize for? Days you woke up?
And for transparency, I am triple vaccinated (maybe more, I lost count), have had 0 covid infections as far as I know, masked for a long time while it seemed to make sense. But, man, being permanently dead-alive is just not for me.
Your comment is completely unfair. You are entirely dismissive of those who are not ignorant of long Covid and of those who have experienced the hell that Covid could be.
And you'd rather be dead? Careful what you wish for.
I wear a P95, not for Covid, but because I simply don't like getting sick even with a cold. Also, it blocks pollution which is independently important for the brain.
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.
Most people with a weak immune system don't supplement a correct dose of basic immune boosting supplements like vitamin D3 (4-6 KIU), zinc (15-25 mg), selenium (200 mcg), and beta glucan, which typically is why they have a weak immune system in the first place.
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.
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.
> 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 ant-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.
Yeah I got this last week and I felt like I got hit by a bus 12 hours later. The pharmacist claimed the second dose is worse. But getting the disease is no picnic at all. I had it in my 20s and it was like someone kept stabbing me in the eye, all day long for a week.
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.
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 a diagnosis of dementia from a hospital.
There's countless treatments and countless diseases. It is very much worth combing data to find treatments with potential off-label uses, but with that many combinations of treatments and diseases, much more care needs to go into eliminating not just non-causative correlations, but straight-up random correlations that have a very small probability of happening on their own, but are likely to happen in a large enough group of comparisons.
> 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 mean, you conformed to the norms and customs of horsepaste quackery, and in that sense you "did it right". However, the science here is a little off-point. Ivermectin had observable benefits in some localities during the pandemic. In all likelihood, everyone who walks into a hospital for any reason in those countries should be given Ivermectin, because they all have undiagnosed parasites.
Dementia might have dozens of risk factors, each adding up a little. Physical and emotional stress, insomnia, head microinjuries, arteriovascular risk factors, infections and there lies herpes zoster. Only the latter has a causal treatment and is only single stone on the wall of disease.
I got shingles in my early 50s and did not know there were antivirals that could help mitigate its effects. I now have postherpetic neuralgia and the pain is not quite enough to off myself but the fact that I have to live with this for the rest of my life weighs me down.
It turns out that "pain management" is more art than science and almost all the pharma options out there come with significant risks and concerns. I ended up turning to kratom to manage the pain, which it does, but it's come at significant cost as well (addiction being one of them). I'm now going to try peptides (ARA-290 and BPC-157) to see if maybe that can help but it's all a crap shoot.
I share this as a warning/advice: get the vaccine if you can, even if insurance resists, push back. It may be worth it out of pocket IMHO. If you can't, remember to get access to antivirals immediately if you can.
169 comments
[ 3.9 ms ] story [ 81.0 ms ] threadThe earlier you start the better.
This means addressing hearing loss, e.g. via hearing aids.
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.
(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.)
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)
Big Yawn
> [1] Of the reported 22,289 bathing waters across Europe (EU-27, Albania and Switzerland) in 2025, 84% were rated excellent quality. This share reached 85% at the EU level.
[1] https://www.eea.europa.eu/en/analysis/publications/european-...
> [2] In 2025, 297 bathing waters in England (66.1 per cent) met the Excellent standard
Note the sharply increasing amount of "Poor" waters.
And that's despite the methodology allowing to presence of untreated sewage and human faeces in the "excellent" waters: https://www.theferret.scot/scottish-beaches-excellent-pollut...
[2] https://www.gov.uk/government/statistics/bathing-water-quali...
With treatment waiting times, dental treatment availability and deaths while waiting for the ambulance I don't think I need to get into gory details.
Of course I got shingles when I was 64. Caught early and got anti-virals and had no lasting effects.
I'm glad you didn't have any lasting effects.
But if I couldn't I could still go to Mexico and buy brand name Shingrix.
https://www.shingrix.com/side-effects/
I know people who've had shingles and it is not only a major PITA but can be life-threatening, can blind you, etc., just bad stuff. Don't delay taking advised precautions, including injections.
And you can absolutely get Shingles before 50 (in some cases)
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).
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.
https://www.gov.uk/government/news/free-chickenpox-vaccinati...
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. 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 than in 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.
I had shingles in my 30s. It was the sickest I've ever been.
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.
Is that not usually true in other countries?
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.
Some countries are even more open. You can walk up to pharmacies in some countries and ask for most medications without a prescription. Up until 10-20 years ago you could walk into pharmacies in some countries and get abusable drugs, too, but that became enough of a problem that they cracked down on it.
The unique thing about the US is that we have access to almost everything first, and you can find a doctor willing to prescribe it to you if you look hard enough. In many other countries doctors don't want to stray far from the government prescribing guidelines. You may also not be allowed certain treatments unless your doctor can prove you meet the government requirements.
In the US, the enforcement is on the backend, if at all. There have been many cases of doctors getting the bright idea of turning their prescription pad into a money printer and writing prescriptions for scheduled medications to anyone willing to pay cash. Some of them make millions before the DEA catches up and goes after them. The smarter ones have moved into spaces where the enforcement brings less attention. Prescribing opioids is out, but I can't even turn on the radio without getting ads for doctors who will write me a prescription for testosterone to "get an edge in the gym".
Medications are different. Need prescription for that, although $$ and a zoom call can solve that problem.
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.
I tell me patients this to increase uptake, so we can reduce alzheimer's prevalence.
(I'm a doctor)
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.
They also activate the immune system in generaly, which could probably go either way in terms of longevity.
In general I don't think vaccines are preventing so much as delaying dementia, but if they stop chronic infection they might be.
edit: Sorry this is the follow up study but the 40% study is linked within
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-...
If you're not sure, get tested. It's a simple blood draw.
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.
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.
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.
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!
FWIW Eric Topol is an extremely unreliable source. He has “fame” but most of his stories end up being wrong because of his poor analysis like the review above. I subscribed to him during the pandemic when he migrated to substack but ended my subscription after countless bad articles.
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.
Whoa wait what? This is the first time I’ve heard of this - is this actually common knowledge?
When I learned it, it was in the context of the influenza and similar common viruses.
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.
That’s not “extrapolating some.” That’s just making stuff up.
The study you cited is from Taiwan and merely states that “Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did.”
“physicians who are older are more likely to have dementia”.
But beyond that, pediatricians or doctors who work in hospitals or clinics covers most doctors who aren’t work from home radiologists.
The discussion is very low-yield though, since infections are already a minor point re: dementia, and none of the evidence is conclusive.
>Among physicians, pediatricians seemed to have higher rates.
Not just pediatricians, but physicians that work at hospitals and clinics.
Which is nearly all of them.
But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.
In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).
The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians, and the study is meaningless.
Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.
Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.
In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.
But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia.
Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.
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.
Because courts of law have recognized covid mRNA injections as therapeutic treatments, they cannot be mandated.
'The plaintiffs alleged that the vaccines do not prevent someone from becoming infected with COVID-19 and characterized it as a treatment rather than a “traditional vaccine.”'
https://calmatters.org/education/2024/06/covid-vaccine-manda...
The reason the case was dismissed was because the requirement was removed.
The case was reopened on appeal due to the rules being temporarily re-established.
Anything else is nonsense. This is spelled out in the article but wrapped with a bunch of whatifs and maybes and possiblies.
If your hypothesis was correct, then NOTHING is a vaccine.
And similar questions about obesity "causing" many diseases, sunburns causing skin cancer (although that sounds somewhat plausible) etc.
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.
I also understand that a third of the elderly will have shingles by their 80s if unvaccinated.
Very shortsighted article in that regard, but that's the new normal.
If people are concerned about brain health, they'd be wise to continue a zero-covid lifestyle into 2026 and beyond, since each re-infection (which vaccines don't prevent) increases the risk of severe health outcomes, including brain-related issues among lots of others. Adding to the confusion, 40% of COVID infections are asymptomatic but carry the same longterm risks.
Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
Fortunately at least a tiny minority are waking up to this fact, as can be seen by constant growth in communities like /r/zerocovidcommunity and Google Trends data for 'zero covid'.
And for transparency, I am triple vaccinated (maybe more, I lost count), have had 0 covid infections as far as I know, masked for a long time while it seemed to make sense. But, man, being permanently dead-alive is just not for me.
And you'd rather be dead? Careful what you wish for.
Vaccines won't save you.
Almost half of infections have no symptoms but still carry longterm risks.
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 lesson is to be extremely suspicious of findings of causation based on observational studies.
Why couldn't both these factors contribute to the result of the study?
I want folks to get it but - I feel "Just Get It" admonitions foster a vibe that the cost is negligible.
Unfortunately the apparent ant-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.
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.
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 a diagnosis of dementia from a hospital.
There's countless treatments and countless diseases. It is very much worth combing data to find treatments with potential off-label uses, but with that many combinations of treatments and diseases, much more care needs to go into eliminating not just non-causative correlations, but straight-up random correlations that have a very small probability of happening on their own, but are likely to happen in a large enough group of comparisons.
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/
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
Did I do it right?
https://c19early.org/i
It turns out that "pain management" is more art than science and almost all the pharma options out there come with significant risks and concerns. I ended up turning to kratom to manage the pain, which it does, but it's come at significant cost as well (addiction being one of them). I'm now going to try peptides (ARA-290 and BPC-157) to see if maybe that can help but it's all a crap shoot.
I share this as a warning/advice: get the vaccine if you can, even if insurance resists, push back. It may be worth it out of pocket IMHO. If you can't, remember to get access to antivirals immediately if you can.