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Because of the high cost of dementia care, anything that significantly reduces risk has Macroeconomic impact.

There have been studies that showed shingles vaccine lowers dementia risk but this one is HUGE and the subjects were high-risk patients who were already in nursing homes.


MedPage Today
Study Looks at Risk for Dementia After Shingles Vaccine in High-Risk Group

Analysis assessed 500,000 skilled-nursing facility residents in the U.S.
Study Looks at Risk for Dementia After Shingles Vaccine in High-Risk Group
— Analysis assessed 500,000 skilled-nursing facility residents in the U.S.

by Judy George, Deputy Managing Editor, MedPage Today, June 15, 2026

Older adults at higher risk for dementia were less likely to have a dementia diagnosis if they received a herpes zoster (shingles) shot, a cohort study using target trial emulation showed.

Among 500,000 people in skilled-nursing facilities for post-acute or long-term care, those who received the recombinant zoster vaccine (Shingrix) had a 24% lower risk of being diagnosed with dementia over 4 years compared with those not vaccinated (risk ratio [RR] 0.76, 95% CI 0.69-0.84), reported Kaleen Hayes, PharmD, PhD, of the Brown University School of Public Health in Providence, Rhode Island, and co-authors.

Receiving at least one zoster shot was tied to a cumulative 4-year dementia risk that was 5.81 (95% CI 3.9-7.5) percentage points lower – 18.8% versus 24.6% with no vaccine… The cohort included 509,926 participants with a mean age of 79… [end quote]

I know 6 people who got shingles, including my husband and one who almost lost her eyesight. I got the original shingles vaccine (Zostavax) as soon as I was eligible and then the new Shingrix even though I had to pay over $400 out of pocket. Given this new information it’s an urgent priority for seniors, especially since it’s free to Medicare Part D patients.

The Macroeconomic impact is tremendous.

The recent anti-amyloid drugs which supposedly slow Alzheimer’s Disease (AD) are extremely expensive and pathetically ineffective. Anti-Amyloid Drugs (Lecanemab / Donanemab) slow decline in early AD to a difference of less than 1 point between the drug and a placebo over a year and a half. Many experts point out that this mathematical difference is so small it is often imperceptible to the patient or their family in daily life. Lifelong or long-term intravenous (IV) infusions every 2 to 4 weeks, significant risk; 12% to 24% of trial patients developed ARIA (brain swelling or micro-bleeding), ~$26,000 to $32,000 per year for the drug alone (not including imaging/infusion costs).

The government should put up billboards encouraging seniors to get their free shingles vaccines.

Wendy

Are we really sure the study was not tilted? Everyone is terrified of dementia. So there is an incentive to claim a "study" showed some benefit against what terrifies people. I have noticed, with a combination of amusement and disgust, how GLP-1s have been touted for a wide range of maladies. Recently a "study" claimed everyone should drink alcohol, because it's a "social lubricant", which has supposed benefit.

Steve

Steve wrote: "Are we really sure the study was not tilted?"

Go ahead.

Imagine the study was tilted.

Would you cut off your nose to spite your face and avoid the shingles vaccine because of your cynical conspiracy-theory neurosis?

Wendy

Would you cut off your nose to spite your face and avoid the shingles vaccine because of your cynical conspiracy-theory neurosis?

I really don't understand the rampant cynicism in our society, but it certainly plays into the various we v. them political scenarios.

As for the shingles vaccine (which was entirely free to me, as it was and is to many others), even if there is only strong, but not yet sufficient evidence for the dementia aspect, where is the harm in getting it, especially since it's a two for one: shingles elimination or relief and potentially dementia reduction.

Pete

I read about this study and effect a little while ago.

For some reason that isn't currently clear, the risk reduction is quite a bit stronger for females than for males. But still measurable for both, so sign me up.

Jim

I have noticed, with a combination of amusement and disgust, how GLP-1s have been touted for a wide range of maladies.

Agree - I think we're seeing two things at work:

1. People underestimate just how many health improvements can result from substantial weight loss, regardless of whether that weight loss comes from diet, exercise, bariatric surgery, or a GLP-1 medication.

2. There's a degree of confirmation bias. People who are taking GLP-1s are naturally more likely to notice, share, and eagerly embrace studies suggesting additional benefits, which can sometimes make the evidence appear stronger or more conclusive in the media than it actually is.

That's not to say GLP-1s don't have positive effects beyond weight loss. It's too early to draw definitive conclusions, and it may ultimately turn out that they do. However, I think many discussions fail to adequately separate the effects of the medication itself from the effects of the weight loss it produces.

As for the shingles vaccine (which was entirely free to me, as it was and is to many others), even if there is only strong, but not yet sufficient evidence for the dementia aspect, where is the harm in getting it, especially since it's a two for one: shingles elimination or relief and potentially dementia reduction.

I had an interesting debate recently with a relative.

I fully support vaccination and have little concern about long-term side effects from vaccines, but I tend to be far more cautious about newer medications intended for chronic, long-term use, including GLP-1s.

But my relative holds the opposite views and couldn't understand how I could be comfortable with one but not the other.

What finally made it click for them was when I explained that a key difference is the duration of exposure.

With vaccines, the components are present in the body for a very brief period of time. So any side effects from it should show up fairly quickly. The lasting effect comes from the immune system's response and memory, not from the vaccine continually acting on the body for years.

By contrast, someone taking a long-term medication exposes their body to that medication's effects continuously for months, years, or even decades.

Because of that difference, I prefer to see extensive long-term safety data for a medication intended for long term use, whereas I don't have those concerns over a vaccine that is administered once or only occasionally.

It's not that I assume newer long-term medications are unsafe, but the risk-benefit calculation is very different when the body is being exposed to a treatment over such a long period of time.

That's why I don't see the two positions as contradictory. To me, they reflect different levels of caution based on fundamentally different patterns of exposure.

Knighted wrote, "With vaccines, the components are present in the body for a very brief period of time. So any side effects from it should show up fairly quickly. The lasting effect comes from the immune system's response and memory, not from the vaccine continually acting on the body for years. "

While I am enthusiastically pro-vaccine (and in fact got both versions of the shingles vaccine) I have to point out that some people do have a lasting effect from the immune system's response and memory. This first became publicized after the population-wide swine flu vaccination program in 1976. The program was officially halted on December 16, 1976, after the vaccine was linked to an increased risk of Guillain-Barré syndrome, a rare neurological disorder. I remember this well because I and my entire family got this vaccine. We were hit hard by the 1968 Hong Kong flu.

The risk of developing Guillain-Barré syndrome (GBS) after receiving a flu vaccine is extremely rare, occurring in about 1 to 2 people per million vaccinated. This translates to a percentage of roughly 0.0001% to 0.0002%. The risk is highly concentrated within the first 6 weeks following immunization. The majority of individuals return to normal health or independent walking within a year.

I don't let this minuscule risk prevent me from getting a flu shot every year. But the risk is non-zero.

Wendy

I really don't understand the rampant cynicism in our society,...

My background and training is that of a research chemist, and as such, I learned to properly develop a program of research to accurately make assumptions and develop testing that would test those questions. Unfortunately, just like political surveys that can have a spin to obtain the answers they want to be able to present as "accurate," not all research studies are created equal. I do not take a research conclusion as acceptable until I have read the original design study. As technical liaison to marketing in the company I worked for, I had to constantly push back on their interpretation of my research projects, reigning in the statements they wanted to make with regard to the products I developed with a terse, "That is not what the study showed."

I am not vaccine phobic, and indeed have had both shingles vaccines given an experience with shingles that I desired NEVER to repeat. That said, the flu vaccine I avoid, particularly after the pushback on the reported "death rate" from the flu that was published during Covid. It resulted in ER doctors calling BS, as they should certainly have seen some flu deaths during their career had it been that high. The CDC finally admitted that the death rate had been extrapolated from the number of those getting the flu, not an actual count, but hey, if it resulted in more people getting vaccinated then all the better. They are actively confusing science with marketing, which should not be one and the same. Perhaps OK for the general public, but none actually are average and some of us have adverse reactions to the vaccines themselves, so scaring us without foundation into taking greater risks is unconscionable. I for one resent being treated like a child and want my science properly executed rather than a way to manipulate me into what THEY think is right for ME. Many meds have adverse effects on me, my mom and my son, and I have been told by my Dr not to get mRNA vaccines anymore, as they make me quite ill. (Other meds, like opioids, simply don't work for us at all, and we get our pain relief from Advil and Tylenol.) Ironically, DH gets the flu vaccine every year, and he seems to come down with it often, while unvaccinated me does not.

Studies on meds give doctors an overall picture of what will probably work well for a good portion of civilization, but it is up to you to figure out what works for you. Most meds are tested on younger white men. If you are not one of those, your chance of deviating from the "norm" are higher.

IP

That said, the flu vaccine I avoid, particularly after the pushback on the reported "death rate" from the flu that was published during Covid.

The refrigerated trucks being used as morgues in New York didn’t convince you?

I lost 7 people that I knew (in real life) including three “in-law” relatives who decided to vacation together over the Memorial Day weekend on the Cape in Massachusetts during that first spring (they all contracted it, were hospitalized, and died within 10 days), and four others who I knew either from high school or from various workplaces, all announced on Facebook by their spouses or others, all of whom described the agony of watching them die in an isolated room where their relatives could not go even to hold their hand for fear of contamination.

Seven. Once the vaccine became available two things happened: we ran for it and got it, and we suffered no more losses.

Anecdotal? Sure. Also real world and personal.

I have not had Covid yet, and I get the “new strain” vaccine every time it comes out. Mrs. Goofy skipped one, went to a jewelry making retreat at a well known arts school, contracted it, and stayed the week isolated in her cabin while the hosts brought meals to her door. Yeah she stays up to date now too.

While I am enthusiastically pro-vaccine (and in fact got both versions of the shingles vaccine) I have to point out that some people do have a lasting effect from the immune system's response and memory. This first became publicized after the population-wide swine flu vaccination program in 1976. The program was officially halted on December 16, 1976, after the vaccine was linked to an increased risk of Guillain-Barré syndrome, a rare neurological disorder. I remember this well because I and my entire family got this vaccine. We were hit hard by the 1968 Hong Kong flu.

Very true - and I wasn't implying vaccines can't have side effects. I was just pointing out that any harm caused by a vaccine must originate shortly after vaccination, because that's the only time the body is actually exposed to it.

There are many who falsely believe that a vaccine lingers in the body and can spontaneously produce harmful effects later in life, but there's no plausible biological mechanism for that.

That's why vaccine safety monitoring focuses heavily on the weeks and months after vaccination. When genuine vaccine-related adverse events occur, they are overwhelmingly detected within that timeframe.

As for Guillain-Barré syndrome, my father was actually one of the people to develop that, but in his case it was a result of an infection rather than the swine flu vaccine.

That's another important point people often overlook: the same immune response that can (rarely) be triggered by a vaccine can also be triggered by the disease itself, often at a much higher rate.

So even when a vaccine carries a real risk of side effects, it can still be a net positive if that risk is substantially lower than the risk posed by the disease it helps prevent.

Myocarditis is a prime example of this. While it can occur rarely after COVID vaccination, the risk of it occurring is far higher from the COVID infection itself.

The refrigerated trucks being used as morgues in New York didn’t convince you?

Were those for the flu or Covid? Perhaps because of confirmation bias, I related more to the medical professionals who said they too had not seen deaths from flu, followed by the ADMISSION from the CDC that their flu death numbers were extrapolated from flu cases rather than actual deaths. In my almost 63 years I have had one flu shot and one and only one case of the flu, personally. I have an excellent immune system and tend not to get sick. Have been vaccinated for Covid multiple times and have had Covid twice, followed by long covid after the second bought. MRNA Covid vaccines make me ill AND IT IS MY DOCTOR, who has told me to avoid mRNA vaccines after the five I have had throwing me into long Covid. Works for you? Awesome. WE ARE NOT ALL THE SAME. DUH.

I take your anecdotal evidence and raise it with mine, and that of DH who has never found a vaccine he refuses to take yet is always the one getting sick. We spend 23.5/24 hours together, so the difference is unlikely to be exposure to virus. We all have to be our own medical advocates. My personal evidence is pretty darned compelling for my personal decisions. You do you.

IT IS MY DOCTOR, who has told me to avoid mRNA vaccines

One thought: I don't know your doctor, but as a general rule, just because someone is a doctor does not rule out their being an absolute unscientific dolt.

An old CDC graph from back in the day
https://ichef.bbci.co.uk/news/1536/cpsprodpb/1492/...
From this page
https://www.bbc.com/news/59757395

So...yeah.
If you don't believe in effective vaccines, that's actually wonderful: everything has a silver lining. Higher global average IQ over time!

Jim

have an excellent immune system and tend not to get sick. Have been vaccinated for Covid multiple times and have had Covid twice, followed by long covid after the second bought. MRNA Covid vaccines make me ill AND IT IS MY DOCTOR,

Vaccines can make you feel unwell, I had one flu shot that caused me a sharp momentary pain in the stomach, then I felt unwell for a bit, but I still get flu shots. The idea you have about MRNA just ain't so, all vaccines can give you temporary reactions, MRNA isn't any different, so google, then decide. You can find loons in any profession, practicing medicine is 60-70% science and 30-40% art, so a loon can still be a good Doctor otherwise.

Had an internet friend who insisted he'd never been sick a day in his life and never vaxxed. Most people don't remember all childhood vaxxes, but he insisted. Then he got shingles, which means he had chickenpox as a kid. This is how our memories serve us - confirmation bias is real.

If you don't believe in effective vaccines...

I guess no one actually reads what one posts. I would not have had FIVE Covid shots, as detailed in my post, if I did not believe in vaccines. My doctor is always pushing my getting vaccines, and indeed I got the (non mRNA) pneumonia shot this year. She has also been the one dealing with my reactions to the mRNA vaccines and has told me not to take them anymore. I really don't need another bought of long Covid that it brings on for me, each bought worse than the one before as more of the vaccine enters my body. Just because a vaccine has been shown to be safe for the majority of the population, does not mean that it is safe for everyone. I have inverse reactions to many meds, as did my Mom and my son. Dad and my second son have no issues. WE ARE NOT ALL THE SAME, so you all need to get off your high horses and for your sakes be proactive in your medical experience.

IP,
who also has allergies to 3 classes of antibiotics, and has a body that won't respond to opioids, which means there is a bigger need to focus on avoiding illness/injury rather than reacting to it

If you don't believe in effective vaccines...
...
I guess no one actually reads what one posts.

To be clear I was responding to your doctor's comment, who seems plainly a fool. Not you.

Jim

To be clear I was responding to your doctor's comment, who seems plainly a fool.

Because she used actual data from my body that indicated I should not take an mRNA? She is still encouraging the non mRNA vaccines, and has sent me for a crap ton of tests that eliminate other possible variables beyond bad vaccine reaction. If that is a fool in your eyes and in those of your post recommenders, you all are clearly not capable of critical or scientific thinking. Is the data from 5 mRNA Covid vaccine shots not enough for your highbrow opinions? How many mRNA vaccines with increasingly poor reactions from each additional shot is enough for you to decide that one should not continue to stress ones body?

There is a trend here, and it indicates full stop of mRNA for this body. I am not telling you not to get a vaccine. Your reactions are all just another form of political correctness. How about independent thinking and responding to data, rather than just buying into the If This Then That approach of the pharmaceutical industry that says EVERYONE MUST DO THIS, even if you die in the process.

Most MDs seem to be technicians following protocol. She seems to be more of a scientist applying a theory, collecting data, and using that data to revise the theory as it applies to one patient, verses an average population of patients which is what is presented in the study conclusions for meds. I am clearly NOT average. I have MANY data points that show that, and it is not an opinion. I do not fit the norm.

Don't expect me to kill myself to "make you safer."

IP,
fully aware that there are idiots out there that reject all vaccines, and fully aware that some of us simply physically can't take all the vaccines du jour, and it's beyond time that you are aware of it too. Stop being smug and uninformed.

Because she used actual data from my body that indicated I should not take an mRNA?

Yup, without a doubt! Is there any question about it? Science, not narrative.

Your body is absolutely chock full of mRNA, just like everyone else's.

The three main sources might be
* Your own cells telling proteins what to do, which, you know, keeps you alive.
* Viruses you inhale every day and try to make a home, which have been carefully designed by evolution over aeons, usually to do bad things to you
* Maybe mRNA vaccines, which have been carefully designed to do good things for you.

To generalize that mRNA vaccines are "bad" for a particular person because they contain mRNA is something a fool would say, like that you should avoid calcium because you're "special" and felt bad after eating tofu, so your cells work differently from everyone else's and calcium is poison for you. It has no foundation in reality. You're full of mRNA anyway. Some might be beneficial and some might be deleterious, but the fact that it's mRNA, per se, doesn't say anything about that either way.

Take it or don't, but don't let your doctor invent (or spread!) a new nonsensical dogma based on the notion that mRNA, merely because it's mRNA, is bad for some people. 'Taint so.

If the advice were slightly different--you have unusually bad reactions to this vaccine and its variants, so it's risky to take it again--sounds like actual reasoning. But characterizing that as "keep away from mRNA" is no better than saying "keep away from vaccines in blue bottles".

Jim

I am far from being an anti--vaxer. I keep track of them on my International Yellow Fever card. Off the top of my head, besides the usual kid's shots, smallpox, polio (including a recent booster before a trip to India), Hepatitis A & B, Tetanus, tuberculosis, and probably a few I've forgotten, I've also taken both varieties of shingles shots.

I've had a rather large number of COVID shots - I guess I could figure it out - but I took an extra one in 2022, so I'm guessing it's now up to nine or ten - all Moderna mRNA. Based on an antibody test around 2021, I had had one nearly asymptomatic bout. My wife's shots mimic mine exactly. One of the mRNA shots gave me sort of a day of flu-type feeling. We both caught COVID (along with the rest of a wedding party - including the brie and groom) about a year ago with both of us somewhat uncomfortable for about a day.

That said, vaccines are not universally effective. My wife's second Shingrix shot gave her symptoms which seemed like a mild case of shingles for about a day (she is also allergic to penicillin). I haven't had the flu since about high school (more or less). I have taken an annual flu shot "forever" yet had a relatively mild bout of the flu about a month or two ago.

Considering the broad traveling we do, I figure I want to be protected against the maximum spectrum of diseases we might run into.

Jeff

I have had at least 8 mRNA Covid shots without a bad reaction.

That being said, vaccines (and other pharmaceuticals) contain many "inactive" ingredients in addition to the "active" ingredients. These may include solvents, stabilizers and preservatives. It's possible that your bad reaction was to one (or more) of the "inactive" ingredients. That's not uncommon in bad reactions to generic drugs which have different "inactive" ingredients from brand-name drugs even if the active ingredient is identical.

mRNA is sensitive to storage conditions. It's chemically unstable and can break down if it's not very cold. This was a factor in my choice of Moderna over the competing vaccine in 2020 since Moderna claimed better stability. I had already experienced the problems that could be caused in a product that had a temperature excursion during shipping.

I'm not discounting your bad reactions to mRNA vaccines. Obviously, each mRNA molecule is different. The vaccine is designed for the mRNA from the virus to be different from your own body's many mRNA molecules and to trigger an immune reaction. Your immune system may be violently rejecting the mRNA from the virus while most people have a more moderate immune reaction. Cytokine cascades (extreme immune system reactions) caused by Covid killed healthy, young people in 2020.

We are all individuals. Of course you should listen to your own body.

But it's possible that other mRNA vaccines might not cause as extreme a reaction. They may have different mRNA-containing active antigens. They may have different "inactive" ingredients.

I continue to get a Covid and flu shot every year. DH and I never got Covid due to scrupulous distancing and many vaccinations. We are both over 70 and have lung disease. If we got sick we would get very, very sick and possibly die.

Wendy

Because she used actual data from my body that indicated I should not take an mRNA? She is still encouraging the non mRNA vaccines, and has sent me for a crap ton of tests that eliminate other possible variables beyond bad vaccine reaction.

Well, you said mRNA made you ill, which is actually a mild reaction. Mild reactions happen all the time. If you had a severe allergic reaction, that's a different story, but the symptoms to that aren't feeling ill. If your Doctor is giving you a battery of tests - are they the sort that goes with a severe allergic reaction? If she suspects that, they normally tell you that's what the tests are for. If you had a severe allergic reaction, you'd have breathing problems (coughing, hacking, wheezing, etc.), rashes like hives, and a jump in pulse rate. Most of the time those reactions happen within 20 minutes, but I have helped people who had the reactions hours later. Did you have any of those symptoms?

while most people have a more moderate immune reaction.

Just for the record, I have never had a reaction to any vaccine shot. Ever. Not even a sore arm, nothing.

That makes it harder for me to empathize with people who have, I suppose, but Mrs. Goofy is the same, so it works for us.

To generalize that mRNA vaccines are "bad" for a particular person because they contain mRNA is something a fool would say...

I have not read all the dialog here on this topic, but I don't see anyone literally saying not to get an mRNA vaccine "because it contains mRNA." The advice could be not to get that particular kind of vaccine because of something else about it, e.g., its delivery system/carrier.

All I can offer in this regard is that my wife has a huge, immediate hives reaction to the Moderna jab, and it lasts for months. The pharmacist speculated that it was an allergic reaction to something in that vaccine (NOT the mRNA) and recommended that she get the Novavax one instead.

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